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Nursing Management
TRANSPYLORIC
FEEDINGS
Transpyloric feedings are administred
directly into the small bowel through the following types of tubes:
.
Nasoduodenal (ND)
.
Nasojejunal (NJ)
. Jejunostomy
Transpyloric feedings, which should
be given continuously, may be used because they have a lower risk of causing
gastroesophageal reflux or pulmonary aspiration. Jejunostomy tubes are inserted
through a permanent opening in the jejunum and the abdominal wall. Jejunostomy
tubes have an additional advantage because they are not easily dislodged and
they are readily visible, as opposed to ND NJ, and NG tubes, which are easily
visible and easily dislodged.
FORMULA
The formula used should be altered to meet the
resident’s need. Individuals may experience less diarrhea if the formula is
diluted to about 300 mOsm/kg It may be necessary to dilute formulas to one-half
or one-fourth their strength and to deliver them slowly when the resident first
receives the formula, but the strength and rate of delivery of the formula
should be increased over the following days. In addition, formula should be
delivered at room temperature.
FEEDINGS
Feedings should also be tailored to the needs of
individual residents. It is recommended that severely malnourished individuals
receive normal levels of feedings rather than a gradual introduction, since
these individuals need adequate nutrition immediately. To
increase nutrients in the resident who is receiving enteral tube feedings as a
supplement to oral intake, several small meals that are high in fat and protein
should be provided.
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