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Yetersiz beslenme, cerrahi hastalarında büyük bir sorundur. Ameliyat geçiren hastalar beslenme durumunu etkileyebilecek birçok fizyolojik ve metabolik değişikliklerle karşı karşıya kalırlar. Ameliyat sonrası ağrı, mide bulantısı, kusma ve iştahsızlık küçük ameliyatlarda bile sorun yaratabilirken enfeksiyon, yara iyileşmesi ve katabolizma büyük ameliyatlardan sonra hastalar için daha önemli problem oluşturabilir. Bu sorunlar beslenme yetersizliği olan cerrahi hastaları için daha önemlidir. Yetersiz beslenen hastalarda ameliyat sonrası komplikasyon ve ölüm riski fazladır. Beslenme yetersizliği gastrointestinal sistem, böbrekler, kalp ve akciğerler gibi birçok organ sisteminin çalışmasını olumsuz yönde etkileyebilir. Bu hastalarda kas kuvveti ve bağışıklık fonksiyonu da zarar görür ve enfeksiyonlara karşı daha savunmasızdırlar. Yara iyileşmesi mobilizasyon ve ameliyat sonrası iyileşme süresi gecikir. Tüm bu faktörler hastanede kalış süresinin uzamasına, daha yüksek geri kabul oranlarına ve artan sağlık masraflarına neden olabilir. Hastanın tıbbi durumu ve gereksinimlerine göre beslenme oral, enteral ve parenteral yoldan uygulanabilir. Erken oral beslenme ameliyat sonrası dönemde hastalar için tercih edilen beslenme şeklidir. Oral yolun kullanılamadığı durumlarda enteral ve parenteral beslenme desteği sağlanmalıdır. Enteral beslenme gastrointestinal fonksiyonları koruduğu ve kan akımını artırdığı için parenteral beslenmeden daha fazla tercih edilmektedir. Ameliyat sonrası dönemde hastaların güvenli, uygun ve yeterli beslenmeye ve sıvılara erişmesini sağlamak her hemşirenin görevidir. Bu derlemede ameliyat öncesi ve sonrası dönemde enteral ve parenteral beslenmeye ilişkin kanıtlar ve hemşirelik bakımı değerlendirilmiştir.
Insufficient nutrition is a major problem for the surgical patients. Patients who are under surgery are faced with many physiological and metabolic changes that can affect their dietary condition. After surgery pain, abdominal illness, vomiting and appetite can cause problems even in small surgeries, while infection, wound healing and catabolism can create more significant problems for patients after large surgeries. These problems are more important for surgical patients with nutritional deficiency. In patients with insufficient nutrition, the risk of postoperative complications and death is higher. Nutrition deficiency can negatively affect the work of many organ systems, such as the gastrointestinal system, kidneys, heart and lungs. In these patients, the muscle strength and immune function are also damaged, and they are more inadequate against infections. The healing of the wound is mobilized and the healing period after surgery is delayed. All of these factors can lead to an extension of the duration of stay in the hospital, higher recovery rates and increased health costs. Depending on the patient’s medical condition and needs, nutrition can be applied oral, enteral and parenteral. Early oral nutrition is the preferred form of nutrition for patients in the postoperative period. In cases where the oral path is not used, enteral and parenteral nutrition support should be provided. Enteral nutrition is preferred more than parenteral nutrition because it preserves gastrointestinal functions and increases blood flow. In the postoperative period, it is the duty of every nurse to ensure that patients have access to safe, adequate and adequate nutrition and fluids. This collection assessed evidence of enteral and parenteral nutrition and nursing care in the pre- and postoperative period.
Malnutrition is a major problem in surgery patients. Patients undergoing surgery face many physiological and metabolic changes that may affect nutritional status. Postoperative pain, nausea, vomiting, and anorexia may problem those performing even minor operations, but infection, wound healing and catabolism may create more difficulties for patients after major surgeries. These problems are more important for surgical patients with nutritional deficiencies. Patients who are undernourished have a high risk of postoperative complications and death. Malnutrition can adversely affect the functioning of many organ systems such as the gastrointestinal tract, kidneys, heart, and lungs. In these patients, muscle strength and immune function are also damaged and more vulnerable to infections. Wound healing, mobilization and postoperative recovery time are delayed. All these elements can cause to length of hospital stay, higher readmission rates, and rising healthcare costs. Nutrition can be administered orally, enterally and parenterally according to the patient's medical condition and needs. Enteral and parenteral nutrition should be provided if the oral route is not available. Early oral feeding is the preferred form of nutrition for patients in the postoperative period. Enteral nutrition is more preferred than parenteral nutrition as it protects gastrointestinal function and increases blood flow. It is every nurse’s duty to provide that patients take access to safe, proper and enough nutrition and fluids in postoperative time. In this review, evidence-based practices of enteral and parenteral nutrition before and after surgery and nursing care were evaluated.
Field : Sağlık Bilimleri
Journal Type : Uluslararası
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