Gastrointestinal Objectives

Question 1

why is bowel care so important for the critically ill pt?

Answer 1

-can cause pain, abdomen distension and confusion

Question 2

what is the normal range for blood glucose?

Answer 2

-6 - 10mmol in ICU

Question 3

what is Actrapid, indications and dosage?

Answer 3

• Actrapid decreases BSL by binding to insulin receptors to increase glucose uptake and decrease glucose output
• used as a quick acting insulin to decrease BSL
• 2-10 units/hr titrated to BSL

Question 4

you are caring for an intubated pt on an insulin infusion. You check their BSL and it is 2mmol/L. What are your actions?

Answer 4

stop insulin infusion

• inform Dr
• administer glucose or dextrose

Question 5

when would you consider commencing oral intake on an extubated patient?

Answer 5

4 hours after extubation

-sip test first

Question 6

How would you assess a pt swallow reflex?

Answer 6

• watch pt manage oral secretions
• ask pt if they have any trouble with swallowing
• speech pathologist referal if noticing pt coughing from drinking, eating or taking medications

Question 7

why is early enteral feeding so important?

Answer 7

• to prevent malnutrition
• reduce muscle mass and fat metabolism wastage
• assist with healing

Question 8

What type of patients may require TPN?

Answer 8

-pts that are unable to meet their own nutritional requirements due to unsafe or inadequate oral dietary intake.

Question 9

what co-infusions can TPN run with?

Answer 9

• sterile water

- insulin infusions

Question 10

Can TPN be stopped abruptly?

Answer 10

Yes - up to 6 hours

• if pt has perforated bowel
• notify dietician

Question 11

what is the protocol for weaning TPN?

Answer 11

• review by dietician and speech pathologist

- has a set amount pt can take - volume, texture and feeding posture