GEP Medicine in Society Handbook 2019/20
5. Secondary Care Themed Days
5.10. Day 11 Theme: Nutrition and Feeding in the In-patient setting
Introduction – Sick patients are often catabolic and require increased nutritional intake and support at a time when they are often unable to feed themselves or simply do not feel like eating. Neurological and gastrointestinal conditions may also affect a patient’s ability to swallow normally or safely (termed dysphagia). During the past thirty years supplemental feeding techniques and support have improved, allowing patients to be fed.
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Challenge Box – What are the mechanisms that allow a person to swallow normally? What are the common processes that affect these mechanisms? How would you |
Learning Issues
- What are the reasons why patients may not receive adequate nutrition in hospital? What simple things could you do to improve their nutritional intake?
- How much does the NHS spend on food for each patient per day?
- Which nutritional supplements are commonly used on the wards? Comment on their nutritional contents.
- What are NG, PEG and PEJ and TPN feeding? What are their risks and benefits?
- What disorders commonly stop patients eating?
- Which members of the MDT are essential when assessing a patient’s swallow?
- Why may pulse oximetry be used when assessing a patient’s swallow?
Learning tasks – set by SALT
- Compare and contrast your own dietary intake for your day at Newham with that of a typical inpatient.
- List three types of patient who may require ‘special’ diets and the essential elements of those diets.
- List the stages involved in assessing a patient's swallow.
- List at least 5 clinical signs of aspiration (immediate and/or delayed)
- List the risks of PEG feeding. What are the common methods used to try and avoid them and treat them once they have occurred?