NLE Gastrointestinal Nursing — Nutritional & Metabolic SupportConcept Map

Nutritional & Metabolic Support — Full Concept Hierarchy

Comprehensive mind map showing all major topics in Nutritional & Metabolic Support, organized hierarchically from central concept through assessment, obesity, malnutrition/refeeding, enteral and parenteral nutrition, and bariatric nursing considerations. This map displays the full scope of chapter content and relationships between key concepts.

Nutritional Assessment & Intervention Decision Tree

Decision tree flowchart guiding nurses through nutritional assessment and intervention selection. Starts with assessment parameters, branches to obesity/malnutrition/normal status, then leads to appropriate interventions (oral supplements, enteral feeding, TPN, bariatric surgery) with specific safety checks and monitoring requirements for each pathway. Includes refeeding syndrome precautions and NLE safety-critical TPN rules.

TPN Administration Safety Protocol — Critical Rules for NLE

Step-by-step TPN safety protocol emphasizing NLE-critical rules: CENTRAL line only, aseptic pump technique, never abrupt cessation (taper and hang D10W if delayed), blood glucose monitoring every 4–6 hours, and recognition of air embolism risk (left side, Trendelenburg, Valsalva). Includes monitoring requirements and transition protocol as GI function recovers.

Enteral Feeding Safety — Tube Placement Verification & Aspiration Prevention

Comprehensive enteral feeding safety flowchart covering tube placement verification (X-ray + bedside pH check, never auscultation alone), aspiration prevention (HOB 30–45° during and after feeds), gastric residual checks, medication administration precautions, and complication recognition. Emphasizes the NLE-critical rule: verify before EVERY feed and EVERY medication.

Refeeding Syndrome — Pathophysiology & Prevention in Malnourished Patients

Detailed flowchart showing refeeding syndrome pathophysiology: starvation → feeding stimulus → insulin surge → intracellular electrolyte shift → dangerous hypophosphatemia, hypokalemia, hypomagnesemia. Prevention strategy emphasizes starting LOW and SLOW, giving thiamine first, and aggressive daily electrolyte replacement and monitoring in the first week. This is a high-yield NLE safety topic.

Bariatric Surgery Postoperative Nursing — Complication Recognition & Management

Postoperative bariatric surgery nursing guide emphasizing early leak detection (tachycardia + fever + rising pain = ominous sign), airway management for sleep-apnea-prone patients, VTE prevention, and long-term dumping syndrome prevention education (small meals, low simple carbs, fluids between not with meals, lie down after eating). Includes critical lifelong vitamin B12, iron, folate, calcium, vitamin D, and thiamine supplementation protocol.

Common Micronutrient Deficiencies Post-Bariatric Surgery — Clinical Recognition

Distribution of common micronutrient deficiencies after bariatric surgery. Vitamin B12 deficiency is most prevalent (40%), followed by iron (30%), vitamin D/calcium (20%), and folate/thiamine (10%). Each requires lifelong supplementation and monitoring, with specific clinical manifestations: B12 (paresthesia, ataxia, pernicious anemia), iron (microcytic anemia, fatigue), vitamin D/calcium (bone pain, osteomalacia), and thiamine (Wernicke encephalopathy).

Patient Nutritional Status Transition Model — Assessment to Intervention

State transition diagram showing patient movement through nutritional assessment and intervention pathways. Demonstrates five main pathways: obesity (diet → pharmacotherapy → bariatric surgery → lifelong supplements), normal nutritional status (routine monitoring), mild-moderate malnutrition (oral supplements), GI-intact malnutrition (enteral feeding), and severe malnutrition/starvation (refeeding with thiamine + electrolyte replacement, or TPN via central line with glucose monitoring). Each pathway shows critical decision points and transitions to successful outcome.