Special nutritional support (feeding methods).pptxSowmya Jaiswal
Nutritional support provides nourishment to patients who cannot eat normally. It involves either enteral or parenteral feeding. Enteral feeding delivers nutrients through the gastrointestinal tract using tubes, while parenteral feeding delivers nutrients intravenously. Transitional feeding involves gradually transitioning patients from parenteral to enteral feeding as their gastrointestinal function returns. Dietitians play an important role in assessing patients' nutritional needs, selecting appropriate formulas, educating patients, and managing complications during all stages of nutritional support.
This document discusses parenteral and enteral nutrition. It defines nutrition and describes the different types of nutrients including macronutrients like carbohydrates, proteins and fats, and micronutrients like vitamins and minerals. It then explains the different routes of providing nutrition, including oral, enteral via tubes like NG tubes or G-tubes, and parenteral or intravenous nutrition. Enteral nutrition is used when someone cannot eat orally but their GI tract is functional, while parenteral nutrition bypasses the GI tract by delivering nutrients intravenously. The document outlines common conditions where enteral or parenteral nutrition may be required.
This document discusses nutritional support for surgical patients. It begins by outlining the learning objectives which are to describe the pathophysiology and importance of nutritional support, the aims of support measures, and indications and complications of different forms of support. It then defines nutritional support and discusses the principles of support including indications for pre-operative and post-operative support via enteral or parenteral means. Specific patient factors that affect nutritional status and requirements are also outlined.
The document discusses parenteral and enteral nutrition for critically ill patients. It recommends early enteral nutrition within 48 hours for critically ill patients without contraindications to reduce infections and mortality. For patients who cannot tolerate enteral nutrition, initiating parenteral nutrition within the first few days may be considered for malnourished patients, though the effects are unknown. The complications, formulations, administration methods, and monitoring of both enteral and parenteral nutrition are also covered.
This chapter discusses meeting nutritional needs. It covers the importance of nutrition, factors affecting nutritional status, and methods for assessing nutritional status. The chapter outlines different diets like clear liquid, full liquid, and soft diets that can be used for various conditions. It also reviews therapeutic diets for restricting sodium, protein etc. The chapter focuses on the nurse's role in ensuring patients' nutritional needs are met through oral, enteral like nasogastric tube feeding, or parenteral nutrition. Complications of total parenteral nutrition and care for gastrointestinal procedures like gastric lavage are also addressed.
This document discusses parental nutrition, including its definition, indications, administration routes, formulation, and documentation. Parental nutrition involves infusing nutrients directly into the circulatory system to bypass the gastrointestinal tract. It is indicated for patients who cannot receive adequate nutrition enterally due to GI dysfunction. Formulations provide nitrogen, amino acids, energy sources like dextrose and lipids, electrolytes, trace elements, and vitamins. Components are individualized for each patient's needs. Monitoring is important when on parental nutrition.
Perspectives 29 Treating a Patient with an Intestinal Obstructiontourtt
Intestinal obstructions account for 20% of all acute surgical admissions. Mortality and morbidity are dependent on the early recognition and correct diagnosis of obstruction. If untreated, strangulated obstructions cause death in 100% of patients; however, the mortality rate decreases to 8% with prompt surgical intervention. Intestinal obstruction is caused by a variety of pathologic processes including postoperative adhesions, malignancy, Crohn's disease, and hernias. Dr. Kent outlines the diagnosis and perioperative treatment of patients with intestinal obstruction. Ms. Lau discusses the advantages of closed enteral feeding systems over open systems, including less bacterial contamination and safer increased hang times, which have the potential to improve patient outcomes and safety.
Special nutritional support (feeding methods).pptxSowmya Jaiswal
Nutritional support provides nourishment to patients who cannot eat normally. It involves either enteral or parenteral feeding. Enteral feeding delivers nutrients through the gastrointestinal tract using tubes, while parenteral feeding delivers nutrients intravenously. Transitional feeding involves gradually transitioning patients from parenteral to enteral feeding as their gastrointestinal function returns. Dietitians play an important role in assessing patients' nutritional needs, selecting appropriate formulas, educating patients, and managing complications during all stages of nutritional support.
This document discusses parenteral and enteral nutrition. It defines nutrition and describes the different types of nutrients including macronutrients like carbohydrates, proteins and fats, and micronutrients like vitamins and minerals. It then explains the different routes of providing nutrition, including oral, enteral via tubes like NG tubes or G-tubes, and parenteral or intravenous nutrition. Enteral nutrition is used when someone cannot eat orally but their GI tract is functional, while parenteral nutrition bypasses the GI tract by delivering nutrients intravenously. The document outlines common conditions where enteral or parenteral nutrition may be required.
This document discusses nutritional support for surgical patients. It begins by outlining the learning objectives which are to describe the pathophysiology and importance of nutritional support, the aims of support measures, and indications and complications of different forms of support. It then defines nutritional support and discusses the principles of support including indications for pre-operative and post-operative support via enteral or parenteral means. Specific patient factors that affect nutritional status and requirements are also outlined.
The document discusses parenteral and enteral nutrition for critically ill patients. It recommends early enteral nutrition within 48 hours for critically ill patients without contraindications to reduce infections and mortality. For patients who cannot tolerate enteral nutrition, initiating parenteral nutrition within the first few days may be considered for malnourished patients, though the effects are unknown. The complications, formulations, administration methods, and monitoring of both enteral and parenteral nutrition are also covered.
This chapter discusses meeting nutritional needs. It covers the importance of nutrition, factors affecting nutritional status, and methods for assessing nutritional status. The chapter outlines different diets like clear liquid, full liquid, and soft diets that can be used for various conditions. It also reviews therapeutic diets for restricting sodium, protein etc. The chapter focuses on the nurse's role in ensuring patients' nutritional needs are met through oral, enteral like nasogastric tube feeding, or parenteral nutrition. Complications of total parenteral nutrition and care for gastrointestinal procedures like gastric lavage are also addressed.
This document discusses parental nutrition, including its definition, indications, administration routes, formulation, and documentation. Parental nutrition involves infusing nutrients directly into the circulatory system to bypass the gastrointestinal tract. It is indicated for patients who cannot receive adequate nutrition enterally due to GI dysfunction. Formulations provide nitrogen, amino acids, energy sources like dextrose and lipids, electrolytes, trace elements, and vitamins. Components are individualized for each patient's needs. Monitoring is important when on parental nutrition.
Perspectives 29 Treating a Patient with an Intestinal Obstructiontourtt
Intestinal obstructions account for 20% of all acute surgical admissions. Mortality and morbidity are dependent on the early recognition and correct diagnosis of obstruction. If untreated, strangulated obstructions cause death in 100% of patients; however, the mortality rate decreases to 8% with prompt surgical intervention. Intestinal obstruction is caused by a variety of pathologic processes including postoperative adhesions, malignancy, Crohn's disease, and hernias. Dr. Kent outlines the diagnosis and perioperative treatment of patients with intestinal obstruction. Ms. Lau discusses the advantages of closed enteral feeding systems over open systems, including less bacterial contamination and safer increased hang times, which have the potential to improve patient outcomes and safety.
This document discusses enteral and parenteral feeding methods. Enteral feeding refers to delivering nutrients through the gastrointestinal tract, either orally or through tubes placed in the nose, mouth or abdomen. Tube feeding provides nutrition when oral intake is impaired. Parenteral feeding involves intravenous delivery of nutrients and is used when enteral feeding is not possible due to conditions like short bowel syndrome or bowel obstruction. Both methods aim to meet nutritional needs but parenteral feeding carries higher risks like infection and requires venous access.
Post surgery Nutrition- Semi elemental Formulaabir mukherjee
Nutritional support is important for patients after surgery to support recovery. Early enteral nutrition within 24-48 hours after surgery is recommended to improve outcomes as long as the patient is stable. Semi-elemental diets are better absorbed and tolerated for post-operative patients, helping to avoid total parenteral nutrition. Semi-elemental diets also help maintain gut integrity which is important for recovery and reducing risks of infection.
1. Nutrition is now recognized as an important subspecialty, as proper nutrition can improve patient outcomes like muscle strength, immune function, and wound healing.
2. Malnutrition is common in hospitalized patients, with 1/3 at risk, and even small amounts of weight loss are associated with worse outcomes. Nutritional support teams provide care for complex cases requiring enteral or parenteral nutrition.
3. Indications for nutritional support include a BMI <19, unintentional weight loss, and inability to meet nutritional needs enterally. Tube feeding is used when oral intake is inadequate, and parenteral nutrition is for intestinal failure when the gut cannot be used.
1) The document provides guidance on optimal nutrition therapy for ICU patients, post-ICU patients, and those in long-term recovery.
2) It recommends starting enteral nutrition within 48 hours of ICU admission and gradually increasing calories and proteins to prevent overfeeding and refeeding syndrome.
3) The optimal calorie and protein targets may vary during the different phases of recovery; at least 1.3 g/kg/day of proteins should be targeted after the initial ICU phase.
The document discusses nutrition support and the conditions that require specialized nutrition through enteral or parenteral means. It covers the indications, contraindications, advantages, and disadvantages of enteral nutrition support through various tube feeding routes and administration methods. The roles and responsibilities of nutrition support dietitians in implementing individualized nutrition care plans are also outlined.
Nutrition is important for surgical patients. Malnutrition can compound complications, while well-nourished patients tolerate surgery better. Several factors are used to assess a patient's nutritional status prior to surgery, including weight loss, serum albumin levels, and medical history. For patients who cannot eat adequately after surgery, enteral or parenteral nutrition may be needed to meet nutrient demands and support healing. Enteral nutrition involves feeding through a stomach or intestinal tube, while parenteral nutrition is administered intravenously.
This document discusses malnutrition in hospital patients and nutritional support. It provides information on screening patients for malnutrition, who needs nutritional support, the benefits of support, and enteral and parenteral nutrition routes and guidelines. Key points include that many hospital patients are malnourished due to increased needs, losses, or decreased intake; screening involves history, exam, and labs; and enteral nutrition is preferred over parenteral when possible due to fewer complications.
This document provides an overview of key concepts related to nutrition. It begins by defining nutrition and identifying the physiological value of nutrients. It then describes how diet guidelines and menu planning can promote nutrition and health. Culture and age-related changes that can influence nutritional status are also discussed. The document outlines the process of assessing a client's nutritional status and preparing food for sick patients. Expected outcomes of nursing interventions that promote optimal nutrition are described. Common nursing interventions for nutritional deficits are identified. The roles of nutritional support teams are discussed. Indications for different feeding methods like enteral and parenteral nutrition are explained.
This document discusses nutrition support for critically ill patients in the intensive care unit (ICU). It provides a brief history of ICU nutrition and outlines the basis for nutritional support. Nutritional support is important to address the catabolism and malnutrition that often develops in critically ill patients. Enteral nutrition is preferred over parenteral nutrition when possible due to lower risks of infection and preservation of gut function. The document reviews nutritional requirements, supplementation, routes of administration including enteral and parenteral options, and potential complications of nutrition support.
Nutritional support is important for surgical patients to prevent complications. Three key aspects of nutritional support discussed are:
1) Enteral nutrition is preferred over parenteral nutrition when possible, with a hierarchy of feeding methods from oral to tube feeding to be followed.
2) Malnutrition increases surgical risk, so nutritional screening and optimization of intake, including supplementation, is important pre-and post-operatively.
3) Close monitoring of caloric and protein intake as well as electrolytes and glucose is needed for patients receiving enteral or parenteral nutrition support.
This document provides an overview of nutrition in surgical patients. It discusses the basics of nutrition including caloric and protein requirements. The importance of nutrition for surgical patients is described along with the complications of malnutrition like infection and poor wound healing. Methods of nutritional assessment involving history, exams, and labs are outlined. Both enteral and parenteral nutrition are covered, including indications, contraindications, administration methods, and potential complications. The take home messages emphasize the importance of meeting caloric needs to avoid complications, using enteral nutrition when possible, and closely monitoring patients on nutrition support.
Nutritional depletion is common in hospitalized patients, especially the elderly. While enteral nutrition is preferred when possible, total parenteral nutrition (TPN) is an option but provides no survival benefit and increased complications. For patients who can eat, balanced meals should be provided with assistance as needed. A percutaneous endoscopic gastrostomy (PEG) tube may be considered for long-term enteral feeding over 1 month but outcomes are unclear in advanced dementia, so alternative strategies like hand feeding should be discussed.
Surgical Nutrition Insights - Dr Valeria Simone MDMeghaSingh194
Surgical nutrition plays a crucial role in optimizing patient outcomes and promoting the healing process. As advancements in surgical techniques continue to evolve, so does the understanding of the impact of nutrition on postoperative recovery. Let's explore more: https://www.southlakegeneralsurgery.com/surgical-nutrition-insights/
1. Critical illness such as sepsis can lead to catabolism and muscle wasting. Early enteral or parenteral nutrition is recommended to improve outcomes.
2. Malnutrition is common in patients with conditions like liver or renal failure, burns, neurological disorders, and short bowel syndrome. Nutritional support aims to meet caloric and protein needs based on the individual's condition.
3. Enteral nutrition is preferred over parenteral when possible due to lower risks of infection and other complications. Early initiation of feeding within 24-48 hours of admission is recommended for many critically ill patients.
Importance of nutritional management during hospitalizationBushra Tariq
The document discusses the importance of nutritional management for hospitalized patients. It notes that up to 50% of hospitalized patients experience some degree of malnutrition. Providing adequate nutrition support through enteral or parenteral nutrition can improve patient outcomes, reduce recovery time, and lower healthcare costs. The document provides guidelines for estimating caloric and protein needs for critically ill patients and recommends early enteral nutrition within 24-48 hours when possible to support gut health and integrity.
Total parenteral nutrition (TPN) provides complete nutrition to patients intravenously when they cannot eat or absorb enough nutrients from food. It is used when the enteral route is unable to sustain sufficient caloric intake. TPN can be administered peripherally through arm veins for short term use or centrally through larger veins for longer term needs. While enteral nutrition is preferred when possible due to its benefits, TPN is important for patients who cannot or should not eat to prevent complications from malnutrition. Careful monitoring is needed with TPN to address nutrient needs and avoid potential complications.
This document discusses nutrition in surgical patients. It begins with the basics of nutrition including definitions of malnutrition and nutritional requirements. The importance of proper nutrition for surgical patients is described along with methods for nutritional assessment. Both enteral and parenteral nutrition are covered, including indications, contraindications, administration methods, and potential complications. The document emphasizes the importance of a multidisciplinary approach and initiating nutrition support early to optimize surgical outcomes.
This document discusses nutrition and nutritional support for patients. It notes that malnutrition is common in hospitalized patients, especially those with gastrointestinal diseases or postoperative complications, and that malnourished patients have higher risks of complications and death. The aim of nutritional support is to identify at-risk patients and meet their nutritional needs through the most appropriate route to minimize complications. Methods of assessment and artificial nutritional support through enteral or parenteral means are described, along with their potential complications.
This document discusses nutrition support in surgery patients. It notes that the aim of nutrition support is to identify malnourished patients and meet their nutritional needs, as malnutrition increases risks of complications and mortality. It covers nutritional requirements, types of malnutrition, nutritional assessment techniques, indications for enteral and parenteral nutrition support, complications of both, and combinations of enteral and parenteral feeding.
This document discusses nutrition and fasting in chronic liver disease. It outlines several metabolic changes that occur in chronic liver disease, including decreased glycogen stores and glucose intolerance. It provides general nutrition guidelines for patients with liver disease, recommending adequate calories, proteins, vitamins and minerals. It discusses the benefits of fasting, including detoxification, reduced inflammation, blood sugar and weight loss. However, it notes fasting can worsen conditions in some patients and is not advised for all cases of liver disease.
Mr. Harshal Pangar, a 16-year-old male, presented with a 3-month history of a lump on his left arm that increased in size and caused pressing pain, worsened by lifting heavy weights or long writing. Examination found a round, movable lump without discoloration. Investigations including biopsy confirmed a diagnosis of lipoma. Analysis of the case found key symptoms of desiring spicy non-veg food, aversion to milk and spinach, and thermally being chilly. Belladonna 200 potency was prescribed twice daily for 7 days based on the susceptibility of the patient and characteristic symptoms matching the remedy.
This document discusses acute peritonitis, including its definition, causes, routes of spreading, microbiology, and types (localized vs diffuse). Peritonitis is defined as inflammation of the peritoneum, which can be caused by bacterial or chemical sources. Common causes include gastrointestinal perforation or translocation. Gram-negative bacteria are frequently involved and can cause endotoxic shock. Peritonitis may spread via the bowel, female genital tract, or hematogenously. Localized peritonitis remains confined to areas like the pelvis or subphrenic space due to anatomical barriers, while diffuse peritonitis spreads more widely in the peritoneal cavity.
This document discusses enteral and parenteral feeding methods. Enteral feeding refers to delivering nutrients through the gastrointestinal tract, either orally or through tubes placed in the nose, mouth or abdomen. Tube feeding provides nutrition when oral intake is impaired. Parenteral feeding involves intravenous delivery of nutrients and is used when enteral feeding is not possible due to conditions like short bowel syndrome or bowel obstruction. Both methods aim to meet nutritional needs but parenteral feeding carries higher risks like infection and requires venous access.
Post surgery Nutrition- Semi elemental Formulaabir mukherjee
Nutritional support is important for patients after surgery to support recovery. Early enteral nutrition within 24-48 hours after surgery is recommended to improve outcomes as long as the patient is stable. Semi-elemental diets are better absorbed and tolerated for post-operative patients, helping to avoid total parenteral nutrition. Semi-elemental diets also help maintain gut integrity which is important for recovery and reducing risks of infection.
1. Nutrition is now recognized as an important subspecialty, as proper nutrition can improve patient outcomes like muscle strength, immune function, and wound healing.
2. Malnutrition is common in hospitalized patients, with 1/3 at risk, and even small amounts of weight loss are associated with worse outcomes. Nutritional support teams provide care for complex cases requiring enteral or parenteral nutrition.
3. Indications for nutritional support include a BMI <19, unintentional weight loss, and inability to meet nutritional needs enterally. Tube feeding is used when oral intake is inadequate, and parenteral nutrition is for intestinal failure when the gut cannot be used.
1) The document provides guidance on optimal nutrition therapy for ICU patients, post-ICU patients, and those in long-term recovery.
2) It recommends starting enteral nutrition within 48 hours of ICU admission and gradually increasing calories and proteins to prevent overfeeding and refeeding syndrome.
3) The optimal calorie and protein targets may vary during the different phases of recovery; at least 1.3 g/kg/day of proteins should be targeted after the initial ICU phase.
The document discusses nutrition support and the conditions that require specialized nutrition through enteral or parenteral means. It covers the indications, contraindications, advantages, and disadvantages of enteral nutrition support through various tube feeding routes and administration methods. The roles and responsibilities of nutrition support dietitians in implementing individualized nutrition care plans are also outlined.
Nutrition is important for surgical patients. Malnutrition can compound complications, while well-nourished patients tolerate surgery better. Several factors are used to assess a patient's nutritional status prior to surgery, including weight loss, serum albumin levels, and medical history. For patients who cannot eat adequately after surgery, enteral or parenteral nutrition may be needed to meet nutrient demands and support healing. Enteral nutrition involves feeding through a stomach or intestinal tube, while parenteral nutrition is administered intravenously.
This document discusses malnutrition in hospital patients and nutritional support. It provides information on screening patients for malnutrition, who needs nutritional support, the benefits of support, and enteral and parenteral nutrition routes and guidelines. Key points include that many hospital patients are malnourished due to increased needs, losses, or decreased intake; screening involves history, exam, and labs; and enteral nutrition is preferred over parenteral when possible due to fewer complications.
This document provides an overview of key concepts related to nutrition. It begins by defining nutrition and identifying the physiological value of nutrients. It then describes how diet guidelines and menu planning can promote nutrition and health. Culture and age-related changes that can influence nutritional status are also discussed. The document outlines the process of assessing a client's nutritional status and preparing food for sick patients. Expected outcomes of nursing interventions that promote optimal nutrition are described. Common nursing interventions for nutritional deficits are identified. The roles of nutritional support teams are discussed. Indications for different feeding methods like enteral and parenteral nutrition are explained.
This document discusses nutrition support for critically ill patients in the intensive care unit (ICU). It provides a brief history of ICU nutrition and outlines the basis for nutritional support. Nutritional support is important to address the catabolism and malnutrition that often develops in critically ill patients. Enteral nutrition is preferred over parenteral nutrition when possible due to lower risks of infection and preservation of gut function. The document reviews nutritional requirements, supplementation, routes of administration including enteral and parenteral options, and potential complications of nutrition support.
Nutritional support is important for surgical patients to prevent complications. Three key aspects of nutritional support discussed are:
1) Enteral nutrition is preferred over parenteral nutrition when possible, with a hierarchy of feeding methods from oral to tube feeding to be followed.
2) Malnutrition increases surgical risk, so nutritional screening and optimization of intake, including supplementation, is important pre-and post-operatively.
3) Close monitoring of caloric and protein intake as well as electrolytes and glucose is needed for patients receiving enteral or parenteral nutrition support.
This document provides an overview of nutrition in surgical patients. It discusses the basics of nutrition including caloric and protein requirements. The importance of nutrition for surgical patients is described along with the complications of malnutrition like infection and poor wound healing. Methods of nutritional assessment involving history, exams, and labs are outlined. Both enteral and parenteral nutrition are covered, including indications, contraindications, administration methods, and potential complications. The take home messages emphasize the importance of meeting caloric needs to avoid complications, using enteral nutrition when possible, and closely monitoring patients on nutrition support.
Nutritional depletion is common in hospitalized patients, especially the elderly. While enteral nutrition is preferred when possible, total parenteral nutrition (TPN) is an option but provides no survival benefit and increased complications. For patients who can eat, balanced meals should be provided with assistance as needed. A percutaneous endoscopic gastrostomy (PEG) tube may be considered for long-term enteral feeding over 1 month but outcomes are unclear in advanced dementia, so alternative strategies like hand feeding should be discussed.
Surgical Nutrition Insights - Dr Valeria Simone MDMeghaSingh194
Surgical nutrition plays a crucial role in optimizing patient outcomes and promoting the healing process. As advancements in surgical techniques continue to evolve, so does the understanding of the impact of nutrition on postoperative recovery. Let's explore more: https://www.southlakegeneralsurgery.com/surgical-nutrition-insights/
1. Critical illness such as sepsis can lead to catabolism and muscle wasting. Early enteral or parenteral nutrition is recommended to improve outcomes.
2. Malnutrition is common in patients with conditions like liver or renal failure, burns, neurological disorders, and short bowel syndrome. Nutritional support aims to meet caloric and protein needs based on the individual's condition.
3. Enteral nutrition is preferred over parenteral when possible due to lower risks of infection and other complications. Early initiation of feeding within 24-48 hours of admission is recommended for many critically ill patients.
Importance of nutritional management during hospitalizationBushra Tariq
The document discusses the importance of nutritional management for hospitalized patients. It notes that up to 50% of hospitalized patients experience some degree of malnutrition. Providing adequate nutrition support through enteral or parenteral nutrition can improve patient outcomes, reduce recovery time, and lower healthcare costs. The document provides guidelines for estimating caloric and protein needs for critically ill patients and recommends early enteral nutrition within 24-48 hours when possible to support gut health and integrity.
Total parenteral nutrition (TPN) provides complete nutrition to patients intravenously when they cannot eat or absorb enough nutrients from food. It is used when the enteral route is unable to sustain sufficient caloric intake. TPN can be administered peripherally through arm veins for short term use or centrally through larger veins for longer term needs. While enteral nutrition is preferred when possible due to its benefits, TPN is important for patients who cannot or should not eat to prevent complications from malnutrition. Careful monitoring is needed with TPN to address nutrient needs and avoid potential complications.
This document discusses nutrition in surgical patients. It begins with the basics of nutrition including definitions of malnutrition and nutritional requirements. The importance of proper nutrition for surgical patients is described along with methods for nutritional assessment. Both enteral and parenteral nutrition are covered, including indications, contraindications, administration methods, and potential complications. The document emphasizes the importance of a multidisciplinary approach and initiating nutrition support early to optimize surgical outcomes.
This document discusses nutrition and nutritional support for patients. It notes that malnutrition is common in hospitalized patients, especially those with gastrointestinal diseases or postoperative complications, and that malnourished patients have higher risks of complications and death. The aim of nutritional support is to identify at-risk patients and meet their nutritional needs through the most appropriate route to minimize complications. Methods of assessment and artificial nutritional support through enteral or parenteral means are described, along with their potential complications.
This document discusses nutrition support in surgery patients. It notes that the aim of nutrition support is to identify malnourished patients and meet their nutritional needs, as malnutrition increases risks of complications and mortality. It covers nutritional requirements, types of malnutrition, nutritional assessment techniques, indications for enteral and parenteral nutrition support, complications of both, and combinations of enteral and parenteral feeding.
This document discusses nutrition and fasting in chronic liver disease. It outlines several metabolic changes that occur in chronic liver disease, including decreased glycogen stores and glucose intolerance. It provides general nutrition guidelines for patients with liver disease, recommending adequate calories, proteins, vitamins and minerals. It discusses the benefits of fasting, including detoxification, reduced inflammation, blood sugar and weight loss. However, it notes fasting can worsen conditions in some patients and is not advised for all cases of liver disease.
Mr. Harshal Pangar, a 16-year-old male, presented with a 3-month history of a lump on his left arm that increased in size and caused pressing pain, worsened by lifting heavy weights or long writing. Examination found a round, movable lump without discoloration. Investigations including biopsy confirmed a diagnosis of lipoma. Analysis of the case found key symptoms of desiring spicy non-veg food, aversion to milk and spinach, and thermally being chilly. Belladonna 200 potency was prescribed twice daily for 7 days based on the susceptibility of the patient and characteristic symptoms matching the remedy.
This document discusses acute peritonitis, including its definition, causes, routes of spreading, microbiology, and types (localized vs diffuse). Peritonitis is defined as inflammation of the peritoneum, which can be caused by bacterial or chemical sources. Common causes include gastrointestinal perforation or translocation. Gram-negative bacteria are frequently involved and can cause endotoxic shock. Peritonitis may spread via the bowel, female genital tract, or hematogenously. Localized peritonitis remains confined to areas like the pelvis or subphrenic space due to anatomical barriers, while diffuse peritonitis spreads more widely in the peritoneal cavity.
This document discusses acute peritonitis, including its definition, causes, routes of spreading, microbiological aspects, and types (localized vs diffuse). Peritonitis is defined as inflammation of the peritoneum, which can be caused by bacterial or chemical sources. Common causes include gastrointestinal perforation or translocation. Gram-negative bacteria are frequently involved and can cause endotoxic shock. Localized peritonitis is often confined by anatomical barriers, while diffuse peritonitis more easily spreads in the peritoneal cavity.
The document provides medical information about a 38-year-old female patient presenting with varicose veins. She has a 10-year history of cramping and burning pain in her lower limbs that worsens with exertion. On examination, dilated and tortuous veins are visible on her legs. Based on her symptoms, medical history, and homeopathic principles, Pulsatilla 30 is prescribed for 7 days to address her varicose vein symptoms. Follow-up is planned to assess treatment response.
The document discusses various theories about how homeopathy works from the perspectives of Samuel Hahnemann, the founder of homeopathy, and James Tyler Kent, a 19th century homeopath. It explores their views that highly diluted substances can still be therapeutic and that potentization reduces remedies to their "simple substance" which is endowed with formative intelligence from God and stimulates the vital force. The document also examines the nature and qualities of the vital force and simple substances, how they adapt, dominate the body, and are subject to continuous reduction while maintaining their identity.
This document discusses various methods for analyzing and evaluating symptoms in homeopathic case taking and remedy selection. It describes Hahnemannian, Kentian, Boenninghausen, and Boericke methods for categorizing symptoms as general, common, or particular. Mental and physical general symptoms are given higher priority than others. After analyzing the totality of a case, the symptoms are arranged according to repertory rubrics to form a repertorial totality to aid remedy selection. The goal is to identify the most important and characteristic symptoms to accurately match the individual case picture to the remedy picture.
The document discusses the importance of thoroughly documenting a patient's full set of symptoms in order to determine the most appropriate homeopathic treatment. It notes that no single patient exhibits all the symptoms of a disease, so physicians must examine multiple patients to develop a complete picture. This is especially important for chronic diseases like psora, where individual patients only show a portion of overall symptoms. Once a full symptom profile is established, physicians can select a similar medicinal substance from known remedies to target the whole disease state.
This document provides information on various infectious skin conditions and their homeopathic management. It discusses boils, carbuncles, abscesses, cellulitis, and erysipelas. For each condition, it describes the definition, etiology, clinical features, and suitable homeopathic remedies. Belladonna, Hepar sulph, Petroleum, Arsenicum album, and Tarentula cubensis are some of the remedies mentioned for treating boils, carbuncles and abscesses.
This document provides guidance on basic first aid procedures for common medical emergencies. It outlines steps to take for issues like breathing problems, bleeding, shock, choking, burns, broken bones, heat-related illnesses, fainting, seizures and more. Key advice includes assessing the safety of the scene, prioritizing care, controlling bleeding, administering CPR if needed, cooling down heatstroke victims, and knowing when to call emergency services. Being trained in first aid and CPR is recommended so one can effectively handle emergencies.
The document outlines principles and techniques for administering first aid in medical emergencies. It discusses assessing the scene, prioritizing care, and providing treatment for issues like bleeding, shock, burns, fractures, and more. The objectives are to recognize benefits of first aid training, identify proper emergency procedures, and assist coworkers while avoiding further harm.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
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What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
Gender and Mental Health - Counselling and Family Therapy Applications and In...PsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
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Philippine Edukasyong Pantahanan at Pangkabuhayan (EPP) CurriculumMJDuyan
(𝐓𝐋𝐄 𝟏𝟎𝟎) (𝐋𝐞𝐬𝐬𝐨𝐧 𝟏)-𝐏𝐫𝐞𝐥𝐢𝐦𝐬
𝐃𝐢𝐬𝐜𝐮𝐬𝐬 𝐭𝐡𝐞 𝐄𝐏𝐏 𝐂𝐮𝐫𝐫𝐢𝐜𝐮𝐥𝐮𝐦 𝐢𝐧 𝐭𝐡𝐞 𝐏𝐡𝐢𝐥𝐢𝐩𝐩𝐢𝐧𝐞𝐬:
- Understand the goals and objectives of the Edukasyong Pantahanan at Pangkabuhayan (EPP) curriculum, recognizing its importance in fostering practical life skills and values among students. Students will also be able to identify the key components and subjects covered, such as agriculture, home economics, industrial arts, and information and communication technology.
𝐄𝐱𝐩𝐥𝐚𝐢𝐧 𝐭𝐡𝐞 𝐍𝐚𝐭𝐮𝐫𝐞 𝐚𝐧𝐝 𝐒𝐜𝐨𝐩𝐞 𝐨𝐟 𝐚𝐧 𝐄𝐧𝐭𝐫𝐞𝐩𝐫𝐞𝐧𝐞𝐮𝐫:
-Define entrepreneurship, distinguishing it from general business activities by emphasizing its focus on innovation, risk-taking, and value creation. Students will describe the characteristics and traits of successful entrepreneurs, including their roles and responsibilities, and discuss the broader economic and social impacts of entrepreneurial activities on both local and global scales.
This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
3. In last two decades, there has been an
increasing realization of key role that nutrition
plays in surgery.
The operative results in terms of morbidity and
survival are usually the best when patients are
in good nutritional state, and worst when
malnourished.
Surgical procedures temporarily interfere with
the digestive, absorptive, and assimilative
function of body at a time when nutritional
requirements are more.
6. 1. Enteral nutrition refers to any method of
feeding that uses the gastrointestinal (GI) tract
to deliver nutrition and calories. It can include a
normal oral diet, the use of liquid supplements
or delivery by use of a tube (tube feeding).
2. There are many reasons for enteral and
parenteral nutrition including GI disorders such
as bowel obstruction, short bowel syndrome,
Crohn's disease, and ulcerative colitis; as well as
certain cancers or in comatose patients.
7. 1. When patients have problems with eating or
digestion, it is sometimes necessary to
provide nutrition with artificial food, which is
specially formulated to provide the right
balance of fats, proteins, sugars, vitamins and
minerals.
2. These artificial preparations can be delivered
into the gut to be absorbed in the usual way,
which is known as Enteral Nutrition.
8. Indications for the use of EN-
1. Intestinal fistulae
2. Short Bowel Syndrome-a. Messenteric
infarction
b. Internal or External herniation with
strangulation.
c. Major abdominal trauma.
d. IBD- Crohn's Disease.
11. • Parenteral nutrition refers to the delivery of
calories and nutrients into a vein. This could
be as simple as carbohydrate calories
delivered as simple sugar in an intravenous
solution or all of the required nutrients could
be delivered including carbohydrate, protein,
fat, electrolytes (for example sodium and
potassium), vitamins and trace elements (for
example copper and zinc).
12. If the patients gut cannot be used to absorb
nutrients, then nutrition must be delivered into the
patient’s blood stream, bypassing the gut. Reasons
for this type of feeding include-
1. Intestinal Obstruction, Paralytic ileus.
2. Perforations of the gut where feeding will result
in worsening infections.
3. Where a large part of the gut has been removed
and the patient cannot absorb enough food (short
bowel syndrome)
4. Where parts of the bowel are diseased and not
able to absorb properly (functional short bowel)
13. Parenteral nutrition is slowly pumped into the
blood stream through a drip. As it can be very
irritant to blood vessels, it is normally given into
a large vein near the heart though a central
venous line placed into the upper arm, chest or
neck. Using parenteral nutrition can sometimes
result in serious problems such as blood
infections or an upset in biochemistry.
Therefore, patients need intensive monitoring.
14. Indications for the use of TPN-
1. Alimentary tract obstruction secondary to
neoplasm or stricture of oesophagus, gastric
carcinoma or pyloric obstruction
2. Paralytic ileus
3. Ulcerative colitis/crohns disease/ tuberculous
enteritis)
4. Acute pancreatitis
15.
16.
17. Recovery from any nutritional deficit will follow
on the return of normal feeding.
Any delay in return to normal diet such as may
be imposed by nature of operation e.g.
Oesophagectomy or complications of surgical
procedures(ileus, peritonitis ,intestinal fistulae,
sepsis and shock) can severely aggravate
problems of maintaining nutrition.
Malnutrition causes delay in wound healing and
increases susceptibility to infection.
18. Nutritional intake is low in post operative
patients on IV fluids alone, in those with
dysphagia, anorexia and many of cancer
patients.
Energy output is more in hyper metabolic state
like severe stress, major trauma, pyrexia.
19. • Nutritional support in renal diseases-
1. Partial EN (enteral nutrition) should always
be aimed for in patients with renal failure
that require nutritional support.
2. Patients with renal failure who show marked
metabolic derangements and changes in
nutritional requirements require the use of
specifically adapted nutrient solutions.
3. Patients under HD have a higher risk of
developing malnutrition. Intradialytic PN
(IDPN) should be used if causes of
malnutrition cannot be eliminated and other
interventions fail.
20. 4. IDPN should only be carried out when
modifiable causes of malnutrition are excluded
and enhanced oral (like i.e. additional energy
drinks) or enteral supply is unsuccessful or
cannot be carried out.
21. • Nutritional support in liver diseases-
1. Protein malnutrition is advance feature of
liver disease.
2. Most important nutritional indicator is
hypoalbuminaemia.
3. Objective of nutritional support in liver
failure is to provide adequate calories and
proteins without aggravating hepatic
encephalopathy.
22. 4. An adequate nutritional support is essential in
liver disease to sustain hepatic function and to
promote the hepatic regeneration.
5. In patients of liver disease who unable to
tolerate oral feeding TPN is acceptable means of
providing optimal nutritional support.