Parenteral nutrition support should not be given for critical illness

Pros:1It can allow the intestines to rest sufficiently and allow the condition to be relieved. For example, in the case of inflammatory diseases of the intestine (ulcerative colitis, Crohn's disease).

Standard Care Plan for Patients with Myasthenia Gravis - Myasthenia Gravis Care.

Tags: Patient, Muscle, Food, Occurrence, Difficulty, Nutrition, Condition, Weight, Need, Human Ability, Disorder, Skeletal Muscle, Fatigue, Family, Factors, Measures, Syndrome, Method, Fluid, Organism.

Introduction: Symptomatic myasthenia is an autoimmune disease characterized by impaired transmission of neuro-muscle junctions. The clinical feature is that some or all of the skeletal muscles are abnormally prone to fatigue, usually after a short period of contraction, and then recover after rest.

Common nursing problems include: (1) lack of endurance for activity; (2) disuse syndrome; (3) Swallowing.

Text: Symptomatic myasthenia is an autoimmune disease characterized by impaired transmission of nerve-muscle junctions.

The clinical feature is that some or all of the skeletal muscles are abnormally prone to fatigue, usually after a short period of contraction, and then recover after rest.

Common care questions include:

1) Lack of endurance for activity; (2) disuse syndrome; (3) dysphagia; (4) inefficient respiratory patterns; (5) Clearing the respiratory tract is ineffective; (6) lack of knowledge; (7) nutritional deficiencies; Below the body's needs; (8) Fear.

1. Factors related to activity and lack of endurance 1Transmission of nerve-muscle junctions.

2.Muscle atrophy and decreased mobility.

3.Difficulty breathing, imbalance of oxygen supply and demand.

Main performance 1Patients are prone to fatigue and weakness when performing daily activities.

2.Drooping eyelids, difficulty swallowing, and a muffled voice.

3.Dyspnea and hypoxia cause the patient to have difficulty moving.

Goal of care 1The patient is able to maintain an optimal level of activity, which is characterized by normal heart rate, blood pressure, and loss of shortness of breath, weakness, and fatigue during activity.

2.Patients can take the right coping methods at the onset of the disease and save energy.

Nursing measures 1In the acute phase, patients are encouraged to stay in bed adequately.

2.Refer to daily necessities that the patient regularly uses (eg:

toilet paper, teacups, etc.) should be placed within easy reach of the sick person.

3.Assist the patient with activities of daily living according to the condition or needs of the patient to reduce energy expenditure.

4.Place the toilet next to the bed so that the patient can easily reach it.

5.Encourage patients to build confidence and be as self-reliant as possible.

6.Instruct patients to use assistive devices such as bed rails, handrails, and bathroom chairs to save physical strength and avoid falls.

7.Encourage the patient to be physically active within the limits of tolerable activity.

Key evaluation 1Patients are able to maintain an optimal level of activity (e.g., wash their face, dress, go to the toilet, etc.) without shortness of breath, chest tightness, fatigue, or weakness.

2.Whether the patient can tell and adopt the correct methods of saving energy.

2. Neuromuscular disorders associated with disuse syndrome lead to decreased activity.

Main performance 1Some or all of the skeletal muscles are abnormally fatigued easily.

2.Muscles of the lower extremities or other muscles may atrophy in advanced stages.

Goal of care 1Skeletal muscle atrophy should be avoided as much as possible.

2.Reduces the degree of muscle atrophy.

Nursing measures 1Work with patients and families to develop care plans and obtain their active cooperation.

2.Explain the importance of the activity to the patient and family, and instruct the patient and family to massage and passive the affected muscles.

1. The patient has intestinal dysfunction, such as diarrhea, abdominal pain, nausea, vomiting, etc.;

2. The patient has gastrointestinal bleeding, ulcer and other lesions;

3. The patient has impaired liver, kidney and other organ functions, and liver and kidney insufficiency;

4. The patient has lung infection, such as pneumonia, bronchitis, etc.;

5. The patient has dysfunction of avoiding spring grinding and grinding disease, such as allergic diseases, chronic inflammatory diseases, etc.;

6. The patient has cardiovascular diseases, such as myocardial ischemia, heart failure, etc.;

7. The patient has hematologic diseases, such as thrombocytopenia, hematuria, etc.;

8. The patient has gastrointestinal stones, such as gallstones, gallbladder stones, etc.;

9. The patient has intestinal peristalsis slowed down, such as intestinal obstruction, chronic diarrhea, etc.;

10. The patient has parenteral nutrition allergic reactions, such as allergic diarrhea, rash, etc.

a.Congenital malformations of the esophageal and gastrointestinal tract.

b.Occasional diarrhea.

c.Extensive burns.

d.Acute severe pancreatic celery.

e.Acute liver and kidney failure.

Correct answer: Suspicion is buried

Gastrointestinal pathways.

Nutritional support for critically ill patients includes enteral nutrition, parenteral nutrition, and both. Depending on the patient's condition, enteral nutrition can be performed by nasogastric tube, nasojejunal tube, percutaneous endoscopic gastrostoma, percutaneous endoscopic jejunostomy or ventonal opening, or intraoperative gastroenterostomy.

1. The nasogastric route is often used for patients with normal gastrointestinal function, non-coma and patients who can transition to a normal oral diet after a short period of nasogastric feeding, with the advantage of being simple and easy, but there are certain disadvantages, such as the increased incidence of reflux, aspiration, sinusitis and upper respiratory tract infection. 2. Jejunal nutrition should be chosen for severe patients who are intolerant of gastric nutrition or have a high risk of reflux and aspiration. Percutaneous endoscopic gastrostomy refers to percutaneous gastrostomy under the guidance of fiber gastroscopy, and the feeding tube is placed into the gastric cavity, which has the advantage of removing the nasal tube, reducing the complications of nasopharyngeal and upper respiratory tract infection, and can be left with a long-term indwelling feeding tube, which is suitable for coma, esophageal infarction and other severe patients who cannot eat for a long time and have good gastric emptying.

3. Percutaneous endoscopic paraenterostomy inserts the feeding tube into the upper jejunum, which can be used for gastrointestinal decompression at the same time as jejunal nutrition, and long-term catheterization, which has the advantage of reducing the complications of nasal and upper respiratory tract infections, but also reduces the risk of reflux and aspiration, and can be decompressed by gastroduodenum at the same time of feeding, especially for severe patients with risk of aspiration and need gastroduodenal decompression.

Clinical nutrition should include enteral nutrition (nutritional catering, patient dietary management), parenteral nutrition (intravenous nutrition), nutrition clinics, scientific research and teaching, knowledge education and other inseparable parts.

A specific area of nutrition, which is also an integral part of clinical medicine, has gradually differentiated into a marginal discipline in recent years. Its task is to accelerate the patient** by enhancing the clinical effect of other **measures through **diet,**or alleviating the disease**, according to the principles of nutrition. Clinical nutrition plays an important role in the process of disease, the quality of the patient's nutritional status directly affects the healing of wounds and the recovery of the disease, good nutritional status can delay the occurrence and development of some diseases, nutrition can also be used as a means of some diseases.

Clinical nutrition is implemented through the ** diet.

Drink gruel, if you can't drink it, you can use a catheter.

Answer]: bParenteral balance of pure nutrition can occur in the process of nutritional supplementation, such as abnormal glucose metabolism, electrolyte disorders, etc. Because parenteral nutrition needs to be completed through the first cardiac venous catheterization, it can also cause complications such as catheter sepsis, pneumothorax, and thrombosis.

But the most serious is air embolism, a rare but fatal complication.

Answer]: B test point] Complications of parenteral nutrition.

Analysis] Parenteral nutrition can cause metabolic and cymbal syndrome in the process of nutritional supplementation, such as abnormal metabolism of sugar and electrolyte disorders. Because parenteral nutrition is done through central venous catheterization, it may cause complications such as catheter sepsis, pneumothorax, and thrombosis. But the most serious is air embolism, a rare but fatal complication.

Answer: B

The most common complication of enteral nutrition support is diarrhoea. The most serious complications of enteral nutrition support are aspiration and aspiration pneumonia.

Answer] :d analysis: diarrhea and abdominal distension are gastrointestinal complications of enteral nutrition (EN), and feeding tube blockage is a mechanical complication of EN.

Intestinal perforation is not a complication of EN. Aspiration or mimetic pneumonia is an infectious complication of EN, and hail fiber is the most serious complication of EN, which is common in young children, elderly patients, and people with impaired consciousness (D). Sepsis is a complication of parenteral nutrition.