Special nutritional support (feeding methods).pptx

Special nutritional support (enteral, parenteral and transitional feeding)

1. SPECIAL NUTRITIONAL SUPPORT

2. INTRODUCTION Special nutritional support-definition ,types, use TABLE OF CONTENTS ENTERAL FEEDING D efinition,use,types,complication PARENTERAL FEEDING Definition, use ,types, complication TRANSITIONAL FEEDING ENTERAL V/S PARENTERAL CONCLUSION 01 02 03 04 05 06

3. Nutritional support is therapy for people who cannot get enough nourishment by eating or drinking. You may need it if you : Can't swallow Have problems with your appetite Are severely malnourished Can't absorb nutrients through your digestive system You receive nutritional support through a needle or catheter placed in your vein or with a feeding tube, which goes into your stomach . Special nutritional support

4. Nutritional support is often needed for critically ill patients Example: Patients with metabolic stress. Patients with kidney failure requiring dialysis. Patients > 70 years

5. E nteral Feeding 01

6. Enteral feeding refers to intake of food via the gastrointestinal (GI) tract Enteral feeding may mean nutrition taken through the mouth or through a tube that goes directly to the stomach or small intestine Being fed through a tube allows them to receive nutrition and keep their GI tract working. What is Enteral Feeding?

7. Types of Enteral feeding 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 Oroenteric tube starts in the mouth and ends in the intestines.

8. 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 serious illness, which places the body in a state of stress, making it difficult to take in enough nutrients When is Enteral Feeding used?

9. neurological or movement disorders that increase caloric requirements while making it more difficult to eat GI dysfunction or disease, although this may require intravenous (IV) nutrition instead

10. Recommend an appropriate enteral feeding formula Determine the patient's feeding route (e.g., nasogastric, nasoenteric , gastrostomy ) Adjusting the feeding rate, volume, and formula as necessary. Collaborate with other members of the healthcare team Educate the patient and their caregivers on the importance of enteral feeding Monitor the patient's nutritional status and make appropriate changes to the feeding regimen as needed. Document the patient's progress and communicate with the healthcare team Role of dietician

11. Carbohydrates: Typically in the form of maltodextrin , corn syrup, or other simple sugars to provide energy for the body. Proteins: Usually in the form of whey protein, soy protein, or casein to promote tissue growth and repair. Fats: Often in the form of vegetable oils to provide essential fatty acids and promote absorption of fat-soluble vitamins. Vitamins and minerals: Added to the formula to meet the patient's daily requirements. Fiber: May be added to promote gut motility and prevent constipation. Enteral feeding diet

12. Aspiration, which is food going into 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 site Diarrhea due to a liquid diet or possibly medications Tube dislodgement Tube blockage, which may occur if not flushed properly Complications

13. Parenteral Feeding 02

14. Parenteral nutrition is a way for you to receive nutrients by bypassing your digestive system . People who can’t use their digestive systems because of a condition can temporarily or permanently receive nutrition intravenously, through an IV catheter . Parenteral nutrition can be supplementary (partial) or complete (total parenteral nutrition). What is P arenteral feeding

15. Types of Parenteral feeding Central parenteral nutrition (CPN)  is delivered through a central vein — usually, the superior vena cava located under your collarbone, which goes directly to your heart. The larger central vein allows a larger catheter to deliver higher concentrations of nutrition with higher calories. Peripheral parenteral nutrition (PPN)  is delivered through a smaller, peripheral vein, perhaps in your neck or in one of your limbs. PPN is used to provide partial parenteral nutrition temporarily, using the quicker and easier access of the peripheral vein.

16. 1) Partial parenteral nutrition – given temporarily to people who need an immediate boost of calories before transitioning to a longer-term solution — either enteral feeding or gradually resuming mouth feeding given to long-term hospital patients who tend to have general malnutrition for a variety of reasons When is Parenteral feeding used

17. 2) Total parenteral nutrition – if your digestive system isn’t functioning or if you have a  gastrointestinal disease  that requires you to give it complete rest Specific conditions that may require TPN include: Abdominal surgery Chemotherapy Intestinal ischemia Small or large intestinal obstructions Gastrointestinal bleeding Radiation enteritis Extremely premature birth Prolonged   diarrhea Inflammatory bowel diseases

18. Assess the patient's nutritional needs and determine if parenteral nutrition (PN) is appropriate and necessary Select the appropriate PN formula and make adjustments Calculate and adjust the PN solution based on the patient's weight, metabolic requirements, and lab values Monitor the patient's blood glucose levels, electrolyte levels Evaluate the patient's response to the PN and make recommendations for any necessary changes Educate the patient and their caregivers on the importance of PN Monitor the patient's nutritional status and make appropriate changes to the PN regimen as needed Role of dietician

19. Components of a parenteral feeding solution: Amino Acids: added to the parenteral feeding solution in the form of a crystalline amino acid solution Carbohydrates : Glucose is the most common carbohydrate added to parenteral feeding solutions Lipids : Fat emulsions are often added to parenteral feeding solutions to provide essential fatty acids Vitamins and Minerals: These may be added as individual components or as a multivitamin solution Electrolytes: Electrolytes such as sodium, potassium, and chloride are added Trace Elements: Trace elements such as zinc, copper, and selenium Parental feeding diet

20. Infection Blood clots GI atrophy Glucose imbalances Transient liver reactions Parenteral nutrition-associated liver disease (PNALD ) Gallbladder problems Bone demineralization (osteoporosis or  osteomalacia ) Complications

21. Transitional Feeding 03

22. TRANSITIONAL FEEDING

23. Steps

24. Assessment of Nutritional Needs : involve calculating energy and protein requirements based on the patient's weight, medical condition, and level of activity. Selection of Enteral Feeding Formula : The dietitian will work with the healthcare team to select an enteral feeding formula that meets the patient's nutritional needs and medical condition. Feeding Tube Placement : If the patient requires a feeding tube, the dietitian may assist with determining the most appropriate type of tube and placement. Monitoring and Adjustment of Feeding : involve adjusting the feeding rate, volume, or formula to meet the patient's changing nutritional needs. Management of Complications : management of complications related to enteral feeding, such as diarrhea, constipation, or feeding tube dislodgement. Education and Support : The dietitian may also provide guidance on food choices and meal planning for when the patient is able to resume oral feeding. Role of dietician

25. The transition from parenteral to enteral feedings can only be made when the gastrointestinal function has returned . P resence of bowel sounds T he passage of flatus and stools Return of appetite S hould not be vomiting When the patient is ready for the transition to enteral feeding, an oral diet or tube-feeding is initiated When the patient is able to eat, an oral diet is preferred Conditions

26. https:// www.sciencedirect.com/sdfe/pdf/download/eid/1-s2.0-S026156140280022X/first-page-pdf https:// www.chi.sg/Documents/369KTPHNHIP%202021%20Transitional%20Feeding%20Guide%20%20Wean%20the%20Feeding%20Tube%20OffCOMBINED.pdf https://my.clevelandclinic.org/health/treatments/22802-parenteral-nutrition#:~:text=Parenteral%20nutrition%20means%20feeding%20intravenously,system%2C%20from%20mouth%20to%20anus . https://www.mayoclinic.org/tests-procedures/home-enteral-nutrition/about/pac-20384955 RESOURCES

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