Nutrition feeding modes

1. NUTRITION FEEDING
MODES(parenteral &
enteral feeding)
Monica oyanga

2. 1)ENTERAL FEEDING
 Refers to any feeding method that uses the
gastrointestinal tract to deliver nutrients and
calories .
 It can include normal oral diet ,the use of liquid
supplements or delivery by use of the tube(tube
feeding)
 There are majorly two types of enteral feeding :
1.Oral feeding
2.Tube feeding

3. 1)Oral feeding
 Oral nutrition supplements are nutrition support that
provide an effective and non invasive way for people to
their daily nutritional need or increase their nutritional
intake
 People who take oral nutrition supplements may also be
able to eat regular food but cannot meet their nutritional
requirements through a regular diet alone and thus
require supplemental nutrients
 In other instances a patient can benefit the ONS if they
require a liquid based diet
 This is majorly prescribed by a qualified health
practitioner.

4. Tube feeding
 If a person has a condition or illness which limits or
impairs oral intake enteral nutrition therapy can be
administered directly into the gastrointestinal tract as a
tube feeding
 This way of feeding provides life sustaining nutrients and
is often required as a first option feeding methods when a
person is unable to consume food orally or has impaired
digestive system
 Tube feeding includes specialized liquid feedings
containing protein carbohydrates, fats, vitamins, minerals
and other nutrients.

5. Types of enteral feeding tubes
 Nasogastric tube(NGT)-starts in the nose and ends in the
stomach.
 Orogastric tube(OGT)-Starts in the mouth and ends in the
stomach
 Nasoenteric tube-starts in the nose and ends in the
intestines
 Oroerentic tube –starts in the mouth and ends in the
intestines
 Gastronomy tube-is placed through the skin of the
abdomen straight to the stomach
 Jejunostomy tube-is placed through the skin of the
abdomen straight into the intestines

6. Nasogastric feeding tube(NGT)
 a tube inserted from the nose through to the stomach.

7. Procedure of placing an NGT/OGT
 Placement of a NGT/OGT while its uncomfortable, is fairly
straightforward and painless
 Anesthesia isn’t required
 Typically a nurse will measure the length of the tube
,lubricate the tip, place the tube in the patients nose or
mouth and advance until the tube is in the stomach.
 The tube usually secured to the skin using a soft tape
 The nurse or the doctor will then pull some gastric juice
out of the tube using a syringe
 They’ll check for the ph. i.e acidic of the liquid to confirm
that the tube is in the stomach
 In some cases a chest x-ray may be needed to confirm
placement .once placement is confirmed ,the tube may
be used immediately.

8. Nasoenteric tubes(nasojujenal &
nasoduodenal)
 In a advanced cases the a tube is passed the nose to the
jejunum(nasojujenum) or from the nose to the duodenum(nasoduodenal)

9. Gastronomy tube
 A tube is placed through the skin of the abdomen straight to the stomach also
known as percutaneous endoscopy gastronomy or button gastronomy.

10. Jejunostomy tube
 A enteric tube are placed through the skin of the abdomen straight into the
intestines also known as percutaneous endoscopic jejunostomy

11. Management of enteric tubes
Flushing.
 The purpose of flushing is to check for patency and
prevent clogging of enteral tubes
 Tap water is suitable for most cases although boiled water
maybe necessary for children under 6 months
 Enteral tube should be flushed with between 5-20mls of
water depending on the viscosity of the feed or
medication
Venting.
 Feeding tubes maybe used to facilitate venting or
decompression of the stomach from the accumulation of
air during such intervention as high flow nasal prongs,
noninvasive or invasive ventilation

12. Indications and contraindications in
enteral feeding tubes.
Indications:
 a stroke which may impair ability to swallow
 Cancer which may cause fatigue, nausea and vomiting that
make it difficult to eat.
 Critical illness or injury which reduces energy or ability to eat
 Failure to thrive or inability to eat in young children or infants
 GI dysfunction or disease although this may require parenteral
mode of nutrition
contraindications:
 Cases of bowel obstruction
 Decreased blood flow to the intestines
 Severe intestinal disease e.g. crohn’s disease

13. Complications of enteric tubes feeding
 Aspiration-this food going to the lungs
 Refeeding syndrome-dangerous electrolyte imbalances
that may occur in people who are very malnourished and
start receiving enteral feeds
 Infection of the tube or insertion site
 Nausea and vomiting that may result from feeds that are
too large or fast or from slowed emptying of the stomach
 Skin irritation at the tube insertion point
 Diarrhea due to a liquid diet or possibly medications
 Tube dislodgement
 Tube blockage, which may occur if not flushed properly.

14. SUMMARY ON ENTERIC NUTRITION

15. 2)PARENTERAL FEEDING METHOD
INTRODUCTION
 Parenteral nutrition is intravenous administration of
nutrients which may include
protein,carbohydrate,fat,minerals and electrolytes
vitamins and other trace elements for patients who can
eat or absorb enough food through tube feeding formula
or by mouth to maintain good nutritional status.
 You'll have a type of venous access device, such as a port
or peripherally inserted catheter inserted so you can
receive liquid nutrition
 Achieving the right nutritional intake in a timely manner
can help combat complication and be an important part of
patient's recover parenteral nutrition is sometimes called
total parenteral nutrition
 Parenteral feeding can be a life saving option in many
circumstances, however its preferably to use enteral
nutrition if at all possible.

16. Types of parenteral feeding:
Peripheral parenteral nutrition-where someone gets supplementary nutrition
Total parenteral nutrition-you get all your nutrition requirements through the vein.

17. INDICATIONS & CONTRAINDICATIONS
Indications
 Inadequate absorption resulting from short bowel syndrome
 Gastrointestinal fistula
 Bowel obstruction
 Prolonged bowel rest
 Severe malnutrition ,significant weight loss and when enteral nutrition is not
possible
Contraindications
 Infant with less than 8cm of the small bowel
 Irreversibly decerebate patients
 Patients with critical cardiovascular instability or metabolic instabilities
 When GI feeding is possible

18. Complications of parenteral nutrition
 Fluids overload or dehydration
 Infection risk from the line
 Thrombosis
 Hyperglycemia
 Hypoglycemia
 Liver failure
 Micronutrient deficiency
THE END!

19. SUMMARY