lewis ch 39 - nutritional problems Flashcards
indications for enteral nutrition (8)
- anorexia
- orofacial fractures
- head/neck cancer
- neurologic or psychiatric conditions
- extensive burns
- critical illness
- chemotherapy
- radiation therapy
nursing considerations and assessments to monitor with enteral nutrition (6)
- daily weights
- assess for bowel sounds before feedings
- accurate I&O
- initial glucose checks
- label with date nad time started (change pump tubing q24h)
- elevate HOB 30-45 degrees
what can be delegated to the UAP with enteral nutrition (4)
- weigh patient
- offer ordered nutritional supplements
- provide oral care
- HOB 30-45 degrees
what can be delegated to the LPN/LVN with enteral nutrition (4)
- insert NGT in stable patient
- irrigate NGT
- remove NGT
- give meds through NGT to stable patient
how often should you check gastric residuals for patient with feeding tube
q4h for first 48 hours
when should you hold a feeding for patient with enteral nutrition
if residual is >500 mL
3 possible complications of enteral nutrition
- clogged tube
- improper tube positioning
- aspiration
how to prevent clogged tubes with enteral nutrition (3)
- crush pills into powder
- use liquid meds instead of pills
- flush per protocol/order
how to prevent improper tube positioning with enteral nutrition (2)
- confirm placement via initial xray
- mark exit length on tube after xray
how to prevent aspiration with enteral nutrition (3)
- assess for crackles in lungs or shortness of breath
- elevate HOB 30-45 degrees
- check gastric residuals
common indications for parenteral nutrition (8)
- chronic severe vomiting and diarrhea
- complicated surgery or trauma
- GI obstruction
- GI tract anomalies and fistulae
- intractable diarrhea
- severe anorexia
- severe malabsorption
- short bowel syndrome
how many minimum calories does the normal adult require per day
1200-1500
how often should you check blood glucose levels with parenteral nutrition
q4-6h
how often should you check vital signs for patient with parenteral nutrition
q4-8h
what range should the patients glucose stay within while receiving parenteral nutrition
110-150
