Pharm ch. 14 Flashcards
provides energy, promotes growth, and development
Nutrition
without it, the metabolic processes of the body begin to either delay or stop
Nutritional support
malnutrition and anorexia, could cause decreased organ function, decreased immunity
Inadequate nutrition
could be affected by stress, illness, finances, and employment issues
supplemental intakes: puddings, bars, and supplemental nutritional drinks
Oral feeding
straight to the GI tract, can be short or long term, given by NG tube or PEG tube
Enteral feeding
for those who are ill and who receive feedings into the small intestine
over 24 hrs
continuous feeding
every 3 - 6 hrs over 30 - 60 min
given by gravity drip or infusion pump
intermittent feeding
very first method that was used for enteral feedings
250 - 400 mL administered via syringe into the tube (a lot at a time)
4 - 6 times a day
Make sure to flush tube before and after feedings, same with medications
Bolus feeding
- aspiration pneumonitis
- dehydration
- diarrhea
- constipation
Complications of enteral feedings
- HOB should be 30 - 45 degrees during feeding, keep bed elevated for at least 30 - 60 minutes after feeding; risk for aspiration is reduced by elevating HOB
- make sure patient has audible bowel sounds by performing GI assessment w/ auscultation to see if their GI tract is functioning
- ALWAYS monitor for gastric residual volume before initiating tube feedings; 4 - 6 hrs if continuous
- confirm the positioning of new insertion of the tubing
- confirm placement using x-ray
- before each feeding, check for movements of the tubing and listen for gurgling sounds after inserting air into tubing
Safety of enteral feedings
Given through IV
Parenteral feeding
- hyperglycemia
- hypoglycemia
- air embolism
- infection
- hypervolemia
complications of parenteral feeding
Are used synonymously
- parenteral feeding (nutrition)
- total parenteral nutrition
- hyperalimentation
one of the most serious life-threatening complications of tube feedings
it happens when contents of the tube feeding go into the lungs of the patient from the GI tract
aspiration pneumonitis
diarrhea leads to this complication
can be caused by high-protein
formulas
hyperosmolar solutions draws water out of the cells that leads to serum osmolality
fluid intake must be monitored
for fluid balance, 30 to 35 mL should be maintained unless contraindicated
dehydration
complication that is caused by:
rapid administrations of feeding
contamination of formula
low-fiber formulas
tube movement
specific drugs: check them all!!!
it can be managed by reducing the rate of infusion, dilating solution w/ water, changing solution, discontinuing drug, increasing daily water intake, administering enteral solutions that contains fiber
diarrhea
another common complication of EN
corrected by changing formula, increasing water, or requesting a laxative
constipation
prevents air embolism during dressing, cap, and tubing changes
have the patient turn his or her head in the opposite direction of the insertion site and take a deep breath, hold it, and bear down
ALWAYS keep the clamp on the central line tubing closed unless it’s being used
Valsalva maneuver
occurs when the infusion rate is too high
Hyperglycemia
fluid abruptions
too much glucose
Hypoglycemia
when air goes into central line catheter system
air embolism
another enteral feeding method
infused over 8 - 16 hrs
cyclic method
contamination and lack of treatment of aseptic technique, catheter, and solution
infection
excessive fluid volume
increased iv rate, renal dysfunction, heart and hepatic failure
hypervolemia
