常见管灌喂食之问题与对策.PPTVIP

常見管灌餵食之問題與對策 萬芳醫院 金美雲 Complications of enteral nutrition Access problems Pressure necrosis/ulceration/stenosis Tube displacement/migration Tube obstruction Leakage from ostomy /stoma site Complications of enteral nutrition Administration problems Regurgitation Aspiration Microbial contamination Complications of enteral nutrition Gastrointestinal complications Nausea/vomiting Diarrhea Distention/bloating/cramping Osmotic Delayed gastric emptying Secretory Constipation Drugs/medications High gastric residuals Treatment/therapies Hypoalbuminemia Maldigestion/malabsorption Formula choice/rate Complications of enteral nutrition Metabolic complications Refeeding syndrome Drug-nutrient interactions Glucose intolerance/hyperglycemia/hypoglycemia Hydration status-dehydration/overhydration Hyponatremia Hyperkalemia/hypokalemia Hyperphosphatemia/hypophosphatemia Micronutrient deficiencies Prevention or correction of tube-feeding complications Aspiration pneumonia Possible causes- compromised gastroesophageal sphincter, delayed gastric emptying, gastric obstruction Preventive/corrective measures- nasoenteric, gastrostomy, or jejunostomy feeding in high-risk clients small-diameter transnasal tube elevate head of bed during and 30 minutes after feeding continuous drip method of delivery check gastric residual ＊Stable patients, especially those on long-term feeding, do not need residuals checked regularly. Prevention or correction of tube-feeding complications Clogged feeding tube Possible causes- formula too thick for tube medications Preventive/corrective measures- select appropriate tube size, di