1. NutritionNutrition NUR 102 Lab Module I

2. Enteral Nutrition Definition—administration of nutrients directly into the GI tract Beneficial when oral feedings are not possible, but the stomach or intestines are able to digest nutrients Preferred over parenteral nutrition

3. Evidence-Based Practice Indications –Impaired swallowing or gag reflex usually related to a neurological process –Nutritional deficit due to decreased food ingestion –Inability to eat related to surgery, injury, or disease

4. Continued… Complications –Displacement of tube –Electrolyte imbalance –Hyperglycemia –Constipation –Diarrhea –Clogging of the tube –Vomiting –Pulmonary aspiration

5. Enteral Feeding Types –Nasogastric—a small tube that is passed through the nares into the stomach –Nasointestinal—tungsten-weighted tube inserted through the nares to allow peristalsis to move the tube through the pyloric sphincter into the duodenum or jejunum –Gastrostomy—surgically placed feeding tube inserted into the stomach in the LUQ of the abdomen

6. Continued…

9. Equipment Needed NG tube Catheter tip syringe, 60cc Tape or tube fixation device Cup of water or ice chips for the patient Clean gloves

10. Continued…

11. Insertion of a Nasogastric or Nasointestinal Tube Refer to Skill 30-1, pg 1014

12. Verifying Tube Placement X-ray after initial insertion pH of aspirate Air bolus auscultation Aspiration of gastric contents or feeding

13. NG Tube Irrigation Refer to Skill 30-3, pg 1025

14. Types of NG Feedings Intermittent or Bolus Continuous drip

15. Equipment for Feeding Clean gloves 60cc syringe or feeding bag Formula

16. Feeding Administration Refer to Skill 30-4, pg 1028

17. Evaluation of Feeding Measure residual per policy—notify MD if >100cc Monitor blood sugar levels per policy Intake and output every 8 hours Monitor lab values—albumin, prealbumin, protein, transferrin

18. Continued… Daily weights Assess respiratory status Assess level of comfort Assess abdomen—bowel sounds

19. Gastrostomy Feedings Refer to Skill 30-5, pg 1036

20. NCLEX Review Questions

21. Parenteral Therapy Definition—specialized nutrition support delivered intravenously Ideal for patients who cannot digest or absorb enteral nutrition Provides amino acids, dextrose, fat emulsions, vitamins, minerals, and trace elements

22. Central Venous Catheter

23. PICC Line

24. Nursing Care Refer to Skill 31-1, pg 1049, Skill31- 2, pg 1-57, and Skill 31-3, pg 1061

25. NCLEX Review Questions