mna m osby ’ s long term care assistant chapter 25 nutritional support and iv therapy

MNAMosby’s Long Term Care Assistant Chapter 25Nutritional Support and IV Therapy

Nutritional Support

Many people cannot eat or drink because of illness or injury.

Special orders needed

Aspiration

Breathing fluid, food, vomitus or an object into the lungs

Enteral Nutrition

Causes of inability to ingest, chew or swallow food:

Cancer

Trauma

Coma

Dysphagia

Dementia

Types of Feeding Tubes

Nasogastric Tube (NG)

Inserted through the nose and into the stomach

Types of Feeding Tubes

Nasointestinal TubeInserted through the nose and into the small intestines

Types of Feeding Tubes

Gastrostomy Tube

Inserted into the stomach surgically

Types of Feeding Tubes

Jejunostomy Tube

Inserted surgically into the jejunum of the small intestines

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.

Types of Feeding Tubes

(PEG)

Formulas for Feeding

Doctor orders type of formula

Nurse administers feeding.

Most contain protein, carbohydrates, fats, vitamins and minerals

Feeding Times

Intermittent

Continuous

Given at certain times

Given over 24 hours

Observations for Feeding Tubes

Patient is at risk for

•Diarrhea

•Aspiration

•Constipation

Feeding Tubes

Report:

Nausea/Vomiting

Distended abdomen

Redness, drainage at insertion site

Diarrhea

Difficulty breathing

Feeding Tubes

Regurgitation

Backward flow of stomach contents into the mouth

Feeding Tubes

Position in Semi- fowlers

Avoid left- lying position

Preventing Aspiration

Feeding Tubes

Comfort Measures

Usually not allowed to eat or drink

Oral care Q2

Parenteral Nutrition

Giving nutrients through a catheter inserted into a vein

Parenteral Nutrition

Often called TPN

Nutrients do not enter the GI tract

Go directly into the vein

Parenteral Nutrition

Contains: water protein carbs vitamins minerals

Parenteral Nutrition

Reasons for TPN:Disease, injury,

surgery to GI tractSevere trauma,

infection or burnsNPO for more than 5-

7 daysComaCancer

Parenteral Nutrition

Report:Fever, chillsChest painSOBCoughN/VDiarrhea

IV Therapy

Intravenous Therapy

Giving fluids through a catheter inserted into a vein

IV Therapy

Provides fluidsReplace

vitamin and mineral loss

Give drugs or blood

IV Sites

Peripheral

Centralvenous

Away from the center of the body.

Ex: arm, leg, scalp

Close to the heartEx: subclavian,

jugular

IV Equipment

Assisting with IV Therapy

Report bleedingProtect the bag,

tubing, catheter, site

Observe the flow rate

Report empty bags

Review

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

True False

Review

Regurgitation is the swelling of body tissue

True False

Review

Persons with feeding tubes need frequent oral hygiene.

True False

Review

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

True False

Review

You are responsible for inserting feeding tubes.

True False

Review

You are never responsible for IV therapy

True False

Review

A naso gastric tube is inserted directly into the stomach

True False

Review

A gastrostomy tube is a tube inserted into the

stomach