ABSTRACT
Malnutrition causes much ill health, delays recovery and increases mortality. Early and appropriate nutrition, preferably enteral, is fundamental to care. Protecting the gut may prevent sepsis. Nurses therefore should assess nutritional needs. Many intensive care unit (ICU) patients are unable to identify need to defecate or report constipation, yet are prone to bowel dysfunction. Nurses should therefore monitor bowel function. Diarrhoea frequently occurs in ICU patients, usually being caused by disease or treatments. Major bowel surgery often necessitates colostomy formation. Colostomy care is the same in ICU as elsewhere, except that ICU patients can seldom care for their own colostomies. Colour and perfusion of stomas should be checked at least once every shift and any concerns reported. Most trusts employ stoma nurses, who should be actively involved. Protein is the most important macronutrient in critical illness, as it promotes wound healing, immunity and muscle-building.
