What nutrition therapy options are available to patients with these types of nutrition complications? Which nutrition therapy method would you suggest and why? Are there other considerations that need to be made before making the nutrition therapy recommendation to the supervising dietitian and Physician?
Cancer is a deadly disease that can occur in any part of the body. Metastasis may occur which increases metabolic needs (Douglas, 2012). There are various treatment modalities for cancer as chemotherapy, radiotherapy and surgical correction that causes various side effects. The main complications would be nausea, vomiting and diarrhea which have to be overcome and boosted with some nutritional means.
The extensive chemotherapy and radiation therapy in the abdominal area destroys both cancer and normal epithelial lining cells of the bowel wall. As a result, the toxic waste is produced that stimulates the nausea receptors located in the medulla causing nausea and vomiting and if it is prolonged may reduce weight as the patient manifest. Diarrhea occurs due to the rapid proliferation of epithelial cells to compensate the lost cells (Douglas, 2012, Langhorne, 2007). Due to colon resection, the length of the colon decreases that leads to these side effects. Further HIV also causes increased body wasting and so anorexia, nausea, vomiting, diarrhea occurs (Douglas, 2012, Langhorne, 2007).
There are two major nutrition therapy options for this patient as enteral and parenteral nutrition. In enteral nutrition, nutrients are given through nose/ mouth via gastro intestinal tract. This helps to meet nutritional needs of the patient with nausea, vomiting and diarrhea (Douglas, 2012, Lewis, 2013). In total parenteral nutrition, nutrients as dextrose, vitamins, minerals, fatty acids, electrolytes and trace elements are given intravenously (Douglas, 2012).
Parenteral nutrition therapy is best as the patient has nausea, vomiting and diarrhea and may not tolerate nutrients given enterally. In parenteral therapy the nutrients are given intravenously which may reduce these side effects. Both peripheral and central method could be followed for this type.
As a nutritional aide, we should consider ethical aspects, family wishes and prognosis. The patient is in stage 4 of colon cancer and parenteral nutrition is the only option to save his life (Langhorne, 2007). We have to explain their family about the importance of this therapy to enhance the nutritional status. To increase the prognosis and extend the life of the patient, it is the best method.
Douglas, C. (2012). Potter and Perry’s Fundamentals of Nursing- Australian version. (4th ed.). St. Louis, Missouri: Elsevier
Langhorne, M. (2007). Oncology Nursing. (5th ed.). St. Louis, Missouri: Elsevier
Lewis, S.M., Heitkemper, M. M., & Dirksen, S.R. (2013). Medical Surgical Nursing: Assessment and Management of Clinical Problems. (9th ed.). Missouri: Mosby