A_B_2010_Nutrition_Support

A_B_2010_Nutrition_Support - Methods of Nutrition Support...

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Methods of Nutrition Support Chapter 7 1. Conventional (by mouth) 2. Specialized nutrition support Enteral (by tube) Parenteral (by vein)
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Importance of Providing Appropriate Nutrition Support Hospitalized patients are at risk for developing nutritional deficiencies and nutrition-related complications Protein Energy Malnutrition is common in chronically ill and may exist before hospitalization Malnutrition increases risk of mortality and morbidity Micronutrient deficiencies are common in some diseases
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Causes of Poor Nutritional Status 1. Inadequate nutrient intake 2. Maldigestion/ Malabsorption 3. Decreased nutrient utilization/ Impaired metabolism 4. Increased nutrient requirements 5. Increased nutrient losses (know specific examples for each category that are indications for specialized nutrition support)
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Causes of Poor Nutritional Status 1. Inadequate nutrient intake, due to: Poor dentition Paralysis Economic difficulties Social problems Loss of appetite Swallowing difficulties Inability to eat due to medical condition 2. Maldigestion/ Malabsorption, due to: Pancreatic insufficiency Gastric resection or atrophy Bacterial overgrowth Celiac disease Ulcerative colitis Short bowel syndrome Radiation enteritis 4. Increased nutrient requirements, due to: Burns Trauma Infection / Sepsis Major surgery Cancer AIDS Pregnancy and lactation 3. Decreased nutrient utilization/ Impaired Metabolism, due to: Medications Tissue damage e.g. cirrhosis of liver, renal disease Inborn errors of metabolism 5. Increased nutrient losses, due to Medications Renal disease GI diseases / Diarrhea
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Methods of Feeding & Indications for Specialized Nutrition Support 1. Conventional (by mouth) 2. Enteral (by tube) Impaired ingestion or Inability to consume adequate nutrition orally Impaired digestion, absorption, metabolism Severe wasting or depressed growth 3. Parenteral (by vein) Gastrointestinal incompetency Metabolic stress with poor enteral tolerance or accessibility
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Conventional Feeding Use a normal, unrestricted diet whenever possible Reasons: easier to plan a nutritionally adequate diet simplifies the procedure for providing meals at home & in hospital patient does not feel a sense of alienation reduces the number and variety of special items that must be prepared
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Clear Liquid Full Liquid Soft Regular (Modified Therapeutic Diets) Changes from the house diet Caloric level Consistency Single nutrient manipulation Preparation Food restriction Number, size, frequency of meals Addition of supplements
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Conventional Feeding: Modified (Therapeutic) Diets Reasons why some patients may consume by mouth a diet that has been modified to meet their needs: 1. Improve nutritional status e.g. Burns – high protein diet, CVD - low fat/cholesterol 2. Rest an organ e.g. Pancreatitis – (npo) or clear liquid
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A_B_2010_Nutrition_Support - Methods of Nutrition Support...

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