Tag Archives: Nausea & Vomiting

Nursing Care of Clients with Dysphagia, Anorexia, Nausea & Vomiting, and Nutrition Needs

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1. Care of Client with Dysphagia

Introduction:

  • The word Dysphagia is derived from the Greek words “dys” meaning difficulty and “phagia” meaning to eat.
  • Dysphagia refers to difficulty in swallowing food or liquids.

Causes:

  • Old age (elderly people are at higher risk)
  • History of stroke
  • Cancer patients undergoing radiation or chemotherapy
  • Cranial nerve dysfunction
  • Infections
  • Parkinson’s disease
  • Facial paralysis

Nursing Care:

  • Assessment is the first and most important step.
  • Nurses are often the first to recognize signs of dysphagia.
  • Interventions may include:
    • Giving soft, semi-solid or pureed food
    • Ensuring patient sits upright while eating
    • Monitoring for aspiration
    • Maintaining proper hydration
    • Referring to a speech-language pathologist if needed

2. Care of Client with Anorexia

Introduction:

  • Anorexia is an eating disorder characterized by a significantly reduced appetite or aversion to food.
  • It is a serious psychological condition, often starting as extreme dieting and leading to severe weight loss.
  • Most common in teenage girls and young women.

Nursing Care:

  • Monitor nutritional intake carefully.
  • Maintain electrolyte balance and hydration.
  • Encourage a positive body image.
  • Provide emotional support and refer for counseling if needed.
  • Monitor vital signs and weight regularly.

3. Care of Patient with Nausea and Vomiting

Introduction:

  • Nausea is a feeling of uneasiness or discomfort in the stomach, often leading to vomiting.
  • It can occur due to various causes.

Causes:

  • Chemotherapy
  • Pregnancy
  • Ingestion of toxic substances
  • Inhalation of foul odors
  • Gastrointestinal disorders
  • Reduced peristalsis
  • Food poisoning

Nursing Care:

  • Perform a complete nursing assessment.
  • Help relieve symptoms through:
    • Administering anti-emetics as prescribed
    • Maintaining hydration (IV fluids or oral rehydration)
    • Providing small, frequent meals
    • Keeping the environment clean and odor-free

4. Meeting Nutritional Needs

Oral Nutrition:

  • If the patient can eat orally, provide a balanced and nutritious diet.
  • Follow the physician’s order for any therapeutic diet (e.g., low sodium, DASH diet, diabetic diet).

Types of Diet:

  1. Vegan Diet – Only plant-based foods; no animal products at all.
  2. Lacto-Vegetarian – Includes milk and plant-based foods; excludes eggs and meat.
  3. Lacto-Ovo Vegetarian – Includes milk and eggs; excludes meat and fish.
  4. Ovo-Vegetarian – Includes eggs; excludes milk and other animal products.

5. Enteral Nutrition (Tube Feeding)

Introduction:

  • Enteral feeding involves giving liquid nutrition directly into the gastrointestinal tract via a tube.

Nasogastric Tube Feeding:

  • A nasogastric (NG) tube is inserted through the nose into the stomach.
  • Used for short-term nutritional support.

Indications:

  • Bowel obstruction
  • Gastric immobility
  • Poisoning
  • GI bleeding
  • Inability to eat by mouth

Purposes:

  • Provide nutrition
  • Decompress the stomach
  • Remove gas or fluids
  • Administer medications
  • Prevent aspiration

Articles Required:

  • Drawsheet and mackintosh
  • NG tube (14–16 French)
  • Sterile gloves
  • 20 ml syringe
  • Lubricating jelly
  • Water and glass
  • Kidney tray, paper bag
  • Stethoscope
  • pH strip (to confirm placement)

Pre-procedure Care:

  • Obtain informed consent
  • Gather all equipment at bedside
  • Provide privacy and explain procedure
  • Place the patient in a high Fowler’s position
  • Determine which nostril to use

6. Parenteral Nutrition

Introduction:

  • Parenteral Nutrition (PN) is the intravenous (IV) administration of nutrition, used when oral or enteral feeding is not possible.

Types:

  1. TPN (Total Parenteral Nutrition) – Complete IV nutrition
  2. PPN (Partial Parenteral Nutrition) – Supplementary IV nutrition

Indications:

  • Severe malnutrition
  • Ulcerative colitis
  • Renal or hepatic failure
  • Cancer
  • Post-surgery
  • Hypermetabolic states
  • Patients unable or unwilling to eat

Components of TPN:

  • Carbohydrates (60–70%)
  • Lipids (30%)
  • Amino acids/proteins (15–20%)
  • Multivitamins
  • Minerals and electrolytes
  • Water
  • Regular insulin (to manage blood glucose)
  • Heparin (to prevent clotting in IV line)

Routes of Administration:

  1. Peripheral Vein – For short-term, less concentrated solution
  2. Central Vein – For long-term or highly concentrated solutions (via central line or PICC)