Answer to Question 1
Enteral nutritional support via a gastroduodenal tube or a J-tube to continue feeding the gut and maintaining the integrity of the intestinal lining and immunological function.
Parenteral nutrition should only be considered if other gastrointestinal problems (e.g. high-output fistulas) exist and enteral nutrition is contraindicated
Answer to Question 2
Recommend nutrition support if solid food consumption is inadequate - if oral consumption is too low, adequate nutriture (energy and protein) should be provided via nutrition support
Consume 5-6 small meals per day - smaller meals may alleviate the feelings of discomfort/pain from large meals and allow for quicker gastric emptying of the meal (due to the lower volume)
Encourage activity after eating (not lying down) - keeping the upper body in an upright position can allow gravity to assist in the movement of the gastric contents towards the pylorus
Select foods low in fiber and fat - fiber can thicken the gastric contents and slow their passage into the small intestine; fat will stimulate cholecystokinin and hence inhibit gastric emptying
Provide nutrition education to minimize symptoms of malabsorption/maldigestion - educating the client to consume foods consisting of high energy, protein, and micronutrient content can prevent nutritional inadequacies
Palpating the thyroid gland from behind the patient is a most effective way of assessing the gland f
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Patient with rheumatoid arthritis.
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