Feedings Flashcards
What are enteral feedings?
Enteral feedings (still using the gut)
Administering enteral feedings via an NG-tube, the nurse should
keep the HOB elevated at 45degrees for an hour after feeding to reduce the risk of aspiration.
laboratory values to monitor for patients requiring continuous enteral feeding
Electrolyte levels, glucose levels
What should you do when providing enteral feeding and residuals exceed 250 mL for two consecutive assessments?
Withhold the feeding.
Notify the provider.
Maintain semi-Fowler’s position.
Recheck residual in 1 hr.
What should you do when providing enteral feeding and your pt has N/V?
Withhold the feeding. Turn the client to the side.
Notify the provider.
Check the tube’s patency.
Aspirate for residual.
Auscultate for bowel sounds.
Obtain a chest x-ray.
Do Enteral clients eat food?
functioning GI tract but unable to swallow or take in calories/protein orally
Examples of enteral feeding
Nasogastric tube (NG tube)
▪ Gastrostomy tube (G-Tube)
▪ Jejunostomy Tube (J-Tube)
Total parentral feedings are tested for what?
Prealbumin levels-normal levels should be at: 15-36
What is given in TPN?
amino acids, dextrose, electrolytes, vitamins, sterile water, fats
Desired outcomes of TPN
Improved nutrition
weight maintenance
nitrogen balance
How do you assess improved TPN status?
Daily weight 1kg per day
increases of pre albumin 15-36
increased urea nitrogen levels 10-20
How do you prep client for PN?
client’s weight
BMI
nutritional status
diagnostics
labs
include: CBC, blood chem profile PT/aPTT
needs glucose platelet ct.
education
electronic infusion
micron filter
What do you ask the client what he’s allergic to?
soybeans, safflower, eggs (if lipids are prescribed)
What do you (nurse) monitor when administering?
blood glucose
flow rate
cracking of TPN solution (calcium phosphate content is too high)
Verify w-2nd nurse
How long do you wait between taking PN out of refrigerator?
1 hr
Technique
Strict aseptic technique-reduces infection risk sterile technique when changing central line and tubing
Change the bag of IV tubing for dextrose solution how often?
every 24 hrs.
How often do you change intermittent IV lipid infusions?
Should not hang for more than 12 hrs microbial growth prevention
Lipid infusions need to be stopped how many hr prior to getting a blood specimen?
12 hrs. for accurate triglycerides
How should you discontinue?
SLOWLY!!
why should you give enteral substance during long term PN administration?
Diluted juice example to prevent atrophy of GI tract
TPN vs. PPN
TPN: intense nutritional support for extended time
PPN: unable to consume enough calories to meet metabolic need or when nutritional support is needed for a short time
TPN patient examples
Cancer, bowel disorders, critically ill, trauma, excessive burns, need for high caloric requirements
