Question

Discuss parenteral and enteral nutrition. Why would these sources of nutrition be utilized in the clinical setting? Name two nursing interventions with each type of nutritional source. What complications can occur with each type of nutrition?

Answer 1

Parenteral nutrition is provision of nutritional requirements intravenously. This bypasses the gut and supplies the nutrients directly into blood from where they are utilized by the body. It is used in situations where gastrointestinal feeding is not possible.

Clinical use:

• Bowel obstruction
• Severe inflammatory bowel disease
• Fistulas that need repair
• Following gastrectomy

Nursing interventions

• The calorie intake should be calculated and adequate macro and micronutrients should be provided as per requirement.
• Micronutrient deficiencies should be corrected
• Extravasation should be prevented.
• Should be instituted through central access whenever possible.

Complications:

• Hyperglycemia
• Infections
• Hypoglycemia
• Dehydration and electrolyte imbalances
• Liver failure
• Micronutrient deficiencies

Enteral nutrition is when the gastrointestinal system is used to deliver the nutritional requirements of the patient. There are different routes possible, grossly divided into oral, gastric and rectal routes.

Nasogastric, nasoenteral, gastostomy or jejunostomy routes can all be used as per the clinical setting

Indications

• Patients with neurological disorders like stroke
• Critical illnesses
• Severe malnutrition
• Cancer

Nursing interventions

• Ensure adequate caloric needs are met
• Ensure hydration
• Aseptic precautions while feeding
• Slow feeding to be done to prevent aspiration

Complications

• Diarrhoea
• Aspiration
• Refeeding syndrome
• Dyselectrolytemias
• Tube blockage and dislodgement