Berhampur 70918*19311 CALL GIRLS IN ESCORT SERVICE WE ARE PROVIDING
SHS.514 lec.05 (1).pptx
1. • COURSE NAME: Introduction to Nutrition Science
• COURSE CODE:SHS.514
• CREDIT HOURS: 3hrs
• Lecture#05
• INSTRUCTOR: Faheem Mustafa
School of Health Sciences
University of Management and technology
3. Learning outcomes
• Transition feeding
• Home nutrition support
• Oral supplements
• Pharmacological use of nutrients
• Interdisciplinary nutrition support
• Therapeutic substances for EN & PN
4. Transition Feeding
• All nutrition support care plans strive to use
the gastrointestinal tract when possible,
either with enteral nutrition or by a total or
partial return to oral intake.
5. • The challenge to clinicians is to maintain
adequate feeding to meet nutritional
requirements throughout the transition
period.
6. • Experts advise that oral diets initially be low
fat, lactose free, and low in other simple
carbohydrates.
• Make digestion easier and minimize the
possibility of an osmotic-type diarrhea.
7. Parenteral to enteral feeding
• To begin the transition from parenteral to enteral
feeding, the initial step is to introduce a minimum
amount of enteral feeding at a low rate of 30 to
40 ml/hr to establish gastrointestinal tolerance
• Once this has been established over a period of
hours, the parenteral rate can be decreased to
keep the nutrient levels at the same prescribed
amount
8. • As the enteral rate is increased by 25 to 30
ml/hr increments every 8 to 24 hours, the
parenteral prescription is reduced accordingly
• Once it is established that the patient
tolerates at about 75% of nutrient needs by
the enteral route, the parenteral solution can
be discontinued
9. • This process ideally takes 2 to 3 days;
however, it may become more complicated,
depending on the degree of gastrointestinal
function.
10. Parenteral to oral feeding
• Once again, this transition is ideally
accomplished by monitoring oral intake and
concomitantly decreasing the parenteral
infusion to maintain a stable nutrient intake
until about 75% of the nutrient needs can be
met consistently by oral intake and when the
parenteral infusion can be stopped.
11. • It is important to continue monitoring the
patient for adequate oral intake once
parenteral nutrition has been stopped
12. Enteral to oral feeding
• A stepwise decrease is also used in the
transition from tube feeding to oral feeding. It
is usually more effective to move from
continuous feeding to a 12- and then an 8-
hour formula administration cycle during the
night.
• This re-establishes hunger and satiety cues for
oral intake during daytime.
13. • In practice, oral diets are often tried after
inadvertent or deliberate removal of a
nasoenteric tube.
• This type of interrupted transition should be
monitored closely for adequate oral intake.
14. • Patients who cannot meet their needs by the
oral route can be maintained by a
combination of enteral nutrition and oral
intake.
15. Oral Supplements
• The most common types of oral supplements
are commercial formulas meant primarily to
augment the intake of solid foods. They often
provide approximately 250 kcal/8-oz or 240-
ml portion and approximately 8 to 14 g of
intact protein
• Some products have 360 or 500 or as much as
575 kcal in a can
16. • Fat sources are often long-chain triglycerides,
although some supplements contain medium-
chain triglycerides
17. • The form of carbohydrate is a key factor to
patient acceptance and tolerance. Supplements
with appreciable amounts of simple
carbohydrate taste sweeter and have higher
osmolarities, which may contribute to
gastrointestinal intolerance.
• Thus both oral dietary intake and the actual
intake of prescribed supplements should be
monitored.
18. Home Nutrition Support
The elements needed to implement home nutrition
successfully include
• identification of appropriate candidates and a
feasible home environment with responsive
caregivers,
• a choice of a suitable nutrition support regimen,
• training of the patient and family, and
• a plan for medical and nutritional follow-up visits
19. Interdisciplinary nutrition support
• Optimal nutrition support requires the
dedication and involvement of multiple
disciplines.
• Historically, in institutions where patients
required complex and sophisticated nutrition
support, nutrition support teams or services
were often developed with patient care
provided by a team consisting of physician,
dietitian, pharmacist, and nurse specialist.
20. Therapeutic Substances in EN & PN
Substances Being Investigated for Potential
Therapeutic Effects in Enteral or Parenteral
Solutions
• Antioxidants such as vitamin C, vitamin E,
vitamin A, zinc, copper, manganese, and
selenium have specific roles in deactivating
free radicals
21.
22. • Arginine is an amino acid that may enhance
nitrogen retention, wound healing, and
immune function.
• B-hydroxy-B-metbylbutyrate (HMB) is
metabolized from leucine and when
supplemented may attenuate muscle (protein)
catabolism associated with cancer cachexia
23. • Carnitine is a
nitrogenous compound
slmthesized from lysine
and methionine that is
required for oxidation of
long chain fatty acids.
24. • Choline is a water-soluble vitamin-like
essential nutrient. choline deficiency has been
associated with hepatic abnormalities in
patients receiving parenteral nutrition.
25. • Medium-chain triglycerides(MCT) do not
require bile acids for digestion and are
absorbed directly into hepatic portal
circulation; they also do not require carnitine
for oxidation
26. • Pbytochemicals are active chemical
compounds found in foods of plant origin that
play a potential beneficial role in the
prevention and treatrnent of disease. Some
classes of phytochemicals include
polyphenols, including flavonoids and
isoflavones; and terpenes, which include
carotenoids
27. • Omega 3 fatty acids are precursors of
prostaglandins that may enhance immune
function and decrease the risk of
cardiovascular disease
