Feeding of seriously ill
Feeding the severely ill requires a special approach and is difficult due to a decrease in appetite and weakness of the masticatory and swallowing movements that result from the restriction of motor activity. In such cases, the patient needs to be fed more often, in small portions, with a spoon. In the dietary regime, allowable and prohibited foods should be considered. Thick food should be diluted with milk, broth or juice and after swallowing give a drink from an appetizer or spoon.
To feed the patient is necessary in a quiet environment, without distracting his attention, for example, by light stimuli or by talking.
Severely ill patients are fed in bed. To do this, they should be given a comfortable sitting or semi-sitting position, or raise their head, laying it on the supplied hand of the nurse.
You can not hurry, otherwise the patient can choke. It is important to ensure that food is not too hot or cold. The number of feedings is usually increased to 5-6 times a day with a relatively small amount of food per meal. Food for the seriously ill should be fully nutritional and vitamin-enriched.
Feeding through the probe
In the unconscious state of a patient or mental disorders, accompanied by a complete refusal of food intake, as well as traumatic injuries of the oral organs, they resort to feeding through the probe. In this way, children with deep prematurity are fed when they lack sucking and swallowing reflexes.
For feeding, prepare a thin gastric tube without olive, a funnel with a capacity of 150-200 ml, a syringe of Janet and 1-2 glasses of liquid or semi-liquid food. The probe, funnel and syringe must be sterilized by boiling and cooled to the temperature of the patient's body. The probe is inserted through the nasal passage. Preliminary nasal passages are examined, cleared of crusts and mucus;The rounded end of the probe is lubricated with glycerin.
When the probe reaches the posterior wall of the oropharynx, the patient( if conscious) is asked to take a swallowing movement or carefully, pushing the index finger through the patient's mouth, lightly press the probe to the back wall of the pharynx, pushing it further along the esophagus, bypassing the larynx and trachea.
When a probe hits the larynx and trachea, it usually causes wheezing stenotic breathing and coughing. In this case, the probe should be pulled back somewhat, let the patient calm down and, as indicated above, gently move the probe along the esophagus into the stomach - approximately to 35-45 cm depending on the patient's growth. To make sure that the probe did not hit the trachea, a piece of cotton wool or tissue paper was brought to its outer end. If cotton wool or paper does not move synchronously with the patient's breathing, they begin to introduce cooked food. In the funnel, the food is poured in small portions or slowly, with stops inserted through the probe using a syringe by Janet. During feeding, you must ensure that the lumen of the probe is not filled, and regularly "wash" it with tea, juice or broth.
After feeding, the funnel and syringe are washed and boiled. The probe is left in the stomach for 4-5 days. The outer end of the probe is attached with an adhesive plaster to the cheek and head of the patient. It is necessary to ensure that the patient does not pull the probe.
Nutrition through the rectum
When poisoning with salts of heavy metals, the patient is taken to the rectum through the rectum.
To this end, most commonly:
• isotonic solutions: 0.85% sodium chloride solution, 5% glucose solution;
• preparations: an aminopeptide for microbiological nutrient media, liquid, alvezine, hydrolysates of a casein containing a full set of amino acids.
Before the introduction of the nutrient solution, the patient is treated with a cleansing enema. After this, the intestines should be allowed time to calm down. Nutrient solutions and liquids are introduced heated to a temperature of 38-40 ° C by a drip or at one time by 50-100 ml 3-4 times a day. For attenuated, elderly, patients with damage to the large intestine and incontinence, use is made of the drip method, since they do not hold nutrient solutions poorly at one-time administration.