Dietetics for NursesProudfit, Fairfax T. (Fairfax Throckmorton)
Science
Dietetics for Nurses
Proudfit, Fairfax T. (Fairfax Throckmorton)
Diet in disease
~Temperature of Enema.~--Care must be taken not to have the
temperature of the nutrient enema too hot or too cold or it will be
promptly rejected. The patient is placed on the side with one knee
flexed; the solution is poured into a fountain syringe bag or an
enamel container (heat the container before pouring the solution into
it or the latter will be chilled). The bag or container has attached
to it a rubber tube with a cock adjusted so that only a small stream
will flow in at a time. To the end of this tube a rubber rectal tube
or catheter--1 cm. (about 1/2 inch)--is attached. This should be well
greased (do not use glycerin as this substance is irritating to the
mucous lining of the rectum). The liquid should be allowed to fill the
tube before it is inserted into the rectum, to prevent any air passing
in with it. The tube should be inserted with a gentle twisting
movement, using very little force or the tender mucous membranes will
be injured. Insert the tube twelve or more inches, since the solution
is more completely absorbed if given high up in the bowel. The bag
containing the solution should be held only a few inches higher than
the rectum, thus allowing only a small stream to pass in and allowing
an air space above the stream for the passage of gas which may be
accumulated in the upper part of the rectum. The tube should be
allowed to remain in the rectum for fifteen or twenty minutes, then
very gently withdrawn to prevent the liquid from being rejected. A pad
of gauze may be pressed against the anus to assist the patient in
retaining the enema. It is well to divert the attention of the patient
also, to further assist her in retaining the liquid.
~Duration of Rectal Feeding.~--Rectal feeding cannot be substituted
for a great length of time, first, because the patient cannot absorb
sufficient nourishment in this way to fully cover the body
requirements, and, second, because the rectum becomes more or less
sensitive and will reject the liquid before it has an opportunity to
be absorbed. From three to four nutrient enemas a day is about the
limit for the average patient. Between the nutrient enemas it is
advisable to give one of saline solution.
The following regime is practiced during the "Total Abstinence Period"
in the treatment of gastric ulcer: 7 A.M., cleansing enema; 8 A.M.,
nutrient enema; 1 P.M., nutrient enema; 3 P.M., saline enema; 6 P.M.,
nutrient enema. One saline and one nutrient enema may be given during
the night if the patient is very weak. She should not be wakened,
however, to be given the enema.
~Feeding by Inunction.~--This method consists in the rubbing into the
body of certain nutrient oils, such as olive oil, cocoanut oil, cocoa
butter, etc. It is of little value, but is occasionally resorted to
with very much emaciated and underfed infants, when digestional
disorders make it impossible to introduce enough food by mouth to
cover the needs of the body.
SPECIAL DIETS
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