Nutrition: A Handbook for Nurses (Wiley Series in Nursing)

Nutrition: A Handbook for Nurses......Page 1
Contents......Page 7
Contributors......Page 13
Preface......Page 15
Introduction......Page 17
Introduction......Page 19
National and European initiatives 1990–2007......Page 20
References......Page 37
What is malnutrition?......Page 41
Signs and consequences of malnutrition......Page 44
Specific vitamin and mineral deficiencies......Page 48
Management of malnutrition......Page 53
Nutrition support......Page 54
Recognising and managing malnutrition in obese patients......Page 56
References......Page 57
Nutrition screening......Page 59
Nutrition assessment......Page 62
Screening tools......Page 69
When to refer to a dietitian......Page 71
References......Page 72
Further reading......Page 73
Introduction......Page 75
Identifying the problems......Page 76
Registered nurse responsibilities in patient nutrition......Page 77
Roles and responsibilities of other individuals involved in patient nutrition......Page 82
The patient in hospital......Page 85
Recommendations to improve patient intake......Page 86
Safety considerations when assisting a patient to eat......Page 88
Helping the dysphagic patient to eat......Page 89
Effects of dementia on oral nutritional intake......Page 90
Protected mealtimes......Page 92
Recording food intake......Page 94
Use of specialised equipment......Page 95
Educating healthcare workers to assist patients with their meals......Page 96
References......Page 97
Introduction......Page 99
Oral nutrition support......Page 100
Options for enteral tube feeding: short-term feeding......Page 104
Options for enteral tube feeding: long-term feeding......Page 116
Enteral tube feeds......Page 133
Drug administration through an enteral feeding tube......Page 138
Flushing enteral feeding tubes......Page 142
Conclusion......Page 143
References......Page 144
Introduction......Page 147
Indications of parenteral nutrition......Page 149
Clinical assessment of the patient requiring parenteral nutrition......Page 150
Routes for intravenous access......Page 152
Types of central venous catheter......Page 153
Non-central access options......Page 156
Using a previously used central venous catheter......Page 157
Aftercare of line and insertion site......Page 158
Dressing changes......Page 159
Observations......Page 161
Estimating nutritional requirements......Page 162
Biochemical and haematological assessment......Page 163
Nutritional content of parenteral nutrition......Page 164
Drug therapy that may affect nutrition support......Page 166
Care of parenteral nutrition before administration......Page 167
Should an in-line filter be used?......Page 169
Patient monitoring......Page 170
Complications associated with the administration of parenteral nutrition......Page 173
Discontinuing parenteral nutrition......Page 178
The role of non-medical prescribing in parenteral nutrition......Page 179
References......Page 180
Further reading......Page 183
Introduction......Page 185
The process of starvation......Page 186
Incidence of re-feeding syndrome......Page 187
Impact on the patient......Page 188
Reducing the risk of re-feeding syndrome......Page 195
Ward checklist for re-feeding syndrome......Page 197
References......Page 198
Introduction......Page 201
Informed consent......Page 203
Decision-making in the competent patient......Page 204
Decision-making in the non-competent patient......Page 205
Best interests......Page 206
Advanced directives......Page 207
Percutaneous endoscopic gastrostomy feeding in advanced dementia......Page 208
Withdrawing nutrition support......Page 210
Conclusion......Page 211
References......Page 212
Further reading......Page 213
Introduction......Page 215
Individual roles within the core team......Page 217
Getting started: developing the Nutrition Support Team......Page 226
Agreeing the referral process......Page 227
Maintaining momentum......Page 228
Agreeing standards for practice......Page 229
Proving the worth of the Nutrition Support Team......Page 231
The role of the Nutrition Steering Committee......Page 233
References......Page 234
Planning discharge......Page 237
Education......Page 238
Training required......Page 239
The review process......Page 240
Potential problems......Page 244
References......Page 247
Support group details......Page 248
Enteral nutrition......Page 249
Combined enteral/parenteral nutrition......Page 261
Parenteral nutrition......Page 264
References......Page 271
Glossary and Abbreviations......Page 273
Index......Page 283