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MNA M osby ’ s Long Term Care Assistant Chapter 25 Nutritional Support and IV Therapy.
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Transcript of MNA M osby ’ s Long Term Care Assistant Chapter 25 Nutritional Support and IV Therapy.
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MNAMosby’s Long Term Care Assistant Chapter 25Nutritional Support and IV Therapy
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Nutritional Support
Many people cannot eat or drink because of illness or injury.
Special orders needed
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Aspiration
Breathing fluid, food, vomitus or an object into the lungs
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Enteral Nutrition
Causes of inability to ingest, chew or swallow food:
Cancer
Trauma
Coma
Dysphagia
Dementia
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Types of Feeding Tubes
Nasogastric Tube (NG)
Inserted through the nose and into the stomach
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Types of Feeding Tubes
Nasointestinal TubeInserted through the nose and into the small intestines
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Types of Feeding Tubes
Gastrostomy Tube
Inserted into the stomach surgically
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Types of Feeding Tubes
Jejunostomy Tube
Inserted surgically into the jejunum of the small intestines
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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.
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Types of Feeding Tubes
(PEG)
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Formulas for Feeding
Doctor orders type of formula
Nurse administers feeding.
Most contain protein, carbohydrates, fats, vitamins and minerals
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Feeding Times
Intermittent
Continuous
Given at certain times
Given over 24 hours
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Observations for Feeding Tubes
Patient is at risk for
•Diarrhea
•Aspiration
•Constipation
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Feeding Tubes
Report:
Nausea/Vomiting
Distended abdomen
Redness, drainage at insertion site
Diarrhea
Difficulty breathing
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Feeding Tubes
Regurgitation
Backward flow of stomach contents into the mouth
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Feeding Tubes
Position in Semi- fowlers
Avoid left- lying position
Preventing Aspiration
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Feeding Tubes
Comfort Measures
Usually not allowed to eat or drink
Oral care Q2
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Parenteral Nutrition
Giving nutrients through a catheter inserted into a vein
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Parenteral Nutrition
Often called TPN
Nutrients do not enter the GI tract
Go directly into the vein
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Parenteral Nutrition
Contains: water protein carbs vitamins minerals
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Parenteral Nutrition
Reasons for TPN:Disease, injury,
surgery to GI tractSevere trauma,
infection or burnsNPO for more than 5-
7 daysComaCancer
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Parenteral Nutrition
Report:Fever, chillsChest painSOBCoughN/VDiarrhea
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IV Therapy
Intravenous Therapy
Giving fluids through a catheter inserted into a vein
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IV Therapy
Provides fluidsReplace
vitamin and mineral loss
Give drugs or blood
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IV Sites
Peripheral
Centralvenous
Away from the center of the body.
Ex: arm, leg, scalp
Close to the heartEx: subclavian,
jugular
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IV Equipment
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Assisting with IV Therapy
Report bleedingProtect the bag,
tubing, catheter, site
Observe the flow rate
Report empty bags
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Review
IV therapy is giving fluid thru a needle or catheter inserted into a vein.
True False
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Review
Regurgitation is the swelling of body tissue
True False
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Review
Persons with feeding tubes need frequent oral hygiene.
True False
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Review
If the alarm sounds on the IV pump, turn it off.
True False
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Review
You are responsible for inserting feeding tubes.
True False
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Review
You are never responsible for IV therapy
True False
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Review
A naso gastric tube is inserted directly into the stomach
True False
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Review
A gastrostomy tube is a tube inserted into the
stomach