Purpose | Principles | How to Care for a Patient in Pain | Nutrition
Nausea and Vomiting | Constipation | Anxiety and Depression | Dyspnea
Fatigue | End-of-Life Decision-Making | Community Resources
How to Refer Patients | Communication | Links and References

Nutritional Management

• Consider amount and cause of weigh loss; refer to previous weights, eating habits and symptoms that might interfere with food intake
• Set goals by understanding patient's desired level of function and prognosis
• Initiate nutritional support early in the course of a chronic illness
• Encourage small, frequent meals and avoid foods with strong odors

Goal -- Support during intensive care unit stay, after stroke, radiation or chemotherapy
Consider Support with -- Oral supplements
Products/Services

• Nutrition consult
• Mighty Shakes, Ensure Pudding, Instant Breakfast
• Lactose free: Boost, Boost Breeze, Enlive, Ensure
• Calorie dense: Ensure Plus, Boost Plus, Two Cal HN

Goal -- Support during serious illness, catabolic states
Consider Support with

• Tube feeding
• Percutaneous endoscopic or radiology gastrostomy IV hyperalimentation
• Oral supplements

Products/Services

• Nutrition consult for tube feeding protocol
• Set goals and time limits

Goal -- Preserve energy and comfort; limited survival
Consider Support with

• IV fluids for dehydration
• Antiemetics
• PEG feedings

Products/Services

• Appetite stimulants
• Megace (megesterol) 160-640 mg/d tablets or solution
• Prednisone 40 mg/d po
• Oxandrin (oxandrolone)  2.5 mg po bid-qid
• Marinol (dronabinol) 2.5 mg po bid
• Antidepressants
• Remeron (mirtazipine) 15 mg daily
• Anxiety and depression
• Nausea and vomiting

Goal -- Terminal care comfort measures
Consider Support with

• Oral supplements
• Antiemetics
• Anti-anxiety drugs
• Pain control
• PEG for drainage or feeding
• IV fluids for dehydration

Products/Services

• Hospice services
• Supportive care services

Cancer Education & Information Center | 3015 N. Ballas Road | St. Louis, Missouri 63131 USA | 314.996.5800