Enteral nutri+on is a method of supplying nutrients and calories to a person who is

unable to obtain sufficient nutri+on through oral feeding. This form of feeding is
administered directly to the gastrointes+nal tract, either through a nasogastric tube,
nasojejunal tube or gastrostomy tube, depending on the clinical situa+on and the
pa+ent's needs.

Indica+ons for Enteral Nutri+on:

Enteral nutri+on is used in a variety of medical situa+ons, which include:

Inability to eat: When a pa+ent is unable to take food by mouth due to illness, surgery
or injury that affects their ability to swallow or eat.

Nutri+onal rehabilita+on: In situa+ons where a pa+ent's nutri+onal status needs to be

improved, such as in cases of malnutri+on or unwanted weight loss.

Gastrointes+nal diseases: In some gastrointes+nal disorders, such as Crohn's disease or

ulcera+ve coli+s, enteral nutri+on can help maintain bowel func+on.

Gastrointes+nal surgery: AHer certain surgeries on the diges+ve tract, enteral nutri+on
may be required to allow the diges+ve system to recover.

Types of Tubes:

There are different types of probes used for enteral nutri+on administra+on, including:

Nasogastric (NG) tube: inserted through the nose and passes down the esophagus into
the stomach. It is suitable for short-term nutri+on administra+on.

Nasoenteral (NE) tube: Similar to the NG, but placed beyond the stomach into the
small intes+ne, which may be necessary in cases of gastric emptying problems.

Gastrostomy tube (G): Placed directly into the stomach through a small incision in the
abdominal wall. It is more suitable for long-term administra+on and when oral feeding
is not possible.

Jejunostomy tube (J): Placed in the jejunum (small intes+ne) and used when access to
the small intes+ne is necessary for nutrient

Considera+ons Before Administra+on:

Before administering enteral nutri+on, several aspects should be considered:

Pa+ent assessment: A healthcare professional should assess the need for enteral
nutri+on, determine the appropriate type of tube, and calculate the pa+ent's specific
nutri+onal requirements.

Feeding formula: A specific feeding formula is selected that contains the appropriate
combina+on of proteins, fats, carbohydrates, vitamins and minerals.

Hygiene and sterile techniques: It is crucial to maintain proper hygiene during tube
inser+on and enteral nutri+on management to prevent infec+on.

Enteral Nutri+on Administra+on:

Enteral nutri+on is administered through the tube using an infusion pump or syringe,
depending on the clinical situa+on and type of tube. The infusion rate and amount of
formula are adjusted according to the pa+ent's needs. Administra+on is medically
supervised and con+nuously monitored to ensure tolerance and adequate nutrient
absorp+on.

Parenteral nutri+on is a way of delivering nutrients directly into the bloodstream,

bypassing the diges+ve system. This is accomplished through an intravenous line and is
used when the gastrointes+nal system cannot adequately absorb or process nutrients.

Types of Parenteral Nutri+on:

Total Parenteral Nutri+on (TPN): In this type, all the necessary nutrients, such as
proteins, fats, carbohydrates, vitamins and minerals, are provided in a complete liquid
solu+on. It is used when the pa+ent is unable to take food orally or enterally.

Par+al Parenteral Nutri+on (PPN): In this case, only some of the necessary nutrients
are provided, and the pa+ent can s+ll obtain some nutrients from oral or enteral
feedings. It is used when the pa+ent can eat or drink to some extent, but s+ll needs
addi+onal intravenous nutrients.

Indica+ons for Parenteral Nutri+on:

Parenteral nutri+on is used in a variety of medical situa+ons, which include:

Postopera+ve pa+ents: AHer significant gastrointes+nal surgery, it may be necessary to

use TPN to allow the diges+ve system to recover.

Pa+ents with intes+nal obstruc+on: When there is an obstruc+on in the intes+ne that
prevents absorp+on of nutrients, TPN is used to maintain nutri+on.

Pa+ents with chronic gastrointes+nal diseases: Some condi+ons such as Crohn's

disease or ulcera+ve coli+s may require TPN at +mes of exacerba+on.
Pa+ents with cancer: TPN may be necessary if cancer or its treatment affects a person's
ability to eat or absorb nutrients.

Complica+ons of Parenteral Nutri+on:

Infec+ons: There is a risk of infec+ons at the site where the IV is inserted or in the
circulatory system. This can be reduced by strict hygiene and sterile techniques.

Metabolic problems: Inadequate administra+on of nutrients or an overload of certain

nutrients can cause metabolic imbalances.

Liver problems: In some cases, TPN can cause liver damage, especially if used long-
term.

Intravenous line complica+ons: Problems such as blockages or thrombosis may occur in

the intravenous line used.

Electrolyte imbalances: TPN can affect electrolyte levels in the body, which can be
harmful.