Dr. Jonathan Spages | Basic Facility Diets for Nutrients

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Dr. Jonathan Spages

• Basic Facility Diets for Nutrients

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Introduction

• Nutrition
• Entire process by which the body takes in food
  for growth and repair and uses it to maintain
  health

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Normal Nutrition

• Food is normally taken into the body through the
  mouth
• The beginning of the digestive tract
• Digestion
• Breaking down foods into substances used by body
  cells for nourishment
• Essential nutrients

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Essential Nutrients

• To be well nourished, we must eat foods that
• Supply heat and energy
• Regulate body functions
• Build and repair body tissue

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Essential Nutrients

• Six essential nutrients
• Proteins
• Carbohydrates
• Fats
• Minerals
• Vitamins
• Water

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The Food Guide Pyramid

• USDA Food Guide Pyramid
• Designed to be individualized to each person to
  maintain a healthy weight

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The Food Guide Pyramid

• In addition
• Each person may use a small number of
  discretionary calories
• These are extra calories used to consume solid
  fats, added sugars, alcohol, or extra food from
  any group

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The Food Guide Pyramid

• For most people
• Discretionary calorie allowance is between 100
  and 300 calories daily

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The Food Guide Pyramid
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Water

• Water is an essential nutrient that is necessary
  to life
• A person can live only a few days without water

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Water

• Water is necessary for all cellular functions in
  the body
• An adequate intake of fluids is required to
  replace fluids lost through urine, stool, sweat,
  and evaporation through skin

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Water

• The normal adult intake of fluids
• Should be two to three quarts a day

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Water

• Offering liquids to patients frequently is
  important because
• Some patients cannot drink liquids without your
  help
• Elderly patients have a decreased sense of thirst
• Adequate fluid intake is necessary to prevent
  urinary problems and constipation

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Basic Facility Diets

• Food served to patients in the health care
  facility is prepared by the dietary department
• It includes the essential nutrients

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Basic Facility Diets

• The way in which it is prepared and its
  consistency
• Will depend on each individual patients
  condition and needs
• Sometimes very strict dietary control is needed

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Regular Diet

• The regular-select or house diet is a normal or
  regular (unrestricted) diet
• Based on the Food Guide Pyramid

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Clear Liquid Diet

• Temporary diet because it is an inadequate diet
• Made up primarily of water and carbohydrates for
  energy
• It may be used postoperatively
• Or when the patient has a condition such as
  nausea and vomiting

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Full Liquid Diet

• Does supply nourishment
• May be used for longer periods of time than the
  clear liquid diet

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Soft Diet

• Usually follows the full liquid diet
• Although this diet nourishes the body,
  between-meal feedings are sometimes given to
  increase the calorie count.

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Special Diets

• Planned to meet specific patient needs
• Patients may need special diets because of
  religious preferences or health needs

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Religious Restrictions

• Religious practice requires changes in diet for
  some patients.

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Therapeutic Diets

• Standard diets can be changed to conform to
  special dietary requirements
• For example
• An order might be written for a low-sodium soft
  diet when a patient has ill-fitting dentures and
  heart disease

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The Diabetic Diet

• Diet is an integral part of the therapy of the
  patient with diabetes mellitus
• The diet is nutritionally adequate
• Sometimes a proper diet is all that is needed to
  control the disease

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Sodium-Restricted Diet

• Sodium-restricted diets may be ordered for
  patients with chronic renal failure and
  cardiovascular disease
• These diets are some of the most difficult diets
  to follow

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Calorie-Restricted Diet

• As long as activity remains constant
• A person must take in approximately 500 calories
  a day less than usual to lose one pound

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Low-Fat/Low-Cholesterol Diet

• Prescribed for patients who suffer from
• Vascular disease
• Heart disease
• Liver disease
• Gallbladder disease
• Those who have difficulty with fat metabolism

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Mechanically Altered Diets

• Any diet may be mechanically altered
• This means that the consistency and texture of
  foods are modified
• Making foods easier to chew and swallow

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Mechanically Altered Diets

• Usually chopped to the texture of hamburger
• Making it easier to swallow
• Soft items, such as bread, are not modified

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Mechanically Altered Diets

• Usually served to patients with dental or chewing
  problems, and those with missing teeth

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Pureed Diet

• Blenderized until it is the consistency of
  pudding or baby food
• Given to patients who have dysphagia
• At risk of aspiration

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Pureed Diet

• The pureed food should not be watery
• If it is the proper consistency, a plastic spoon
  will stand upright without falling
• Make the meal as visually appealing as possible
• Avoid referring to the pureed food items as baby
  food

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Supplements and Nourishments

• Many patients receive a nutritional supplement or
  between-meal nourishments
• Supplements are ordered by the physician and have
  a definite therapeutic value

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Supplements and Nourishments

• Nourishments are substantial food items given to
  patients to increase nutrient intake
• Often planned and ordered by the facility
  dietitian
• Sandwiches or pudding
• Nutritious liquids, such as milkshakes

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Snacks

• Planned and regularly given, or unplanned upon
  patient request
• Given to patients to prevent or eliminate hunger
  between meals

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Calorie Counts and Food Intake Studies

• The physician or dietitian may order special food
  intake studies for a patient with special
  nutritional needs

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Calorie Counts and Food Intake Studies

• The patients food intake is carefully recorded
  for a period of time, usually three days
• The food intake is analyzed for nutritional
  adequacy and number of calories consumed

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Calorie Counts and Food Intake Studies

• The dietitian uses this information
• To plan a diet to meet the patients special
  medical needs

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Fluid Balance

• Balance between liquid intake and liquid output
• We take in approximately 2 ½ quarts of fluid
  daily
• Typical output equals about 2 ½ quarts daily

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Recording Intake and Output

• An accurate recording of intake and output (IO),
  or fluid taken in and given off by the body
• Basic to the care of many patients
• Some patients have an order to force (encourage)
  fluids
• While others have a fluid restriction

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Recording Intake and Output

• A fluid restriction requires a physician order
• You will find information regarding whether to
  push or restrict fluids on the care plan

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Changing Water

• It is important to provide fresh water for
  patients
• Water is essential to life
• In all cases, you should know whether a patient
  is allowed ice or tap water and if water is to be
  especially encouraged

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Sensory Problems

• Some patients have sensory problems affecting
  their appetites, such as problems with food
• Temperature
• Smell
• Taste
• Hearing and vision

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Sensory Problems

• Some patients have sensory problems affecting
  their appetites, such as problems with food
• Touch
• Texture

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Sensory Problems

• Presentation and attractiveness of food are
  especially important for patients
• Whose smell, taste, and texture sensations are
  impaired

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Mealtime Assistance for Patients Who Have
Swallowing Problems

• Patients who have difficulty swallowing
• May require one-to-one assistance
• Prompting
• Or supervision at meals

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Foodborne Illness

• Hot foods must be served hot
• Cold foods must be served cold
• If the food is off-temperature, pathogens may
  multiply, causing foodborne illness
• Follow all temperature and infection control
  precautions when passing trays

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Documenting Meal Intake

• Accurate documentation of each patients meal
  intake is very important
• Keep diet clipboards and lists covered to protect
  the patients privacy

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Total Parenteral Nutrition

• Total parenteral nutrition (TPN)
• A technique in which high-density nutrients are
  introduced into a large vein
• Such as the subclavian or the superior vena cava

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Enteral Feedings

• Enteral feedings are administered by tube
• Many different types of tubes may be used for
  these feedings
• Nurse or physician inserts the feeding tube

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Enteral Feedings

• Specially prepared solutions contain all the
  nutrients required by the body
• Keep the patients head elevated when the feeding
  is infusing, and for an hour after meals

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