一、目的
1.做為出院病患家屬居家照顧前準備
2.確定其技術正確,以防發生合併症
3.提供不能自行吞嚥病患之營養
二、適用狀況
1.需長期使用鼻胃管灌食之病患於病況穩定後2週開始教導家屬灌食,並記錄於護理記錄之出院衛教欄
2.慢性病患在家已長期使用管灌食者
三、步驟
1.洗手
2.準備用物
◆灌食空針
◆溫熱食物:食物之製作請參考營養室提供之資料
◆溫開水
◆彎盆或空容器
◆乾淨毛巾或餐巾紙
3.準備病患
◆協助病患坐起30度到60度
◆如需抽痰翻身,應先完成再進食
◆使用毛巾或餐巾紙圍在病患胸前
◆確定鼻胃管是否在胃內
檢查方法
◆鼻胃管上刻度是否滑出?
◆空針反抽,有無胃內容物抽出?
◆將胃管開口置於水內,有無水泡出現?
4.灌食空針抽20-30C.C.溫開水,接上鼻胃管,一手固定管子及空針接口處,另一手緩緩推入,以溼潤管壁
5.反摺鼻胃管開口處,避免空氣進入或胃內物倒流
6.灌食時,先將空針內氣體排出,再緩慢灌入
7.待全部食物灌完後,再抽30C.C溫開水灌入
8.管子近口端反摺塞入管子開口.
9.灌食完畢,洗淨灌食空針
四.注意事項
1.胃灌食病患應每日給予口腔及鼻腔護理,並更換固定胃管之鼻膠
2.胃管應避免受壓,扭曲或拉出
3.胃灌食物應保持溫熱,灌食速度不宜太快;太快易導致嘔吐與腹瀉
4.灌食應避免空氣灌入胃中,以減少腹脹情形
5.灌食後,保持坐姿30分鐘
6.灌食前空針反抽除檢視管子位置外,並可觀察病人消化能力作為此次灌食量的依據,一般二小時所消化的量超過上次灌食量的1/2即表示消化良好
7.患者使用氣管內管或氣切之病患,灌食前先將氣囊打氣,以防造成吸入性肺炎
8.病危,消化不良及嘔吐之病患,應由護士執行灌食
9.灌食中若有異常情形,立即停止並通知醫師.
10.鼻胃管約一個月更換一次,可至各醫院或聯絡居家護理予以服務what to do when husband cheats
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