Enteral and Parenteral Feeding

‘Enteral nutrition (EN) refers to nutrients given via the gastrointestinal tract’ (GIT) (Crisp and Taylor 2009 pp.1154). EN is considered when an individual is not safe for oral intake or when oral intake is not adequate to meet nutrient requirements, for example when a patient is unable to swallow. Enteral feeding tubes may enter the body at a number of different sites, the choice of enteral feeding route depends on several factors such as the intended duration of the nutrition support, the patients condition, and any limitations to access (such as trauma or obstructions) (Riley, Ferrie, Daniells et al 2007). Enteral feeding can be administered by continuous, intermittent or bolus methods the administration is based on assessment of the individual needs of the patient, however the goal is to provide safe nutrition and hydration. ‘Parenteral nutrition (PN) is a form of specialised nutrition support in which nutrients are provided intravenously’ (Crisp and Taylor 2009 pp.1157). PN is given to patients who are unable to tolerate nutrition via the GI route. PN can be delivered through a peripheral or a central vein (Bullock, Manias 2011 pp. 878). Total parenteral nutrition (TPN) is where a patient is on 100% PN and food and nutrients are given via no other route. (Seppelt, Liem 2007). The nutritional needs of adult-hospitalised patients is important as nutrition provides the body with essential nutrients it needs to aid recovery such as improved wound healing, a decreased catabolic response to injury, improved gastrointestinal permeability, decreased bacterial translocation, and improved clinical outcomes, including a decrease in complication rates and length of stay which comes with cost savings (Gramlich, Kichian, Pinilla et al 2004). Nurses must be familiar with both the indications and nursing considerations for the management of both enteral and parental feeding as well as the complications they face.

Indications for EN can include cancer of the head,