Nobel Tıp Kitabevleri | Page 51

266 266 Nörolojik Bilimler Hemşireliği: Kanıta Dayalı Uygulamalar Neuroscience Nursing: Evidence-Based Practice amacıyla enteral beslemeye devam edilmelidir (Wheshould be continued in order to maximise nutritional Available from: 266 Neuroscience Nursing: Evidence-Based Practice lan et al., 2006; Wiesen et al., 2006). support (Whelan et al., 2006; Wiesen et al., 2006). should be continued in Parenteral beslenme order to maximise nutritional Parenteral nutrition support (Whelan et al., 2006; Wiesen et al., 2006). Parenteral nutrition sadece an option only after yönParenteral beslenme becomes enteral beslenme enteral nutritional methods temlerinin uygun olmadığına karar verildikten sonra Parenteral nutrition have been considered as not being viable. The decision to move to parenteral nutrition is düşünülen bir seçenektir. Parenteral beslenmeye geçiş Parenteral nutrition becomes an option only after enteral usually made on the basis that the patient is kararı genellikle hastanın oral ve/veya as not receiving nutritional methods have been considered enteral yolla being inadequate or unsafe oral and/or enteral nutritional intake, yetersiz veya güvensiz besin almasına bağlı olarak ya viable. The decision to move to parenteral nutrition is or when the patient has a non-functional, inaccessible or da hasta fonksiyonlarını yerine getiremiyorsa, hastayla usually made on the basis that the patient is receiving perforated gastrointestinal tract (NICE, 2006). iletişim kurulamıyorsa veya gastrointestinal yol kesininadequate or unsafe oral and/or enteral nutritional intake, The decision to commence parenteral teye uğramışsa alınır (NICE, 2006). inaccessible or or when the patient has a non-functional, nutrition requires the benefits to be weighed against the alınırken ya perforated gastrointestinal tract (NICE, 2006). Parenteral beslenmeye başlama kararı risks. Parenteral nutrition requires the önünde of a central venous catheter The ve riskleri göz placementbulundurulmalıdır. Pararları decision to commence parenteral nutrition requires thein longtstermbe weighed is therefore risks. kateter tabenefi to use and it against the associated with renteral beslenme uzun süreli santral venöz Parenteral an increased risk of infection and impairment of bağışıklığın nutrition requires the placement of a bağırsak gut catheter kılmasını gerektirir; bu nedenle, central venous -associated in immunity (as a resultitof bypassing associated with an long term use and is therefore atlanması sonucu) yitirilmesi (gastrointestinal yolun the GI tract) (Mestecky, 2006). Peripherally and impairment gut-associated increased risk of infectioninserted centralofcatheters (PICC) ve yüksek enfeksiyon riski ile ilişkilendirilir (Mestecky, are associated with yerleştirilen santral (Mestecky, immunity (as a result ofless risk of infection but can only be 2006). Periferal olarak bypassing the GI tract) kateterlerde used for short term administration catheters (PICC) 2006). Peripherally inserted central of parenteral nutrition (PICC – Peripherally Inserted Central Catheters) enfeksiareand when with less risk of infection but can only be associated the supplement feed is deemed suitable yon riski daha az olmakla birlikte, bunlar sadece kısa dö(NICE, 2006). Parenteral nutrition is costly as nutrition be used for short term administration of parenteral it has to nemli parenteral beslenme için ve hastanın uygun olduğu prepared on and when the an individual basis under strict sterile düşünüldüğünde supplement feed is deemed suitable kullanılabilir (NICE, 2006). Parenteconditions. The nurse must ensure that it solution (NICE, 2006). Parenteral nutrition is costly asthe has to be is ral beslenme, son derece steril koşullar altında bireysel prepared on from light, as it may affect some of the microprotected an individual basis under strict sterile bazda hazırlanması gerektiğinden, yüksek maliyetlidir. conditions. The nurse must technique must be maintained nutrients. Strict aseptic ensure that the solution is Hemşire solüsyonu ışıktan korumalıdır; ışık bazı mikro protectedattaching andas it may affect some of