Immunity, inflammation and infection-
Healthcare associated infections
- may be used to check for blood, parasites, bile, pathogenic organisms, fecal fat, and WBC
- collect in clean, dry container, no urine- destroys parasites, TP contains bismuth that ibterferes with test.
- Deliver specimen to lab immediately, if temp storage, parasite and ove warm, pathogens refrigerated.
- depending on what they are testing- blood= no red meat 2-3 days before.
- drugs salicylate, ascorbic acid, anticoagulants and steroids may interfere
- if visible bloos and or mucus, include it in the specimen.
Enteral tube feedings
- confirm placemet of tube before feeding
- radiographucal is most reliable but not practical
- PH <5 grassy green, clear and colorless and brown
- elevate head 30 degress before and after feeding for 30 minutes
- stop feeding if patient has nausea or pain
- dumping syndrome may occure in very fast feedings
- S/S of dumping: cold sweat, abdominal distention, dizziness, weakness, rapid HR, nausea and diarrhea
Total Parenteral Nutrition (TPN)
- bypasses the digestive tract, nutrients go straight to blood stream
- catheter, central venous or peripherally inserted cath in to large vein
- feeding passes directly to vena cava and RA
- allows for rapid dilution of concentrated feeding
- never administer TPN to smaller vein B/C it would cause throkmbophlebitis
- nutritin can obly be- water, glucose, electrolytes, minerals, and vitamins.
- short term
- 2 types of solutions used- glucose, amino acids, vitamins and minerals
- circulatory overload if infused too fast- changes in blood glucose, or diuresis
types of stomatitis
- Canker sore ( aphthous) Cause- virus or immune system, tx: topical orsystemic corticosteroids-start tx when earliest s/s begin,
- Cold Sores (HS type 1) cause- virus, tx: oral antivirals, acyclovir, valacyclovir nd famciclovir. triggers: stress, excessive sun exposure and URI
- Thrush (candidiasis) cause- candida albicans- yeat tx: antifungals- nystatin- overgrowth of normal flora often triggered by steroid or antibiotic treatment.
mouth shit interventions
- gentle oral hygiene
- medicated mouth wash
- exclude rough or spicy foods
- use soft toothbrush
- high calorie, high protein diet recomended for cancer patients
- adjust size and texture of foods
- errect position preferred
- increase LES pressure
- administer prescribed drugs, that increase LES pressure, neutralize acid, and reduce acid secretions.
- dietary alterations, changes in position.
- avoid food/fluid 2-3 hrs before bedtime to avoid aspiration
- elevate bed 6-12 inches for pt with hiatial hermia
- monitor wt changes
- small frequent meals
- avoid fatty foods, caffeine, chocolate and alcohol
- avoid acidic and spicy foods
dumping syndrome pt teaching
- consume low carbs, refined sugar, moderate in fat, moderate to high protein aka keto
- smaller, frequent meals
- fluids between meals not with them
- lie down for 30 minutes
post sx intervention bypass