Home Gravity Tube Feeding Nutrition

There are some medical conditions such as a stroke, which leaves the patient unable to eat or drink. For some people swallowing is impossible, so they cannot get enough nutrition. With regular eating, the mouth and esophagus are used, but with tube feeding, these are bypassed.
If a patient cannot swallow due to any reason, a gastrostomy tube can be place in the stomach and nutritional feeding can be administered through this tube. There are times when the tube is placed into a small section of the small intestines, called the jejunum. This tube is call a jejunostomy or commonly referred to as a J-Tube.

The special medical nutritional product that is administered through the tube is called a formula. This contains all of the daily nutrients which you will need to have a well-balanced diet. There are different kinds of formulas and the one that is right for you is determined by your physician or dietician.

One way that the formula can be delivered is by gravity feeding. A sample tube feeding schedule is; 1 can of Jevity via the g-tube every 2-3 hours. This is usually done 5 times a day and the amount can be increased to 2 cans at a feeding if the patient tolerates it.

The gravity delivery set holds 1200ml and comes with a drip chamber and a roller clamp. The bag has a built in hanger and has a large opening with a leak proof cap, to help prevent formula spills and wastes. These come 30/case.

The tube feeding supplies will include the formula, a 60ml syringe, feeding tube set, room temperature water and an IV pole. Before starting the procedure, wash your hands thoroughly and also wash and dry the top of the formula cans. Shake the formula well and fill the feeding bag with the amount of cans of formula that the physician has ordered. Hang the bag on the pole.

Prior to starting the feeding, use the syringe to flush the feeding tube with the amount of water the physician has ordered. Then insert the tip end of the tubing into the feeding tube, adjusting the flow by the roller clamp. After the feeding is completed, flush the feeding tube with the amount of water the physician has ordered. This helps to keep the feeding tube from becoming clotted.

The feeding tube can also be utilized for giving medications. Most of the medications can be obtained in liquid form but if a medication is not available in liquid form, a pill can be crushed and placed in warm water before administering. Be sure to check with the pharmacist before crushing a medication to be sure it will work after being crushed. Never dilute your medicine with the formula and do not add the medicine to the formula in the feeding set. Always flush the tube well with water before and after giving the medications, so as not to plug up the tube.

General tips for home gravity feeding is to keep any open cans in the refrigerator. Throw away any formula that has been opened for longer than 48 hours. The patient needs to have their head elevated if in bed or can be sitting in a chair. Use a new feeding bag every day and rinse them out with warm water between refills.

Notify your physician if the patient has more than 3 loose, watery stools a day accompanied by stomach cramps that last for more than 2-3 days. Also if the patient has constipation lasting longer than 5 days or has been unable to take any formula for more than 24 hours, the physician should be notified.

The Determination Of The Medical Diagnosis

The description of medical diagnosis, refers to the process of making the diagnosis, of which the possible disease or disorder is discerned. The history of the medical diagnosis goes back to the earliest days of Hippocrates in Greece. There have been many changes in the medical profession, but the theories that were set down in the early 20th century, still remain today.

If a person detects something that is not known to be normal and expresses a complaint, then it is time to consider what the problem could be. Just the fact that a person goes to a physician itself can be an indication that there needs to be a diagnostic procedure done to determine the problem.
There are different aspects of making a medical diagnosis. One of the most important is the clinical diagnosis. This is made by checking the medical signs and the symptoms reported by the patient, instead of by the use of diagnostic testing.

Laboratory diagnosis are made by the use of significant laboratory testing. An example of this is when an infectious disease will show characteristics of the pathogen involved and is used in combination with the signs and symptoms gathered from the physical examination. The drawing of blood or blood cultures can show the physician which pathogens to treat.

There are also times when medical imaging studies can help with the diagnostic process. Such diagnosis as a fracture, is a common diagnosis that can be made in this manner. X-rays have been used since 1895 and were the first attempt that was made to give images of the interior of the body. There are times when all these are combined to help make the diagnosis needed. The process of identifying all of the possible diagnosis that could be made by the lab and radiologic findings in combination with the signs and symptoms, can help make that final diagnosis.

Years ago, the physicians did not have the information they have today and more people died because of it. It was not uncommon for women to die in childbirth and today it is something that does not happen frequently. The advancements made in the clinics and hospitals of today have saved many a life.

Many clinics today have the ability to do simple x-rays and laboratory testing, which helps the physician make a faster diagnosis and are cheaper for the patient. The hospitals of today are equipped with the best of equipment in order to help with the care and diagnosis of the inpatients. The medical supply companies provide the clinics and hospitals with the best of supplies and equipment needed for this care.

With all the new technology, the future for the medical profession is going to be interesting. A few of the hospitals are already using robodoc's, which roll around checking on the patients. These are on wheels and have a computer screen, which allows the physician and the patient to communicate even if the physician is out of town. Let your imagination go wild and just think, within the next 10 years the changes in the making of the medical diagnosis that might be seen.

Tuberculosis Testing And Treatment

A tuberculosis skin test is done to determine if a person has been exposed to tuberculosis. This test is part of the hiring process for many companies, especially hospitals and any health care facilities. Tuberculosis (TB) is a disease that travels through the air from one person to another.

A positive TB skin test does not mean that the person has the TB bacteria, only that they have been exposed. Follow-up testing must be done in order to tell whether or not the person has latent TB infection (the bacteria is living in the body without making them sick) or the TB disease (the bacteria has progressed and become active). There are many people who have the latent disease that never become sick with the active bacteria.

The common symptoms of TB are:

• Coughing up blood or secretions
• A cough that last longer than 2-3 weeks
• Pain in the chest area
• Fatigue or weakness
• Loss of weight
• Poor appetite
• Chills
• Fever
• Night sweats

Complications can arise if the person infected with the bacteria is already compromised. People that had the TB bacteria previously and were not correctly treated, run a higher risk for the disease to become active. HIV patients that already have a compromised immune system and alcohol and illegal drug abusers, are definitely at a higher risk for complications. Any person that has a disease such as diabetes or any person that is immuno-compromised, needs to be very careful not to be exposed to the TB bacteria.

Tuberculin skin testing is done with the use of a serum for testing (tuberculin) and a tuberculin syringe. The skin test is done using .10 ml of the serum, injected with a tuberculin syringe into the lower part of the inside of the arm.

After 48 to 72 hours the test needs to read by a trained professional to look for a reaction on the arm. If the area is raised, hard or swelling, the area is measured. If the area is reddened, but not raised and hard, it is not considered positive. If the skin test is positive, additional tests are needed to determine if the infection is latent or the TB disease. If the test is negative, this means that the body did not react to the test and that TB is unlikely.

Both latent and progressive TB can be treated. People who have latent TB cannot spread it to others, but if it becomes active they can. That is the reason that these people are often given treatment. Treatment for these people is easier, because they don't have as much of the bacteria in their bodies as someone with active TB.

There are currently 10 drugs that are approved for treatment of active TB. The most common are isoniazid, rifampin, ethambutol, and pyrazinamide. The treatment usually last about 6 to 9 months. It is very important for people to finish the treatment as prescribed. If they don't, the TB bacteria could still be alive and become even more resistant to those drugs.

Safe Disposal For Needles And Syringes

It is very important to manage needles and syringes in the hospital setting. Any device that is used to puncture or lacerate the skin needs to be properly disposed of. These are considered biohazardous waste and must be very carefully handled. Syringes, needles, blades and contaminated glass and even some plastics, are in this category.

In addition to the sharps, anything such as a syringe connected to a needle, is considered sharps waste. Although the syringe cannot puncture the skin, because it was connected to the needle, it is now considered part of the hazardous waste. If a glass or plastic container has been contaminated with biohazardous material, then it is also treated the same as the needles.

If the sharp penetrates the skin, it is possible for the biohazard waste to spread blood-borne pathogens. Hospital staff expose themselves to the risk of transmission of Hepatitis B, Hepatitis C, and HIV, on a daily basis. The volume handled by the staff increases the chances that an accident can occur. Proper handling of the biohazardous waste helps to decrease these risks.

The best way to help prevent injuries is to take extreme care with the management and disposal of the waste. Hospital staff should minimize their contact with the sharps, handling them as little as possible. Hospitals have strict protocols which follows the government regulations, to ensure that staff handle the waste safely and that the waste is disposed of effectively.

Sharp containers are available in various sizes, for the disposal of these needles and syringes, blades, and other biohazardous waste. These heavy duty plastic containers are self-locking and sealable. The containers are made so that the whole container can be disposed of with the other biohazardous waste.

Disposal methods vary from state to state, but the common practice is, the disposal of the biohazardous waste by a truck service. Some hospitals and clinics, have a routine company that comes through the patient rooms and nurses' station and changes the containers for the staff. The staff then changes the sharps containers in between the company's trips, if necessary. Most facilities have the protocol, that these are to be changed when they are 2/3 full. The main cause of accidental needle sticks is needle sticking out of the sharp containers. Always check the policies and protocols for the facility and observe them closely.

The amount of injections that are given worldwide is astronomical. More than 16 billion a year are given, contributing to the increase in the accidental needle stick problem. The development of safety features, such as the auto-disable injection device, which retracts the needle back into the syringe, has helped decrease the accidental needle stick problem. Never recap a needle, always follow the policy of the facility for disposal and be careful.

Potential Risks With An Implanted Venous Access Port And Huber Needle

The implanted venous access port device is a drug delivery system for the delivery of fluids, drugs, or for the drawing of blood samples. The device has the capability to be accessed repeatedly with a Huber needle. The venous port consists of an implantable stainless steel port, with a septum that is self-sealing.

The major risk with the implanted port is infection, a bacterial infection can cause the port to have to be removed and can jeopardize the health of the patient. Aseptic technique should always be used when accessing, deaccessing, or dressing the site. Another complication can be the formation of a blood clot in the catheter. The blood clots can block the device. In order to prevent this problem, the catheter is flushed with saline or heparin as ordered by the health care provider or by the protocol of the facility.

The failure of the mechanical device is possible, although extremely unlikely. Usually what happens in this case, is the catheter that is attached to the device breaks away and if this happens, surgery will be necessary to remove the device and catheter. Normally the patient is not aware of this happening, but it is discovered because the port cannot be flushed or blood cannot be withdrawn.

An additional risk that can occur with the use of the device in children, is that as they grow, the device may move. A pneumothorax, which is an injury to the lung, can also occur with the insertion of the device.

Risk involving the Huber needle, starts with the possible needle stick injuries of the clinician because of the sharpness of the needle itself. It is common for there to be a rebound injury because of the unusual force that is needed to push the needle into the elastic septum. This is troublesome because these implanted access ports are often used for Hepatitis B and AIDS patients.

The Huber needles are designed to emphasize safe and effective needle stick protection. The needle has a safety cover that is to be used in order to help prevent needle sticks. The safety cover helps when removing the Huber needle with one hand, while using the other hand to apply pressure to the access site.

The policies and protocols for proper techniques while accessing and deaccessing the port site with a Huber needle, should be followed carefully. If these protocols are not followed, the chances of an infection or other complications rise dramatically. The dressing that is applied after accessing, should also be changed per facility protocol. Safety and following protocol is always the safest way to help prevent these risks from occurring.

Be safe Don't Get Stuck

Needle sticks in healthcare and other occupational settings definitely continue to be a serious problem. In 2000, the Needlestick Safety and Prevention Act was signed into law by congress. This law amended the Occupational Safety and Health Administration's (OSHA) Bloodborne Pathogen Standard, giving more specific details involving safer needle devices. States and territories that govern their own OSHA programs, also must adopt these revisions.

Needlestick wounds are caused by a needle that accidentally punctures the skin. This is a definite hazard for healthcare workers that work with hypodermic syringes or other equipment that has a needle. These sticks can occur at any time, the worker may be preparing the needle for the injection or disassembling or disposing of the needle. Needles are often thrown into the garbage or linen instead of being properly disposed of and therefore injure other workers, who encounter them unexpectedly.

In spite of all the guidelines and educational training programs for the healthcare professionals, needlesticks continue to be an ongoing problem. The bloodborne infectious diseases are considered to be HIV/Aids, Hepatitis B, and Hepatitis C. Healthcare professionals are strongly encouraged to use blunt-tip suture needles or needle free systems in order to decrease the risk of a needlestick injury. Hazardous fluids can be injected into the workers body by an accidental stick that punctures the skin.

Wolf-Pak provides valves for use with intravenous tubing's, which are one piece, luer-activated valves. They are easy to swab and come as a stand-alone piece or with an extension set pre-attached. These come in 100/box. The smartsite valve is one of the most widely used in the world. This valve, increases compliance and does away with the need for caps and cannulas. These valves are latex free and are suitable for a wide variety of drugs.

The major reason that simple solutions fail to stop the problem is that needles can cause injuries at any stage of their use. The design of the equipment, the type of the procedure, the experience of the staff, recapping, and the disposal of needles, are all factors that influence the reoccurring needle sticks. Approximately 30 to 50% of the needlestick injuries incurred are by nursing and laboratory staff. More than 30% of these injuries occur when the staff is disposing of the needles in sharp containers. The highest accounts of incidents occur because the sharp containers are overfilled.

All facilities have policies in place for the changing of the sharp containers and these policies should be carefully followed by all personnel. If you receive a needlestick, always report it to the proper people. Follow the guidelines and procedures of your facility. When using sharps such as needles or any other type of sharps, always be careful, follow policies and think before you act.

Diabetes And The Insulin Pump

Diabetes is a disease of the metabolic system, in which the patient has high blood sugar. In some cases, the pancreas doesn't produce enough insulin and in other cases, the cells just don't respond to the insulin when it is produced. This high blood sugar can cause a multitude of problems. The classical symptoms of diabetes is frequent urination, hunger, and increase in thirst.

There are 2 different types of diabetes.

Type 1 occurs because the pancreas does not make enough insulin.

Type 2 occurs because the cells in the body do not use the insulin in the right way.

Gestational occurs when a woman is pregnant and develops diabetes, when she did not have it before her pregnancy. Treatment for diabetes can range from controlling diet, oral medications, insulin injections and insulin pumps. Gastric bypass surgery has been known to help with people who have diabetes because of severe obesity and the gestational diabetic, usually resolves after the birth of the baby.

The insulin pumps replace the need to have injections. The pump delivers rapid acting insulin throughout the day by the use of a catheter. When the pump is used, the insulin can be better matched to the lifestyle. When the insulin pumps were first used, they were used more by the patients that were Type 1 diabetics, but now are being used more by people with Type 2 diabetes. The pump does not work by itself, it must be programed. The pump has to be told to deliver the insulin after the blood sugar is checked.

One type of Insulin infusion pump set is the Paradigm , which is used with the MiniMed Paradigm pumps. The user-filled reservoir holds up to 3 ml of insulin and come 10/box. The insulin pump is a small computerized device, similar in size to a cell phone, which is worn on a belt or pocket. This pump allows for the continuous flow of a rapid acting insulin. The insulin enters the body through a catheter that is inserted under the skin of the abdomen and is then taped down. The average insulin pump costs approximately $6,000 and many of the insurance companies have very strict guidelines that have to be followed.

The insulin pump provides a slow release of insulin, similar to what a normal pancreas would do and the thought is that it provides better blood sugars than with a number of injections given throughout the day. Another advantage is that there is no measuring and administering of injections. The one thing that the pump does not help with is that you still have to check your blood sugars at least 4 times a day. The pump catheter set has to be changed every couple of days and you have to be faithful in counting the grams of carbohydrates that you eat. The more successful diabetics that uses an insulin pump are ones that have been giving themselves two shots or less a day. These people tend to have less trouble with their blood sugars. The most important thing with an insulin pump is that the diabetic that is using it has a good knowledge of the procedures they need to follow.

With the insulin pumps, it can take a period of time for adjustment. The possibility of the blood sugar going high if something happens with the insulin pump or catheter can be a problem. The use of the insulin pump depends on the counting of the carbohydrates that are consumed. If the carbohydrates are not being counted, then the pump may not give good control. There is also a potential for infection of the area where the catheter in placed. This is one of the main reasons that people stop using pumps.

Although it is true, that insulin pumps are not for everyone, the fact remains that the most important part of the pump is the diabetic that is using it. Training, counting of carbohydrates, and checking the blood sugar is a must. A lot of people feel that the pump makes their diabetes easier to live with and keeps their blood sugars closer to the normal range.