1. MNA M osby ’ s Long Term Care Assistant Chapter 25 Nutritional Support and IV Therapy

2. Nutritional Support Many people cannot eat or drink because of illness or injury. Special orders needed

3. Aspiration Breathing fluid, food, vomitus or an object into the lungs

4. Enteral Nutrition Causes of inability to ingest, chew or swallow food: Cancer Trauma Coma Dysphagia Dementia

5. Types of Feeding Tubes Nasogastric Tube (NG) Inserted through the nose and into the stomach

6. Types of Feeding Tubes Nasointestinal Tube Inserted through the nose and into the small intestines

7. Types of Feeding Tubes Gastrostomy Tube Inserted into the stomach surgically

9. Types of Feeding Tubes Jejunostomy Tube Inserted surgically into the jejunum of the small intestines

10. Types of Feeding Tubes Percutaneous endoscopic gastrostomy Tube (PEG) Doctor inserts the feeding tube with an endoscope. Endoscope allows visualization. Incision is made into the stomach for correct tube placement.

11. Types of Feeding Tubes (PEG)

12. Formulas for Feeding Doctor orders type of formula Nurse administers feeding. Most contain protein, carbohydrates, fats, vitamins and minerals

13. Feeding Times Intermittent Continuous Given at certain times Given over 24 hours

14. Observations for Feeding Tubes Patient is at risk for Diarrhea Aspiration Constipation

15. Feeding Tubes Report: Nausea/Vomiting Distended abdomen Redness, drainage at insertion site Diarrhea Difficulty breathing

16. Feeding Tubes Regurgitation Backward flow of stomach contents into the mouth

17. Feeding Tubes Position in Semi- fowlers Avoid left- lying position Preventing Aspiration

18. Feeding Tubes Comfort Measures Usually not allowed to eat or drink Oral care Q2

19. Parenteral Nutrition Giving nutrients through a catheter inserted into a vein

20. Parenteral Nutrition Often called TPN Nutrients do not enter the GI tract Go directly into the vein

21. Parenteral Nutrition Contains: water protein carbs vitamins minerals

22. Parenteral Nutrition Reasons for TPN: Disease, injury, surgery to GI tract Severe trauma, infection or burns NPO for more than 5-7 days Coma Cancer

23. Parenteral Nutrition Report: Fever, chills Chest pain SOB Cough N/V Diarrhea

24. IV Therapy Intravenous Therapy Giving fluids through a catheter inserted into a vein

25. IV Therapy Provides fluids Replace vitamin and mineral loss Give drugs or blood

26. IV Sites Peripheral Central venous Away from the center of the body. Ex: arm, leg, scalp Close to the heart Ex: subclavian, jugular

27. IV Equipment

28. Assisting with IV Therapy Report bleeding Protect the bag, tubing, catheter, site Observe the flow rate Report empty bags

29. Review IV therapy is giving fluid thru a needle or catheter inserted into a vein. TrueFalse

30. Review Regurgitation is the swelling of body tissue TrueFalse

31. Review Persons with feeding tubes need frequent oral hygiene. TrueFalse

32. Review If the alarm sounds on the IV pump, turn it off. TrueFalse

33. Review You are responsible for inserting feeding tubes. TrueFalse

34. Review You are never responsible for IV therapy TrueFalse

35. Review A naso gastric tube is inserted directly into the stomach TrueFalse

36. Review A gastrostomy tube is a tube inserted into the stomach