(hī″pĕr-ăl-jē′zē-ă) [″ + algesis, sense of pain] An excessive sensitivity to pain; the opposite of hypalgesia. SYN: hyperalgia.
(hī-pĕr-ăl′jē-ă) [″ + algos, pain] Hyperalgesia.
(hī″pĕr-ăl″ĭ-mĕn-tā′shŭn) The enteral and parenteral infusion of a solution that contains sufficient amino acids, glucose, fatty acids, electrolytes, vitamins, and minerals to sustain life, maintain normal growth and development, and provide for needed tissue repair. The gastrointestinal tract is the route of choice if it is functional. Intravenous hyperalimentation must utilize less concentrated formulations because of the potential for chemical phlebitis that may result from osmotic stress. Infusion through a central line catheter into the superior vena cava provides a sufficient blood volume to dilute more hypertonic solutions. One crucial drawback of a central line is the potential for the line to become infected with either bacteria or fungi.
PATIENT CARE: Vital signs, electrolyte values, and fluid balance (intake, output, and daily weight) are monitored for indications of fluid overload or dehydration. Urine specific gravity is measured, and the patient’s urine is checked for the presence of glucose and acetone every 6 hours. If the hyperalimentation is enteral, the nurse is aware of the placement of the distal end of the tube (above or below the pyloric sphincter); auscultates for bowel sounds; inspects, percusses, and measures for abdominal distention; and assesses for, documents, reports, and treats nausea, vomiting, or diarrhea. As appropriate, stomach contents are monitored for residual volume. Tube patency as well as volume, rate, and type of feeding are maintained; comfort measures are provided (oral misting, oral hygiene, and analgesic throat sprays); and any indications of infections due to long-term nasal tube placement, such as sinusitis, aspiration reflux chemical pneumonia, and other infections, are assessed. For example, sinusitis can occur because the tube impedes sinus drainage, allowing organisms to colonize the sinuses and resulting in fever and nasopurulent drainage. Chemical aspiration pneumonias often occur because of silent reflux regurgitation, resulting in acidic stomach contents and gram-negative organisms entering the respiratory tract. If hyperalimentation is via peripheral blood vessels, the insertion site is checked frequently for evidence of phlebitis; if via a central line, the site is monitored for signs of inflammation or infection, and the patient is assessed for signs and symptoms of sepsis. The insertion site is redressed and administration sets and connectors are changed according to institutional protocol; strict asepsis is maintained throughout these procedures. For all parenteral hyperalimentation, the flow rate should never be sped up if an infusion is behind unless this action is specifically prescribed by the physician. The physician is notified if the line becomes occluded or if fluids are stopped or slowed for any reason. The patient is assessed for hypoglycemia or fluid deficit. For all hyperalimentation, the patient is mobilized as possible. Nutritional status is monitored weekly; weight gain or ...