Question

Read from chapters 36 to 39 from your Textbook

II. Read chapter 39 and write a summary about alternative feeding techniques that may be used when food and fluids are withheld (NPO) from a child.

III. Review the conditions that necessitate nasogastric gavage, gastrostomy, nasoduodenal, or nasojejunal tube feedings.

IV. Guidelines for Nasogastric Tube feedings in children

Answer 1

Question 2.

The feeding required for the child depends on the reason to keep the child on npo.

If npo status is before surgery the child is started on intravenous infusions of either half normal saline or DN S or dextrose.

Formula to find fluid requirement

Eg 35 kg child.

First 10kg 10 ×100=1000ml

Second 10 kg 10×50=500ml

Third 10 kg 10*20=200ml

Remaining kg 5*20=100ml

So the fluid requirement is 1800 ml for a child with 35 kg for 24 hours.

If npo status is due to ingestion of corrosives the child is kept on npo for a while and after depending upon the degree of internal burns feeding is initiated distal to the burns either via a ng tube or gastrostomy tube feeding.

Parenteral nutrition is indicated in chronic malnutrion which can be given as total parenteral nutrition or peripheral parenteral nutrition. Total parenteral nutrition (TPN) is the only source of nutrition the patient is receiving.

Peripheral parenteral nutrion is along with other sources of nutrition that the patient receives.

Naso gastric gavage indications.

Hypermetabolic state including burns, cancer and multiple trauma.

Following head and neck surgery.

In certain neurological conditions such coma or

Gastrostomy indications. cva.

Gastrointestinal diseases and surgery.

Gastrostomy indications.

Swallowing disorders neurological such as cerebral palsy multiple sclerosis or laryngeal nerve palsy.

Esophageal stricture or atresia

Esophageal cancer

Conditions which require prolonged tube feeding for more than a month like corrosive burns.

Naso duodenal tube feeding indications.

Gastroparesis

Acute pancreatitis

Gastric outlet stenosis

Tracheo Esophageal fistula

Stenosis of gastrostomy.

Nasojejunal feeding indications.

oesophageal atresia

Esophageal stricture and cancer

dysphagia due to neuromuscular disorders

trauma.

Naso gastric tube feeding in children

Calculate the amount of calories and protein required.

Give feeds every two hourly.

Burp the baby after giving feeds.