NR 224 Week 4 Core Assignment; Nursing Skill; Nutrition

Week 4 Edapt Notes Fundamentals Enteral nutrition is used for clients whose gastrointestinal tract is functioning. Parenteral nutrition is used for clients whose gastrointestinal tract is not functioning. Room temperature is the safest and most comfortable temperature for gastrointestinal ingestion of enteral nutrition. When preparing to administer an enteral feeding, the nurse should verify nasogastric tube placement, flush the feeding tube with 30 mL of water, and administer the feeding at room temperature. The head of the bed should be elevated at least 30 degrees. The nurse should use aseptic techniques to connect the administration tubing to the feeding container. Enteral nutrition can be administered by a caregiver in the home. Modular formula contains a single macronutrient. Enteral nutrition is administered continuously to critically ill clients. Enteral nutrition is often preferred over parenteral nutrition. 457200847019Enteral nutrition can be administered via the nasoenteral route (nasogastric, nasoduodenal, or nasojejunal) or through gastric tubes inserted into the stomach (gastrostomy) or jejunum (jejunostomy). Enteral nutrition (EN) provides nutrients directly into the gastrointestinal (GI) tract. It is the preferred method to meet nutritional needs when a client is unable to chew or swallow but has a functioning GI tract. Intermittent feedings are when the formula is administered every 4–6 hours in 250–400 mL portions, typically over 30–60 minutes. Flush the tube with 15–30 mL of warm water before and after intermittent feedings. Elevate the head of the bed to at least 30 degrees during feedings and for 30–60 minutes after feedings to reduce the risk of aspiration. Assess gastric residual every 4–6 hours during a continuous feeding and before every intermittent feeding. Before instilling enteral formula, tube placement must be verified by x-ray. Once per shift and prior to feeding, the tube placement must be verified to ensure migration has not occurred. Aspiration of gastrointestinal (GI) contents and measuring pH levels are used to verify ongoing placement. When using a can of formula, fill the feeding bag with enough formula for 4 hours (if continuous) or the prescribed amount (if intermittent). Discard the bag and tubing after 24 hours of use. Place open and unused formula cans in the refrigerator. Pulmonary aspiration of enteral formula into the lungs can result in lung tissue damage, infection, and pneumonia. Interventions include: Verify tube placement prior to feeding. Check gastric residuals before each feeding. Continuously monitor the client receiving enteral nutrition for signs of aspiration and/or respiratory distress (severe coughing, dyspnea, cyanosis, crackles, or wheezing). If aspiration is suspected, stop the feeding immediately and notify the healthcare provider. Suction as appropriate. Elevate the head of the bed at least 30 degrees during feedings and for 30–60 minutes after feedings to reduce the risk of aspiration. Delayed gastric emptying increases the risk of aspiration. Medications to increase peristalsis may be prescribed and administered through the feeding tube. Parenteral nutrition (PN) is a form of specialized nutritional support provided intravenously to clients who are unable to digest or absorb enteral nutrition. There are two types of parenteral nutrition: peripheral and