Nutritional Supplements Lecture Notes

Overview of Nutrients

• Definition: Dietary products undergoing chemical changes during ingestion and metabolism.
• Functions:
  • Enhance tissues and liberate energy.
  • Required for:
    • Cell growth and division.
    • Enzyme activity.
    • Synthesis of carbohydrates, fats, proteins.
    • Hormone secretion, wound healing, immune system, gut integrity, etc.
• Malnutrition: Nutritional needs not met by intake.

Types of Nutritional Support

Enteral Nutrition

• Definition: Administration via gastrointestinal (GI) tract.
• Indications:
  • Abnormal esophageal/stomach peristalsis.
  • Altered anatomy post-surgery.
  • Depressed consciousness or impaired digestive capacity.
• Benefits: Preferred route of administration.
• Contraindications: Allergy or inability to metabolize nutrients.
• Adverse Effects (AE): GI intolerance (diarrhea, aspiration pneumonia, dumping syndrome).
• Interactions:
  • Medications (e.g., antibiotics, Phenytoin) due to delayed gastric emptying.
• Formulations:
  • Complex nutrients derived from proteins, carbohydrates, and fats.
  • Common products: Ensure, Ensure Plus, Isocal, Osmolite, Portagen, Jevity, Sustacal.
  • Available without prescription; less hyperosmolar.
  • Specialized nutrients for individual needs (e.g., MCT Oil for fats, Casec for proteins).

Parenteral Nutrition

• Definition: Direct intravenous (IV) administration, bypassing GI tract.
• Total Parenteral Nutrition (TPN):
  • For patients unable to tolerate or have poor absorption via GI route.
  • Contains vitamins, minerals, amino acids, dextrose, lipids.
  • Requires central line.
• Peripheral Parenteral Nutrition (PPN):
  • Temporary, less harsh on veins.
  • Lower dextrose concentrations.
  • Used when some oral intake is possible.

Nursing Implications

• Nutritional Assessment: Includes dietary history, food intake, weight, and height.
• Laboratory Studies: Total protein, albumin, blood urea nitrogen, blood cell counts, cholesterol.
• Patient Monitoring:
  • Allergies and lactose intolerance.
  • Proper tube placement for enteral feedings.
  • Tolerance and rates of feeding.
  • TPN line care and blood glucose levels.
  • Monitoring for fluid overload, weight, and intake/output volumes.

Key Points

• Assessment: Thorough nutritional review and dietitian consultation.
• Complications: Enteral feeding can lead to hyperglycemia, dumping syndrome, and aspiration.
• Parenteral Nutrition Risks: Include air embolism, infection, fluid overload, glucose imbalances.
• Nursing Care: Essential to prevent complications from nutritional supplementation.