Dietary care for patients with nasal feeding: Dietary care for patients with nasal feeding: Bulbar paralysis, also known as bulbar paralysis, refers to a group of diseases caused by diseases such as the medulla oblongata or the brain, such as dysphagia, choking in drinking water and dysphonia. Usually, what is caused by medullary diseases is called true bulbar paralysis, and what is caused by brain diseases is called pseudobulbar paralysis. The etiology of the disease is complex and can be caused by various encephalopathy. Such as cerebral infarction, cerebral hemorrhage, encephalitis, brain trauma, brain degeneration, demyelinating diseases and brain tumors. Among them, cerebrovascular disease is the most common cause. Because of the high incidence of cerebrovascular disease, it is also very common. At present, there is no ideal clinical treatment for this disease, which is recognized as a refractory disease by Chinese and Western medicine. Patients with this disease have difficulty eating and speaking, and in severe cases, they completely lose their eating and speaking functions and rely on nasal feeding to maintain their lives. Because patients with severe bulbar paralysis need to use nasal feeding for life, many patients still need to use nasal feeding tubes at home after discharge. This paper expounds the nursing of nasal feeding tube and the preparation of nasal feeding diet. Indwelling time of gastric tube indwelling time of gastric tube indwelling time of gastric tube Ordinary gastric tube is replaced every week 1 time, and silicone tube is replaced every month 1 time. After the last feeding at night, pull out the tube quickly and clamp the nozzle at the same time to prevent the liquid from flowing into the trachea. The next morning, the tube was replaced by another nostril. Posture during nasal feeding: When the sphincter of cardia is opened, patients with cerebrovascular accident will suffer from aspiration or even pneumonia due to cough, low swallowing reflex and gastric juice reflux. Before nasal feeding, the bedside should be raised by 30-40 degrees to avoid choking, reflux and vomiting during and after eating, and reduce the occurrence of pneumonia. At the same time, because the swallowing function of the healthy limb is better than that of the affected limb during stroke, the head tends to the healthy side during nasal feeding, which can obviously reduce the accidental inhalation of food with gastric reflux into the trachea. Special attention should be paid to maintaining the semi-supine position for 30-60 minutes after nasal feeding, and then restoring the supine position to avoid suffocation caused by inhaling food into the lungs. 3 temperature temperature temperature temperature: the food should be cooled to 38-40 degrees, and then injected in a place where the inside of the forearm is not burnt. The nasal feeding temperature is too high or too low, which may burn or frostbite mucosa. 4. Common nasal feeding diet and common nasal feeding diet and common nasal feeding diet include mixed milk and homogeneous diet. The foods available for mixed milk are: milk, soybean milk, boiled eggs, thick rice soup, broth, sucrose, vegetable oil, salt and so on. Foods for a homogeneous diet include: rice, rice porridge, noodles, steamed bread, eggs, fish, shrimp, chicken, lean meat, pork liver, vegetables, oil and salt. Patients with nasal feeding need an adaptation process. At first, the amount of nasal feeding should be small and light, and then gradually increase. Those who are in a coma or haven't eaten for a long time are fed 50~ 100 ml of mixed milk every four hours on the first and second days. If there is no special discomfort, you can eat homogenized meals from the third day. For patients who eat a homogeneous meal for a long time, the infusion volume usually includes 200-400 ml of water each time, 3-4 times a day, and the water is supplemented several times, with a total amount of 1500-2000 ml per day. Notes on nasal feeding Notes on nasal feeding Notes on nasal feeding: 1. Observe whether the gastric tube is in the stomach before and after perfusion. When the patient coughs violently or has vomiting reflex, the intra-gastric pressure may increase, and reflux may occur, which may cause the gastric tube to come out and coil in the mouth. 2, every time before nasal feeding should be pumped back. When there is gastric juice, observe whether there is gastrointestinal bleeding or gastric retention (such as bloody, brown or fasting gastric juice greater than 1000 ml). Stop nasal feeding at this time and wait for the symptoms to improve. If there is no abnormality, slowly inject a small amount of warm water (30 ml), and then inject nasal medicine or liquid food. Drugs should be ground into tablets, dissolved and infused. The speed of nasal feeding should be slow, and the patient's reaction should be observed at any time. Turn back the stomach tube every time you suck the nose to feed, so as to prevent air from entering the stomach and causing abdominal distension. 3. Rinse the stomach tube with 30 ml warm water after nasal feeding to avoid food residues fermenting or deteriorating in the stomach, causing gastroenteritis or blocking the patient's lumen. Fold the end of the stomach tube back, wrap it with gauze and tie the rubber band tightly. If tee is used, please clean the tee every day. 4. Active and passive activities, such as physical exercise in bed and indoor and outdoor activities in wheelchairs, mainly promote intestinal peristalsis and are conducive to digestion and absorption. 5, pay attention to oral cleaning, oral care every day. Can keep the mouth clean and moist, and prevent oral ulcers and infections. It can also prevent bad breath and oral dirt, and at the same time, through nursing the oral cavity, observe the changes of the oral cavity and find out whether there is ulcer, bad breath or infection in time. Preparation and requirements of nasal feeding drinks, nasal feeding drinks, nasal feeding drinks and nasal feeding drinks::: Nasal feeding nutrient solution is the main food for patients who are in a coma for a long time or have difficulty chewing and swallowing and cannot eat by mouth. For various reasons, many patients rest in bed. Due to the particularity of food, the normal choice of food is limited. Basically, it's some milk, soybean milk, juice, rice noodles and the like. These foods have limited nutrients and cannot provide high protein, high calorie, high vitamins and high cellulose for the body in many ways. It is not difficult for nasal feeding patients to feed a variety of foods as widely as ordinary people, as long as the preparation method of nutrient solution is scientific and reasonable. The water produced by normal adults' daily diet, drinking water and metabolism is 2000. The calculation method of moisture is that when the high temperature is above 38℃ or the room temperature is above 32℃, for every increase of 1℃, it is necessary to supplement 10% of the daily water demand. Generally, the intake is calculated according to 30ml per kilogram of body weight, and the daily liquid intake is about 2500ml. High fever, excessive sweating and drinking water should be around 3000ml. Formula requirements Formula requirements Formula requirements::: ① Formula preparation should be combined with the condition, and different formulas should be given according to different symptoms and complications. High fever, respiratory tract infection, disturbance of consciousness, wound healing and infection all need high-quality protein and heat supplement. Sodium, potassium, chlorine and water should be determined according to brain edema and electrolyte balance. ② The nutrient solution for nasal feeding should be soft and free of dross, and copper wire should pass through the reed after preparation to avoid blocking the nasal feeding tube. ③ Pay strict attention to operating hygiene. All utensils (measuring cups, funnels, pots, pots and bottles) must be cleaned and disinfected before use, and pay attention to washing hands to prevent bacterial infection. (4) After all kinds of milk are mixed, it is not allowed to heat directly on the fire, and hot water insulation method should be adopted to avoid the mixed milk from condensing into blocks. After mixing the milk, don't cover it while it is hot, and then cover the bottle cap and put it in the refrigerator when it is cold, otherwise it will turn sour easily. ⑤ If acidic juice or vitamin C powder is added, it must be added before irrigation to avoid precipitation of mixed milk. The requirements of nasal feeding diet are fine, appropriate temperature, no residue, comprehensive nutrition and appropriate juice ratio. Protein should pay attention to the combination of plant protein and animal protein, and supplement vitamins and inorganic salts appropriately. Pay attention to hygiene in food, tableware and cooking. The raw materials for preparing meals should be fresh, and the prepared meals should be discarded if they are not eaten within 24 hours.