ENTERAL NUTRITION

Total enteral nutrition (TEN) or tube feedings

refers to a method of infusing nutrient
solutions or formulas directly into the the GI
tract through tubes that enter through the
nose, mouth,or abdominal wall.
 Indicated when the client has impaired
ingestion but normal intestinal
absorption.

INDICATIONS FOR ENTERAL FEEDING

Neurologic and psychiatric
 Anorexia
 Stroke

 Inflammation

 Cancer

 Severe depression

trauma
 Oropharyngeal and Esophageal
 Inflammation
 Cancer
 Trauma

 Gastrointestinal
 Fistula
 Mild inflammatory bowel disease
 Mild absorption
 Mild pancreatitis
 Preoperative bowel preparation
Short – term feeding
 Nasogastric or nasoenteric tubes
 Tubes vary in length and ranging in size from 5F
to 16F

Long – term feeding

 Gastrostomy and jejunostomy tube
 Placed surgically, endoscopically or radiologically
 PEG percutaneous endoscopic gastrostomy
become the most common method of placing a
permanent long term feeding device.
Method of Administration
 Intermittent or continuous drip

 INTERMITTENT or BOLUS FEEDING, 300 to

500 ml delivered several times per day.
 CONTINUOUS feedings are administered via
an infusion pump to control the rate of
infusion.
 Infused over 24 hours
DIAGNOSIS
Nursing diagnosis appropriate for the
client receiving enteral feeding
Imbalance Nutrition : Less than Body
Requirement related to difficulty
swallowing, esophageal or gastric
resection or obstruction or inability to
ingest adequate calories and nutrients.
OUTCOMES- the client will maintain ideal body
weight or gain 1 to 2 pounds per week until
ideal body weight is attained.

INTERVENTIONS
 Prevent contamination of formula and delivery
system
 Assess tube location
 Administer feeding
 Prevent aspiration
 Maintain enteral access
GUIDELINES for the administration of
medication via an enteral feeding tube

 If possible administer medication by mouth

 Use a liquid form of medication if available
 Crush medication into a fine powder and dissolve
in 30 ml of water
 Do not crush enteric- coated or time released
tablets or capsules
 Flush the tube with 30ml of water before and after
giving each medication
 Do not mix multiple medications or give
them together
 Do not deliver a medication into the small
intestine if it must be absorbed in the
stomach like antacids,sucralfate
PARENTERAL NUTRITION
 is indicated to maintain nutritional status
and prevent malnutrition when the client has
inadequate intestinal function or cannot be
fed orally or by tube feeding
 Contains carbohydrates as glucose, fat as

triglycerides and proteins as amino acids.

Clinical Indications for Total Parenteral Nutrition
Malabsorptive syndromes
 Severe short- bowel syndrome

 Severe prolonged radiation enteritis

Motility disorders
 Persistent postoperative or disease –related
ileus
 Intestinal pseudo-obstruction

 Severe persistent vomiting

Nursing Management of the Client Receiving
Parenteral Nutrition
Assessment
 Check infusion bag for correct ingredient and

appearance of the solution

 Assess the condition of the venous site

 Monitor blood glucose levels, rate of infusion

 Observe client for reactions

Diagnosis: Imbalanced nutrition : Less
than body requirements related to the
need for IV delivery of nutrients, fluids
and electrolytes to maintain nutritional
status secondary to malabsorption
problems of the GI tract
Outcomes: The client will maintain ideal body
weight or gain 1 to 2 pounds per week until
ideal body weight is attained.
Interventions:
 Administer PN

 Monitor bld. Glucose levels

 Observing for allergy to PN components

 Maintain vascular access

 Prevent infection