Canterbury DHB

Context

Levels of Nutrition Support

See also:

In This Section

Level 1 - Oral diet and Nutritional Supplements

Level 2 - Enteral nutrition

Level 3 - Parenteral nutrition

Level 1 - Oral diet and Nutritional Supplements

Level 2 - Enteral nutrition

Refers to the use of a feeding tube such as nasogastric (NG), nasojejunal (NJ), or percutaneous endoscopic gastronomy (PEG) to deliver nutrition to a patient's gastrointestinal (GI) tract.

Consider when:

Enteral nutrition may be used as the sole source of nutrition, or in conjunction with oral or parenteral intake to help patients meet their nutritional requirements. The feed is provided by a feeding pump – either continuously over 24 hours or over partial hours of the day e.g., overnight.

Nasogastric tube insertion is completed by a nurse experienced in placing NG tubes. Preferred NG tube sizes are 10F 109 cm. These are kept on BMTU.

A post-insertion X-ray is required to check location before use.

Three feeding pumps are kept in the BMTU. Source any additional feeding pumps via the Orderly Department from Nutrition Services (PMS code: NS).

For more information, see Nasogastric Tube Insertion in Adults on Hospital HealthPathways.

Level 3 - Parenteral nutrition

Refers to the use of intravenous (IV) nutrition given via central line such as a Hickman, PICC or HICC.

Consider when:

PN consists of three nutrient components: dextrose, protein, and lipid. The formula provides water, protein, carbohydrate, and ions (including sodium, potassium, phosphate, magnesium). The concentrations of ions can be adjusted depending on the patient's bloods. Calcium, vitamins, and trace elements (zinc, copper, manganese, iodine, and selenium) are added to the bags.

Parenteral nutrition is available in four different formulations:

Daily monitoring of electrolytes is required – full electrolytes including phosphate. Bloods (BMTP or TPN2) should be taken early morning (6 am)

About this Canterbury DHB document (5053):

Document Owner:

Sean Macpherson (see Who's Who)

Issue Date:

January 2019

Next Review:

January 2022

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 5053