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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
