Nutritional
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Nutrient intake from oral, enteral or parenteral nutrition (including any change in conditions that are affecting food intake)
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Daily initially, reducing to twice weekly when stable
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To ensure that patient is receiving nutrients to meet requirements and that current method of feeding is still the most appropriate. To allow alteration of intake as indicated
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Nutritional
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Actual volume of feed delivered*
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Daily initially, reducing to twice weekly when stable
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To ensure that patient is receiving correct volume of feed. To allow troubleshooting
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Nutritional
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Fluid balance charts (enteral and parenteral)
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Daily initially, reducing to twice weekly when stable
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To ensure patient is not becoming over or under hydrated
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Anthropometric
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Weight*
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Daily if concerns regarding fluid balance, otherwise weekly reducing to monthly
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To assess ongoing nutritional status, determine whether nutritional goals are being achieved and take into account both body fat and muscle
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Anthropometric
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Body mass index (BMI)*
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Start of feeding and then monthly
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To assess ongoing nutritional status, determine whether nutritional goals are being achieved and take into account both body fat and muscle
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Anthropometric
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Mid-arm circumference*
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Monthly, if weight cannot be obtained or is difficult to interpret
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To assess ongoing nutritional status, determine whether nutritional goals are being achieved and take into account both body fat and muscle
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Anthropometric
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Triceps skinfold thickness
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Monthly, if weight cannot be obtained or is difficult to interpret
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To assess ongoing nutritional status, determine whether nutritional goals are being achieved and take into account both body fat and muscle
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Gastrointestinal (GI) function
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Nausea or vomiting*
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Daily initially, reducing to twice weekly
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To ensure tolerance of feed
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GI function
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Diarrhoea*
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Daily initially, reducing to twice weekly
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To rule out any other causes of diarrhoea and then assess tolerance of feeds
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GI function
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Constipation*
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Daily initially, reducing to twice weekly
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To rule out other causes of constipation and then assess tolerance of feeds
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GI function
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Abdominal distension
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As necessary
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Assess tolerance of feed
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Enteral tube – nasally inserted
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Gastric tube position (pH less than or equal to 5.5 using pH paper – or noting position of markers on tube once initial position has been confirmed)
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Before each feed begins
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To ensure tube in correct position
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Enteral tube – nasally inserted
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Nasal erosion
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Daily
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To ensure tolerance of tube
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Enteral tube – nasally inserted
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Fixation (is it secure?)
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Daily
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To help prevent tube becoming dislodged
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Enteral tube – nasally inserted
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Is tube in working order (all pieces intact, tube not blocked or kinked)?
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Daily
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To ensure tube is in working order
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Gastrostomy or jejunostomy
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Stoma site
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Daily
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To ensure site not infected or red, no signs of gastric leakage
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Gastrostomy or jejunostomy
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Tube position (length at external fixation)
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Daily
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To ensure tube has not migrated from or into stomach and external over granulation
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Gastrostomy or jejunostomy
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Tube insertion and rotation (gastrostomy without jejunal extension only)
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Weekly
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Prevent internal overgranulation or prevention of buried bumper syndrome
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Gastrostomy or jejunostomy
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Balloon water volume (balloon retained gastrostomies only)
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Weekly
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To prevent tube falling out
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Gastrostomy or jejunostomy
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Jejunostomy tube position by noting position of external markers
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Daily
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Confirmation of position
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Parenteral nutrition
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Catheter entry site*
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Daily
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Signs of infection or inflammation
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Parenteral nutrition
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Skin over position of catheter tip (peripherally fed people)*
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Daily
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Signs of thrombophlebitis
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Clinical condition
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General condition*
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Daily
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To ensure that patient is tolerating feed and that feeding and route continue to be appropriate
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Clinical condition
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Temperature or blood pressure
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Daily initially, then as needed
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Sign of infection or fluid balance
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Clinical condition
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Drug therapy*
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Daily initially, reducing to monthly when stable
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Appropriate preparation of drug (to reduce incidence of tube blockage). To prevent or reduce drug nutrient interactions
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Long- or short-term goals
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Are goals being met?*
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Daily initially, reducing to twice weekly and then progressively to 3- to 6‑monthly, unless clinical condition changes
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To ensure that feeding is appropriate to overall care of patient
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Long- or short-term goals
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Are goals still appropriate?*
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Daily initially, reducing to twice weekly and then progressively to 3- to 6‑monthly, unless clinical condition changes
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To ensure that feeding is appropriate to overall care of patient
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