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Special Nutritional
Special nutritional needs and nutritional impact on illness - NG Tube
Question | Answer |
---|---|
Nutritional support: when is it needed? | under nutrition that may impair: immunity, wound healing, muscle strength, psychological drive, supplements or dietary creativity do not meed the needs |
Nutrition and GI disorders: DYSPHAGIA | Modifications of food texture |
Nutrition and GI disorders GERD | avoid large late meals, alcohol, caffeine and smoking |
Nutrition and GI disorders: N/V | Low fat carbs |
Nutrition and GI disorders:DUMPING SYNDROME | SMALL FREQUENT MEALS |
Nutrition and GI disorders: PANCREATITIS/CHOLECYSTITIS | LOW FAT, DECREASE STIMULATION OF GALLBLADDER |
Nutrition and GI disorders: htn | DASH diet |
Nutrition and GI disorders: CHF | reduce sodium mx fluid intake |
Nutrition and GI disorders:MI | liquid dietx24 hr, avoid caffeine, small frequent meals |
what is the NG tube used for? | decompression feeding lavage compression |
NG types | GI decompression/drainage (large-bore)-> salem sump(2 lumens), Levin(single lumen). enteral feedings (small bore) dobhoff tube, duo, levin, Nasointestinal tube (andersen tube) |
How to determine the length of the tune to be inserted | measure the ng tube from the tip of the pts ear lobe to the tip of the nose, then tot he xiphoid process, mark the tubing: adhesive tape, indelible ink or striped markings on the tube. |
tube placement verifcations recommendations | initially xray. and pH and aspirations. pH should be acidic so 4. |
NGt insertion | inspect coiled tube, assess pt->nares, lungs, bowels, pain, throat ( no irritation)., inspect Gi secretions -> gastric grassy green of white tan, the intestine would be golden yellow or brownish green |
If pH would secretions was 7, what would this mean? | it would mean that the tubing could possibly be in the respiratory |
NGT removal | NGT removal - inject 10 ml of air to clear the tube of fluid and ensure that is it free of debris, remove the tape fromt he pts nose and release the tube from its anchoring device. Ask the patient to take a deep breath and hold breath while pinching |
greatest thing to do before feeding | check residual prior to feeding, >100 ml or 1/2 previous feeding call MD |
30-50 ml of water/ns flush---When? | before/after medicatiosn & feedings, after cehcking residual |
what is negative nitrogen balance? | less than body requirements = muscle wasting, weight loss, fatigue, eventually, dealth |
PN Solutions? | dextrose, amino acids, electrolytes, vitamins, minerals and fat emulsions - goal provide enough calories/nitrogen to meet patients dialy nutritional needs |