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Enteral Nutrition Guide for Clinicians

This document discusses enteral nutrition, which is defined as nutrition provided through a tube directly into the gastrointestinal tract. The goal is to adequately meet a patient's nutritional needs through the most physiologic, safest, and cost-effective route. Indications for enteral nutrition include poor nutrient retention, prolonged nothing by mouth status, insufficient oral intake, and various gastrointestinal, neurological, cardiorespiratory, and other diseases or conditions. Contraindications include peritonitis, obstruction, ileus, vomiting, and enteric fistulas. Routes of administration include nasoenteric tubes and tube enterostomies. Complications can be gastrointestinal, mechanical, metabolic, or formula-related. Nursing management focuses on preventing and

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127 views22 pages

Enteral Nutrition Guide for Clinicians

This document discusses enteral nutrition, which is defined as nutrition provided through a tube directly into the gastrointestinal tract. The goal is to adequately meet a patient's nutritional needs through the most physiologic, safest, and cost-effective route. Indications for enteral nutrition include poor nutrient retention, prolonged nothing by mouth status, insufficient oral intake, and various gastrointestinal, neurological, cardiorespiratory, and other diseases or conditions. Contraindications include peritonitis, obstruction, ileus, vomiting, and enteric fistulas. Routes of administration include nasoenteric tubes and tube enterostomies. Complications can be gastrointestinal, mechanical, metabolic, or formula-related. Nursing management focuses on preventing and

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poru
Copyright
© © All Rights Reserved
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Available Formats
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ENTERAL

NUTRITION

DEFINATION & GOAL


ENTERAL

NUTRITION IS DEFINED AS
NUTRITION PROVIDED THROUGH A
TUBE DIRECTLY TO GI TRACT.

THE

GOAL OF NUTRITION
INTERVENTION IS TO SUPPLY
ADEQUATE NUTRIENTS TO MEET
THE PATIENTS NUTRITIONAL NEEDS
BY THE MOST PHYSOLOGIC,SAFEST
AND COST-EFFECTIVE ROUTE.

INDICATION FOR EN

POOR NUTRIENT RETENTION

PROLONGED NPO STATUS

INSUFFICIENT INTAKE

INDICATION FOR EN

GASTROINTESTINAL DISEASES

-SHORT BOWEL SYNDROME


-INFLAMMATORY BOWEL
DISEASES
-INTRACTABLE DIRRHOEA OF
INFANCY
-EXTRAHEPATIC BILIARY ATRESIA
-INTESTINAL PSEUDO-OBSTRUCTION
-CHRONIC LIVER DISEASE
-GLYCOGEN LIVER DISEASE

INDICATION FOR EN

NEUROLOGICAL

-STATIC ENCEPHALOPATHY
-DYSPHAGIA
-CNS TUMOR

CARDIORESPIRATORY

-CYSTIC FIBROSIS
-BRONCHOPULMONARY DYSPLASIA
-CONGENITAL HEART DISEASE

INDICATION FOR EN
MALIGNANCY
-POOR
INTAKE:RADIATION/CHEMOTHERAPY
-TERMINAL SUPPORT
HYPERMETABOLIC STATES
-BURNS
-TRAUMA / HEAD INJURY
OTHER
-ANOREXIA NERVOSA
-CHRONIC RENAL DISEASE

CONTRAINDICATION FOR
EN

PERITONITIS

OBSTRUCTION

ILEUS

VOMITING

ENTERIC FISTULA

PANCEATITIS

ROUTES OF EN
ADMINISTRATION

NASOENTERAL

-NASOGASTRIC

-NASODUODENAL

-NASOJEJUNAL

ROUTES OF EN
ADMINISTRATION

TUBE ENTEROSTOMY

-GASTROSTOMY

-JEJUNOSTOMY

TRANSPYLORIC EN

INDICATIONS

-GASTROESOPHAGEAL REFLUX
-ALTERED MENTAL STATUS
-INTRACTABLE EMESIS
-DELAYED GASTRIC EMPTYING
-ABNORMAL SWALLOWING

INITIATION OF EN

APROACHES
-BOLUS Vs CONTINOUS FEEDS
-FULL FEEDS Vs GRADED REGIMENS

ASSESSMENT OF CLINICAL
RESPONSE

ANTHROPOMETRIC MEASUREMENTS

FEEDING TELERANCE

COMPLICATION

GASTROINTESTINAL

MECHANICAL

METABOLIC

FORMULA RELATED

GI COMPLICATIONS

VOMITING

DIARRHEA

CONSTIPATION

ABDOMINAL PAIN / BLOATING

GASTRIC IRRITATION

ASPIRATION

MECHANICAL
COMPLICATIONS

TUBE OCCLUSION

NASOPHARYNGEAL EFFECTS

TUBE FRACTUES

LEAKAGE

DISLODGEMENT

IRRITATION

METABOLIC
COMPLICATIONS

HYPOVOLEMIA

HYPERKALEMIA

HYPOPHOSPHATEMIA

HYPERTONIC DEHYDRATION

FLUID OVERLOAD

FORMULA
COMPLICATIONS

INCOMPATIBILITY WITH MEDICINES

HYPEROSMOLALITY

CONTAMINATION

NURSING MANAGEMENT

NAUSEA AND VOMITING:

ALWAYS KEEP THE HEAD 30-45


DEGREES ELVATED FOR FEEDING.
POSITION Pt. ON RIGHT SIDE TO
FACILITATE PASSAGE OF GASTRIC
CONTENT THROUGH PYLORUS.
DECREASE TOTAL VOLUME OF
FEED.
TO OVERCOME DELAYED GASTRIC
EMPTYING STOP FEED FOR 2
HOURS AND CHECK RESIDUAL

NURSING MANAGEMENT

CONT

TO OVERCOME DELAYED GASTRIC


EMPTYING ADMINISTER PROKINETIC
AGENTS(METOCLOPROMIDE,CISAPRID
E).

TO RELIEVE CONSIPATION PROVIDE


FREE WATER, USE HIGH FIBER
FORMULA.

STOP FEEDING IN CASE OF GI


OBSTRUCTION.

NURSING MANAGEMENT

CONT

FLUSH FEEDING TUBE 3-4 HRLY TO


PREVENT OBSTRUCTION.
TO OVERCOME METABOLIC
COMPLICATIONS FREQUENTLY CHECK
ELECTROLYTES AND BLOOD SUGAR.
TO STIMULATE ORAL GRATIFICATION
PROVIDE ICE CHIPS,SUGAR FREE
CANDIES.
PROVIDE ORAL CARE 4-6 HRLY.

CONCLUSION

EN IS THE PREFERRED METHOD OF


NUTRITIONAL SUPPORT

SAFE AND EFFICACIOUS

WELL TOLERATED

SAFER, CHEAPER, SIMPLER AND MORE


EFFECTIVE THAN PARENTERAL NUTRITION

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