NUTRITION FEEDING MODES(parenteral ^0 enteral feeding).pptx

Nutrition feeding modes

1. NUTRITION FEEDING MODES(parenteral & enteral feeding) Monica oyanga

2. 1)ENTERAL FEEDING Refers to any feeding method that uses the gastrointestinal tract to deliver nutrients and calories . It can include normal oral diet ,the use of liquid supplements or delivery by use of the tube(tube feeding) There are majorly two types of enteral feeding : Oral feeding Tube feeding

3. 1)Oral feeding Oral nutrition supplements are nutrition support that provide an effective and non invasive way for people to their daily nutritional need or increase their nutritional intake People who take oral nutrition supplements may also be able to eat regular food but cannot meet their nutritional requirements through a regular diet alone and thus require supplemental nutrients In other instances a patient can benefit the ONS if they require a liquid based diet This is majorly prescribed by a qualified health practitioner.

4. Tube feeding If a person has a condition or illness which limits or impairs oral intake enteral nutrition therapy can be administered directly into the gastrointestinal tract as a tube feeding This way of feeding provides life sustaining nutrients and is often required as a first option feeding methods when a person is unable to consume food orally or has impaired digestive system Tube feeding includes specialized liquid feedings containing protein carbohydrates, fats, vitamins, minerals and other nutrients.

5. Types of enteral feeding tubes Nasogastric tube(NGT) - starts in the nose and ends in the stomach. Orogastric tube(OGT)- Starts in the mouth and ends in the stomach Nasoenteric tube - starts in the nose and ends in the intestines Oroerentic tube –starts in the mouth and ends in the intestines Gastronomy tube- is placed through the skin of the abdomen straight to the stomach Jejunostomy tube -is placed through the skin of the abdomen straight into the intestines

6. Nasogastric feeding tube(NGT) a tube inserted from the nose through to the stomach.

7. Procedure of placing an NGT/OGT Placement of a NGT/OGT while its uncomfortable, is fairly straightforward and painless Anesthesia isn’t required Typically a nurse will measure the length of the tube ,lubricate the tip, place the tube in the patients nose or mouth and advance until the tube is in the stomach. The tube usually secured to the skin using a soft tape The nurse or the doctor will then pull some gastric juice out of the tube using a syringe They’ll check for the ph. i.e acidic of the liquid to confirm that the tube is in the stomach In some cases a chest x-ray may be needed to confirm placement .once placement is confirmed ,the tube may be used immediately.

8. Nasoenteric tubes( nasojujenal & nasoduodenal) In a advanced cases the a tube is passed the nose to the jejunum( nasojujenum ) or from the nose to the duodenum(nasoduodenal)

9. Gastronomy tube A tube is placed through the skin of the abdomen straight to the stomach also known as percutaneous endoscopy gastronomy or button gastronomy.

10. Jejunostomy tube A enteric tube are placed through the skin of the abdomen straight into the intestines also known as percutaneous endoscopic jejunostomy

11. Management of enteric tubes Flushing. The purpose of flushing is to check for patency and prevent clogging of enteral tubes Tap water is suitable for most cases although boiled water maybe necessary for children under 6 months Enteral tube should be flushed with between 5-20mls of water depending on the viscosity of the feed or medication Venting. Feeding tubes maybe used to facilitate venting or decompression of the stomach from the accumulation of air during such intervention as high flow nasal prongs, noninvasive or invasive ventilation

12. Indications and contraindications in enteral feeding tubes. Indications: a stroke which may impair ability to swallow Cancer which may cause fatigue, nausea and vomiting that make it difficult to eat. Critical illness or injury which reduces energy or ability to eat Failure to thrive or inability to eat in young children or infants GI dysfunction or disease although this may require parenteral mode of nutrition contraindications: Cases of bowel obstruction Decreased blood flow to the intestines Severe intestinal disease e.g. crohn’s disease

13. Complications of enteric tubes feeding Aspiration-this food going to the lungs Refeeding syndrome-dangerous electrolyte imbalances that may occur in people who are very malnourished and start receiving enteral feeds Infection of the tube or insertion site Nausea and vomiting that may result from feeds that are too large or fast or from slowed emptying of the stomach Skin irritation at the tube insertion point Diarrhea due to a liquid diet or possibly medications Tube dislodgement Tube blockage, which may occur if not flushed properly.

14. SUMMARY ON ENTERIC NUTRITION

15. 2)PARENTERAL FEEDING METHOD INTRODUCTION Parenteral nutrition is intravenous administration of nutrients which may include protein,carbohydrate,fat,minerals and electrolytes vitamins and other trace elements for patients who can eat or absorb enough food through tube feeding formula or by mouth to maintain good nutritional status. You'll have a type of venous access device, such as a port or peripherally inserted catheter inserted so you can receive liquid nutrition Achieving the right nutritional intake in a timely manner can help combat complication and be an important part of patient's recover parenteral nutrition is sometimes called total parenteral nutrition Parenteral feeding can be a life saving option in many circumstances, however its preferably to use enteral nutrition if at all possible.

16. Types of parenteral feeding: Peripheral parenteral nutrition - where someone gets supplementary nutrition Total parenteral nutrition - you get all your nutrition requirements through the vein.

17. INDICATIONS & CONTRAINDICATIONS Indications Inadequate absorption resulting from short bowel syndrome Gastrointestinal fistula Bowel obstruction Prolonged bowel rest Severe malnutrition ,significant weight loss and when enteral nutrition is not possible Contraindications Infant with less than 8cm of the small bowel Irreversibly decerebate patients Patients with critical cardiovascular instability or metabolic instabilities When GI feeding is possible

18. Complications of parenteral nutrition Fluids overload or dehydration Infection risk from the line Thrombosis Hyperglycemia Hypoglycemia Liver failure Micronutrient deficiency THE END!

19. SUMMARY