nutrition- noteson i c u nursing（营养——noteson我c u护理）.doc

Nutrition 8/ 2004 How important is nutrition for patients in the MICU? When should I start thinking about nutrition for my patient? What kinds of nutrition are available for MICU patients? How do we figure out what kind of nutrition my patient should or shouldn’t get? What kinds of stomach-access devices are there? 5-1- Salem sumps 5-2- Enteroflexes and Dobhoffs 5-3- G-tubes 5-4- J-tubes (elemental liquid nutrition) How do I make sure that the feeding tube is in the right place, and what can happen if it’s not? How do I make sure that the patient is absorbing the nutrition I’m giving? What labs should I watch? What is the big deal with serum albumin? 9-1- What is a normal albumin? 9-2- What is oncotic pressure? What does albumin have to do with oncotic pressure? What does “third-spaced” mean? Should my patient be getting IV albumin? What is TPN? What is hyperal? 11-1- Why does TPN have to run centrally? Can TPN run through a PICC line? 11-2- Why does TPN have to have a line to itself? 11-3- Can anything run in the same line with TPN? 11-4- Why is it white? 11-5- Why is it sometimes clear and sort of yellowish/greenish? 11-6- What if my patient is on propofol? Why does the team sometimes seem to wait so long before they start my patient on TPN? Do patients on TPN make stool? What if my patient’s TPN doesn’t show up on time? What if I contaminate the bag by accident? What are tube feeds all about? 12-1- What are the different kinds of tube feeds? - Jevity, Jevity with fiber, Jevity Plus, Osmolyte, Promote, Promote with fiber, Alitraq, Vivonex, glutamine, Nepro 12-2- What do I have to know about tube feed pumps? 12-3- When do I change the pump tubing? 12-4- How often should I check the aspirate? 12-5- What if the aspirate is more than 100cc? 12-6- What happens with tube feeding if my patient is on a fentanyl or morphine drip? What is the narcan thing? What is a bowel regimen? 12-7- Wh