Patient Feeding Methods and Renal System Functions

Posted on Mar 12, 2025 in Biology

Oral Feeding

Patient retains the capacity to swallow, with or without difficulty, and can eat by mouth.

Enteral Feeding

Food is administered by a trained professional, such as a pharmacist. Food may be crushed and administered via a tube that goes from the nose to the stomach (nasogastric) or duodenum (nasoduodenal).

Parenteral Route

Food is delivered directly to the circulatory system via a catheter, using a drip method.

Patient Dependency

The patient may be partly or totally dependent.

Food Recommendations

Position the patient in Fowler’s or semi-Fowler’s position. Explain the procedure, administer food in the correct order, clean the patient’s mouth, and check for any remaining food.

Bronchial Aspiration

Risk factors include dysphagia, the underlying disease, or patient position.

Bronchial Aspiration Prevention

  • Change the diet.
  • Avoid liquids or use thickened liquids.
  • Administer food slowly.
  • Observe for symptoms.
  • Ensure no food remains in the mouth.
  • Keep the patient in Fowler’s position for 30-60 minutes after feeding.

Nasoduodenal Tube

Inserted through the nostril until it reaches the duodenum. The patient cannot drink orally, as this poses a risk of gastroesophageal reflux and/or bronchial aspiration. Not recommended for more than 6-8 weeks.

Nasogastric Tube

Inserted from the nose to the stomach. Used for patients with the ability to eat. Food is enteral, with liquid feed administered via a tube into the stomach or duodenum. Parenteral feeding is administered via a catheter into the circulatory system, using only pharmaceutical preparations.

Indications for Nasogastric Tube

  • Conscious patients with a functional stomach.
  • Esophageal or pharyngeal problems.
  • Administering medications.
  • Gastric lavage.
  • Removing gastric contents.
  • Patients undergoing abdominal surgery.

Nasogastric Tube Material

Plaster, nasogastric tube, lubricant, water, straw, gloves, syringes, gauze, stethoscope, suction machine, saline solution.

Procedure

Place the patient in a semi-Fowler’s position. Calculate the length of the tube (distance between the nose and ear to the xiphoid process). Lubricate the distal part of the tube. Advance the tube while aspirating stomach contents and introducing air via a syringe.

Care

Mobilize the tube by rotation. Secure the tube. Keep the patient’s mouth clean and moisturized. Maintain tube patency.

Complications

Diarrhea, dehydration, tube dislodgement, obstruction, regurgitation.

Rectal Probe

Used for enemas or to aid in the dissolution of feces, introduced into the patient’s rectum through the anus.

Cleansing Enema

Solutions designed to stimulate fecal excretion.

Types of Cleansing Enemas

  • Soap and Water: Water at 40°C, possibly with a little oil.
  • Saline: Water at 35-40°C.
  • Commercial: Hypertonic solutions of sodium phosphate. Temperature: 30-40°C.

Volumes (mL)

  • Adult: 700-1000 mL
  • <16 years: 500-700 mL
  • <12 years: 300-500 mL
  • <6 years: 200-300 mL
  • Infant: 150-250 mL

Retention Enema

The solution is kept in the rectum for 30 minutes.

Types of Retention Enemas

  • Oil: 150-200 mL of oil is introduced to lubricate and soften feces and the intestinal mucosa.
  • Medicated: Drugs are dissolved in the enema to be absorbed by the mucosa.
  • Opaque: Used for administering radiopaque substances.

Renal System

Features

  • Eliminates waste products.
  • Maintains stable blood pH.
  • Maintains and assists in the homeostasis of the organism.

Kidney

Bean-shaped, weighing approximately 140 grams and measuring 12 cm, located in the lumbar region.

Parts

  • Renal Cortex: The outermost layer, containing glomeruli and proximal and distal convoluted tubules.
  • Renal Medulla: The core, formed by 15-18 renal pyramids, which carry urine to the renal calyces.
  • Renal Pelvis: The area closest to the renal hilum, formed by the renal calyces.

Ureter

Smooth muscle tube, approximately 15 cm long, carrying urine from the kidney to the bladder, entering at the rear.

Bladder

Stores urine in the pelvic cavity.

Urethra

Connects the bladder to the exterior through the urinary meatus. Length: Female: 3.5 cm; Male: 15-20 cm.

Urine Formation

The nephron is the functional unit of the kidney (small filters located in the renal cortex). Urine is formed in three steps:

  1. Filtration: Almost the entire contents of the blood pass from the kidney to the proximal convoluted tubule.
  2. Absorption and Resorption: Substances pass through the convoluted tubules, undergoing absorption and resorption processes.