Unit 7: The Gastrointestinal System

1. Unit 7: The Gastrointestinal System Chapter 42: Drugs for Nutritional Disorders

2. Vitamins Organic compounds required by the body for normal metabolism Classified as water soluble or lipid (fat) soluble Identify the water soluble and fat soluble vitamins What is one of the major differences between the two? What is the best way to ensure adequate amounts of vitamins are available?

3. Vitamin and Nutrition Related Syndromes http://www.neuro.wustl.edu/NEUROMUSCULAR/nother/vitamin.htm

4. Lipid Soluble Pharmacotherapy Prototype: Vitamin A (Aquasol A) p. 645 Therapy will depend upon specific deficiency Assess, counsel, and monitor clients taking fat-soluble vitamins Obtain good diet history Vit A: baseline visual acuity Assess mineral and electrolyte balance Monitor for bleeding tendencies Vitamin A during pregnancy can cause birth defects Vitamin K administered IV can cause bronchospasm, respiratory and cardiac arrest

5. Water Soluble Pharmacotherapy 12 vitamins comprise the B complex vitamins Nutritional deficiencies are not common In what chronic disorder would we most likely see a deficiency of B complex vitamins? What important roles does Vitamin C play in the body?

6. Water Soluble Pharmacotherapy Assess for s/s of deficiency Good diet history Severe thiamine deficiency can cause brain damage Niacin can be an adjunct therapy in hypercholesterolemia Folate (folic acid) is important to fetal neural tube development If history of kidney stones- avoid Vitamin C

7. Mineral Pharmacotherapy Macrominerals Essential substances 100 mg or more daily Nursing considerations: Assess reason for therapy and monitor Long term Ca+ can cause hypercalcemia Do not use phosphorus supplements if on sodium or potassium restriction Prevent overdose Microminerals AKA: Trace minerals 20 mg or less daily Nursing considerations: Iron associated with hgb Iodine needed for thyroid hormone synthesis Fluorine is beneficial to bones and teeth Zinc is found in at least 100 enzymes Supplementation needed with TPN

8. Undernutriton Ingestion or absorption of fewer nutrients than required for normal body growth and maintenance. Causes Range from simple to complex (see list on p. 654) Must identify underlying cause and focus treatment on resolution of cause or management of symptoms

9. Enteral Nutrition Adminstered via GI tract Best provided by oral consumption Tube feeding necessary when dysphagia or otherwise unable to take oral nutrition. Enteral feeding product chosen based on nutritional needs of client Must check tube placement prior to feedings Flush tubing at intervals to prevent clogging.

10. Total Parenteral Nutrition Short term use- peripheral infusion Long term use- venous access port May be given to build up client�s nutritional status prior to surgery Provides all nutritional needs Must be administered through an infusion pump. Closely monitor glucose, electrolytes, VS Aseptic techniques is essential Do not administer meds through same line