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Feeding methods. Enteral & parenteral nutrition -enteral nutrition is needed for persons with underlying chronic disease or traumatic injury . -also elderly person ,these patients expose to burn ,or malignant cancer need enteral nutrition to restore some of their health. -.
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Enteral & parenteral nutrition -enteral nutrition is needed for persons with underlying chronic disease or traumatic injury .-also elderly person ,these patients expose to burn ,or malignant cancer need enteral nutrition to restore some of their health . -
** mode of enteral nutrition support : oral supplements . -add energy –nutrient food as Ensure with or between Meals . 2-tube feeding : -insufficient food intake either as supplement or as the complete meal .
- ** nutrient component : carbohydrate protein amino acid fat vitamins & minerals . ** ways of formula feeding : nasogastric tube : indicated in short term theorpy . 2- esophagostomy { cancer neck } or traumatic injury 3-gastrostomy : tube placed in the stomach . 4- jejunostomy : Tube placed in the duodenum or jejunum of small intestine . Indicated in case of cancer stomach
** nursing care : check for gastric residuals . note any signs of abdominal distension . monitor vital signs as temperature ,pulse ,respiration . monitor the flow rate & record intake & output . report patient response to the formula . monitor state of hydration . follow up of lab investigation as needed . **N.B: - vomiting ,abdominal distension , frequency of bowel movement after formula feeding ,if developed better to give intermittent bolus feeding until tolerance to formula occur
** parenteral feeding : total parentral nutrition . any feeding methods other than by the normal gastro-intestinal route . given through central or peripheral veins . when the GIT cant be used . ** indication for TPN: problems in the gastro-intestinal tract . sever mal nutrition . patient expose to sepsis ,chemotherapy . malabsorption & inadequate oral intake . massive burn . comatose patient . hepatic insufficiency .
Nutrition during pregnancy & lactation ** factors determining nutritional needs : @ age & parity : teenage mother number of pregnancy & interval between pregnancies ,reflect on outcome of pregnancy . @preconception nutrition : Diet ,food habits General health & fitness. State of nutrition at time of conception . @fetus ,mother ,placenta interaction . ** energy need during pregnancy ,calories increased to nourish baby ,with appropriate weight gain . ** protein need60gm \ day help in rapid growth of the fetus ,enlargement of uterus . ** calcium 1200 gm\day ,essential for skeletal tissue growth . drink cup of milk daily is essential . ** iron 30gm \day . supplementary iron given because of insufficient maternal stores . vitamins A,B,C,D,with adequate exposure to sunlight .
** general dietary problems : nausea & vomiting . hyper emesis gravid rum . constipation . hemorrhoids . heart burn or gastric pressure . ** weight gain during pregnancy : 10-12 Kg -fetus : 3.400 gm -placenta : 450 gm -amniotic fluid : 900 gm -uterus : 1100 gm Breast 1400gm -blood volume : 1800 gm - maternal body : 1800 gm
** nutritional risk factors in pregnancy : age : less than 15 yrs ,more than 35 yrs . frequent pregnancy 3 or more during two years period . poor obstetrical history . poverty . abuse of nicotine ,alcohol ,or drugs inadequate weight ,less than 85 % of standard weight ,more than 120% of standard weight . ** complications of pregnancy : anemia : common problem during pregnancy { iron deficiency ,folate deficiency ,hemorrhagic anemia }
pregnancy induced hypertension { PIH }: -low to free salt diet . -low cholesterol . -high protein ,vitamins ,& minerals . -normal CHO . - monitor of body weight . - restriction of fluid . 3- gestational diabetes mellitus : - low CHO diet especially glucose . -low cholesterol diet . -normal protein diet . Exercise stress reduction . insulin therapy . maternal phenylekentonuria . ** nutrition during lactation : -because mother breast feeding , she need good nutrition in form of protein ,milk ,milk product ,minerals ,& vitamins . -finally mother need period of rest & relaxation to take care of her self ,her baby & her family