Enteral and Parenteral Nutrition

Enteral Nutrition

A medical intervention that involves delivering nutrients directly into the gastrointestinal tract using a tube.

Malnutrition

A condition where the body lacks essential nutrients, leading to impaired function and health.

Dysphagia

Difficulty swallowing that may require tube feeding to bypass the oral route and deliver nutrients directly to the stomach or intestines.

Neurological Disorders

Conditions that impair the ability to eat, making tube feeding a necessary intervention. Examples include comatose, paralyzed, and stroke patients.

Chronic/critical Illnesses

Conditions such as cancer or cystic fibrosis, where maintaining oral intake is difficult or no longer feasible.

Gastrointestinal Disorders

Conditions where gut function is compromised, and tube feeding can provide a way to support nutritional needs while bypassing affected areas.

End-of-Life Care

Tube feeding is given to patients with irreversible conditions when oral intake is no longer feasible, to maintain their quality of life.

Nasoenteric Tube Feeding

The insertion of a plastic tube through the nose, past the throat, and into the stomach or duodenum/jejunum.

Enterostomy Tube Feeding

The placement of a tube into the gastrointestinal tract through a surgical, endoscopic, or radiological method.

Bolus Feeding

Tube feeding delivered four to eight times per day, with each feeding lasting about 15 to 30 minutes.

Intermittent Feeding

Gravity drip feeding at regular intervals, commonly used for ambulatory patients and in the home-care setting.

Continuous Feeding

Delivering enteral nutrition with a constant speed for 24 hours via a nutritional pump.

Tube Feeding Formulas

Specially designed liquid formulations that provide essential nutrients to individuals who are unable to consume food orally.

Standard Polymeric Formulas

Balanced combination of macronutrients, micronutrients, and fiber, suitable for individuals with intact digestive function.

High-Calorie Formula

Enriched with higher amounts of calories to meet the increased energy needs of certain patients.

Elemental or Semi-Elemental Formula

Predigested or partially broken-down nutrients, suitable for individuals with compromised digestive function.

Renal Formula

Adjusted levels of electrolytes, proteins, and other nutrients to support individuals with kidney disease.

Pulmonary Formula

Modified to have a lower carbohydrate content, designed for individuals with respiratory conditions.

Diabetes-Specific Formula

Low in simple sugars and designed to manage blood glucose levels for individuals with diabetes who require tube feeding.

Nursing Responsibilities

Assessment, administration, tube placement verification, flushing the tube, medication administration, monitoring for adverse reactions, patient education, documentation, regular monitoring and reporting, preventing infections, and emergency preparedness.

Parenteral Nutrition (PN)

Method of delivering essential nutrients directly into the bloodstream, bypassing the digestive system.

Total Parenteral Nutrition (TPN)

Complete intravenous nutrition solution that provides all essential macronutrients and micronutrients to meet a patient's total nutritional needs.

Peripheral Parenteral Nutrition (PPN)

Partial parenteral nutrition solution with a limited nutrient composition compared to TPN, suitable for short-term nutritional support.

Parenteral Nutrition (PN)

A method of providing nutrition when central venous access is not feasible or when nutritional requirements are moderate and the duration of nutrition support is expected to be short-term.

Bacterial and Fungal Infections

Complications that can arise from the use of parenteral nutrition, characterized by the presence of harmful microorganisms in the bloodstream or at the central venous access site.

Liver Failure

A potential complication of parenteral nutrition due to the excess glucose contained in the solution, which can lead to liver dysfunction.

Acute Cholecystitis

A complication that may occur due to the complete unuse of the gastrointestinal tract when parenteral nutrition is administered, resulting in inflammation of the gallbladder.

Assessment

The process of conducting a comprehensive evaluation of the patient's nutritional status, medical history, and current clinical condition to determine the suitability of parenteral nutrition.

Central Venous Access Site

The site where the central venous catheter is inserted for the administration of parenteral nutrition. It should be regularly assessed for signs of infection, redness, swelling, or any complications.

Hyperglycemia

A potential complication of parenteral nutrition characterized by high blood glucose levels. It should be monitored and promptly addressed to maintain glycemic control.

Electrolyte Imbalances

Abnormal levels of sodium, potassium, calcium, or phosphorus in the blood, which can occur as a complication of parenteral nutrition. Regular monitoring and adjustment of TPN components are necessary to maintain balance.

TPN Formulation

The accurate preparation of parenteral nutrition solutions based on the patient's nutritional needs. Double-checking the formula is essential to prevent misadministration and potential harm.

Aseptic Technique

A strict infection control practice that should be followed when accessing and caring for the central venous access used for parenteral nutrition administration to prevent infections.

TPN Infusion Rate

The rate at which parenteral nutrition is administered. It should be monitored and regulated according to the prescribed schedule to prevent complications.

Blood Glucose Monitoring

Regular monitoring of blood glucose levels to ensure glycemic control in patients receiving parenteral nutrition. Prompt action should be taken in case of hyperglycemia or hypoglycemia.

Patient Education

Thorough education provided to the patient and family regarding the purpose of parenteral nutrition, potential complications, and the importance of reporting adverse effects promptly.

Home Administration

Training and support provided to patients and caregivers for the administration of parenteral nutrition at home, ensuring they understand procedures and can manage potential issues.

Infection Prevention

Strict adherence to protocols aimed at preventing infections, including proper hand hygiene, aseptic technique during central line care, and following facility policies.

Safety Measures

Precautions taken to ensure patient safety during parenteral nutrition administration, including training patients and caregivers to recognize early signs of complications and seek immediate medical attention.

Documentation

Accurate and timely recording of parenteral nutrition administration details, including solution composition, infusion rates, and the patient's response.