Enteral & Parenteral Nutrition Exam 3 Flashcards
What is enteral nutrition?
Nutrition that is going directly to the GI tract, and the digestive system still processes the food
How often should the patency of the tubing and placement be assessed?
every 4 hours
How should you assess a patient receiving nutrition?
shape and feel of the abdomen
bowel sound presence
tenderness w/ palpation
stability of the tube
daily weights and accurate I&Os
glucose checks for 1st 24 hours
What level should the HOB be at while feeding?
30-45 degrees
What should you do before and after every feeding?
flush w/ water 30mls if not cont
if cont. flush every 4-6 hours and check residual
What should you do if the residual is >500ml?
do not return and call provider
What should you do if the residual is <500ml?
return to the stomach
What should you obtain before the initial feeding?
Abdominal x-ray
What are some potential complications of enteral feeding?
Overfeeding
Diarrhea
Aspiration pneumonia
What are the nursing actions for overfeeding?
check residuals every 4-6 hours
feedings may need to be slowed or withheld
ensure the pump is working correctly
What are the signs of overfeeding?
N/V
Abdominal distention
fluid overload
hyperglycemia
What is the main cause of aspiration pneumonia?
tube displacement
can be life-threatening
What are the nursing actions for aspiration pneumonia?
STOP feeding
suction airway (lying on side)
O2
watch for fever
chest x-ray
auscultate breath sounds
How do you know if the tube is in the stomach?
pH < 4
How do you know if the tube is in the jejunum?
pH > 6
What is parenteral nutrition?
Nutrition is delivered directly to the bloodstream
What is parenteral composed of?
amino acids (protein)
dextrose
electrolytes
minerals
vitamins
fat emulsions can be added although given separately
How does parenteral nutrition HAVE to be administered?
via infusion pump through a central line with a filter
What should you never do while administering TPN?
Abruptly stop the infusion or change the rate
if it is emergent or another bag of TPN is not ready, then replace it with IV dextrose
When should you discard TPN and why?
after 24 hours to prevent microbial growth because of the high glucose content
What assessments should be performed by the nurse when administering TPN?
VS every 4 hours
monitor blood & urine glucose every 6 hours
What are the metabolic complications of TPN?
hyperglycemia
Hypoglycemia
Vitamin deficiencies
What are the nursing actions for metabolic complications of TPN?
draw labs daily
replace fluids
glucose checks
What are the nursing actions for an air embolism from TPN?
prime tubing
clamp cath & lay on left side in Trendelenburg to trap air
admin O2
