Nutrient Administrations: A Case Study

In this assignment I will be describing the characteristics of nutrients and the benefits to the body.

Promptness is very important when monitoring feeding tubes. If a tube is clogged and it is not reached quickly, the patient is going without nutrients they need. A clogged tube basically starves the person because no formula is permitted to flow through the tube.

Only when it is absolutely necessary should a catheter be inserted into a patient. Every patient is assessed for the need for a Foley catheter. If the Foley is inserted, assessments are also then done daily to see if the need is still valid. If the reason is not justifiable the catheter must be removed from the patient (Joint Commission releases new NPSG for CAUTI, 2011). Nurses must follow guidelines while inserting indwelling catheters as well. Aseptic technique is critical to maintain during this process. The use of sterile equipment and a sterile procedure helps to reduce the risk of CAUTI. If in any way the catheter becomes contaminated during the process of insertion, the nurse should discard of the entire catheter and start with a new, sterile kit. Proper hand hygiene is very important before and after contact with indwelling catheters to decrease risk of infection. Maintenance of a close drainage is system is also important that way bacteria are not able to get in and cause infection (Revello & Gallo, 2013). Decreasing the number of times Foleys are inserted and how long they stay in for can help reduce the risk of CAUTI since the longer a Foley stays in, the higher the risk of infection becomes. Nurses must keep the catheter line patent, with no kinks to allow urine to flow freely through into the collection bag. When a urine sample must be obtained it must be done in a sterile

Nasogastric tubes may be very scary and if they are not placed correctly they can cause serious problems. X-rays have proved to be very effective when it comes to checking the placement, but they are expensive. Studies have shown that 16-43.5% of nasogastric tubes in pediatric patients are misplaced (Farrington, M; Lang, S; Cullen, L; Stewart, S, 2013). Complications like: aspiration pneumonia pneumothorax may occur is the nasogastric tube is misplaced into the lungs (Farrington, M; Lang, S; Cullen, L; Stewart, S, 2013). There is little research done on neonates to determine the best way to determine if a nasogastric tube is placed correctly. When it comes to medicine, everyone who is part of the medical team needs to be aware of what current practice is and what evidenced based practice studies show is the best way to perform procedures.

As the nurse, it is your responsibility to ensure pain control. In A.W.s case, would you administer pain medication before the chest tube insertion?

Rectal medications are absorbed very quickly. Suppositories are available and are given into the rectum. Pessaries are given into the vagina.

M2 : Assess how influences on dietary intake may affect the nutritional health of individuals

Although different kinds of tubes are placed in a patient at the bedside every day, it is important to remember the complications that can arise if a tube in not placed correctly or in the right place. Health care workers recognize this risk and take steps to ensure proper insertion. This study recommends that health care workers use at least two bedside methods to verify placement. These include, pH, visual signs of aspirate, patient’s respiratory condition, monitoring the tube every four hours, marking the exit location of the tube and capnography. These methods have all been backed by research to show their validity in determining tube placement. Although included on the list, the auscultation of an air bolus is not included in one of the recommended bedside tests. Although it is widely used in practice, the article states that “no evidence indicates that the auscultatory method is useful for determining the location” ( Methany 2016). If heath care providers relied on the auscultation method as one of the recommended bedside tests, the tube could be in the wrong place in the body or in the lungs. If feedings or medications were given through the tube in the wrong place it could lead to extreme complications or even death. This article notes x ray as, again, the gold standard for ensuring placement. This article along with several

his neurologic intensive care unit (NICU) stay, Y.W. was intubated and placed on mechanical ventilation, had a feeding tube inserted and was placed on tube feedings, had a Foley catheter to down drain (DD), and had multiple IVs inserted. He developed pneumonia 1 month after admission.

The emergency department physician inserts a central venous catheter via the subclavian vein and prescribes Lactated Ringer's solution at 1,000 ml/hr via infusion pump.

Central line bundle is a group of evidence-based practice strategy for patient with central catheters, when implemented together, produce better outcomes than implemented individually (Institute of health care improvement, 2010.). The main elements of central line bundle are hand hygiene, maximal barrier precaution upon insertion, Chlorhexidine skin antisepsis, optimal catheter selection, and daily review of line necessity with prompt removal of unnecessary lines Aseptic technique when using and caring for a central line catheter can decrease the chance of contamination in this critically ill infants. Staff education on adherence to aseptic technique and strict central line care guidelines are essential to decreasing bloodstream infections.

An NG tube with suctioning would also be used if the patient was vomiting frequently. "NG suction may be used to reduce vomiting and gastric distention and to prevent gastric acid contents from entering the duodenum" (Croghan, 2014, pg. 1032).

Parenteral nutrition is contraindicated in any child who does not have an intravenous (IV) line either a peripheral IV line for peripheral or partial parenteral nutrition, or central venous access for IV nutrition or TPN. Allergies to the components of the TPN solution and infection could be a contraindication (Gastroenterology and Hepatology journal, 2012).

A nasogastric (NG) tube is an extended polyurethane or silicone tube that travels via the nasal passages via the oesophagus into the stomach (Khobragade.R, 2016). It is normally inserted in surgical practice for diverse reasons. Nasogastric tubes are inserted through nurses, junior medical doctors and every so often by way of anaesthetists in theatre. It is far vital that workforce placing them recognise an appropriate insertion method in addition to the process for verifying their correct

Proper technique for gaining intravenous (IV) access to a patient is crucial for decreasing the potential of complications of the procedure. There is a rare possibility of multiple detrimental effects due to IV insertion, and by understanding these complications the healthcare provider is better equipped to provide competent medical care. Although a minor procedure, if not done correctly, an IV can negatively impact the patient’s health and possibly prognosis. Furthermore, extended knowledge of the following topics can enable these problems to be caught early and treated promptly.