Special Diets Special Needs

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Special DietsSpecial Needs

• FON 241

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Nutrition Intervention

• Nutrition Assessment
• Height
• Weight
• Recent weight loss/ gain
• Lab results
• Disease state/ special medical conditions
• Chewing/ swallowing ability

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Special Diets

• Standard Diets
• - Includes all foods in appropriate amounts
• Modified Diets
• - Change in consistency
• - Adjustment of calories
• - Change in number or frequency of meals
• - Adjusted fluid amounts or food types

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Progressive Diets

• Used following complicated surgeries.
• Diets advance as recovery progresses.
• Liquid Diets
• 1. Clear Liquid liquid and transparent at body
  temperature (broth, tea, jello).
• 2. Full Liquid both clear and opaque liquids
  (milk, ice cream, etc.)

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Progressive Diets

• Solid Food Diets
• Soft Diets- soft but solid foods, limit highly
  seasoned foods, easy to chew, digest and absorb.
• Low residue- low fiber diet, reduce fecal
  volume.
• Dysphagia- Difficulty in swallowing

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Nutrition Support

• 1. Enteral Nutrition (tube feedings)
• When the gut works use it!
• For patients who cannot eat or drink enough to
  meet nutritional needs.
• Gastrointestinal tract is functioning.
• Formulas are specific to diseases/ patient needs.

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Nutrition Support
Tube feeding products
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Nutrition Support
Jejunal Tube PEG-Tube
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Nutrition Support

• Total Parenteral Nutrition (TPN) Delivery of
  nutrient solutions directly into a vein,
  bypassing the GI tract.
• For use when the GI tract does not work.
• IV solutions contain water, amino acids,
  carbohydrate, fat, vitamins and minerals.

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Nutrition Support (TPN)

• TPN solutions are fed to the patient via a
  catheter placed in a central vein.
• The central veins lie close to the heart, where
  the TPN is rapidly diluted.

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Nutrition Support

• Peripheral Parenteral Nutrition (PPN)
• Smaller nutrient needs are met via a peripheral
  vein.
• Lower concentrations of nutrients are used, as
  the peripheral veins cannot withstand the volume
  or concentration of TPN
• A PICC (peripherally inserted central catheter)
  can be placed in a peripheral vein to deliver TPN
  nutrient concentrations.

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Nutrition Support

• PICC Line
• (Peripherally Inserted Central Catheter)
• Allows higher concentrations of nutrients to be
  delivered via a peripheral vein.

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Special Diets

• Diabetic Diet
• Protein 10-20 of total calories
• Carbohydrate 45-60 of total calories
• Fat 30 of total calories

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Diabetes Carbohydrate Counting

• Carbohydrate Counting Focus on the total
  carbohydrate content of foods.
• Determine your carbohydrate needs.
• Determine meals and snacks
• Example Breakfast 40g CHO
• Lunch 55g CHO
• Snack 25g CHO
• Dinner 55g CHO
• Snack 20g CHO
• TOTAL 195g CHO

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Diabetes Carbohydrate Counting

• Watching Food Labels
• Diabetics should be awareof Total Carbohydrate
  not just Sugar.
• Total Carbohydrate includes simple and
  complex carbohydrate.

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Nutrition and Renal Disease

• Chronic Kidney Disease/ Failure
• - Restricted protein intake
• - Reduced saturated fat/ total fat intake
• - Limited sodium and fluids.
• - Limited potassium (Hemodialysis only)
• - Limited phosphorus
• - Folate and B6 supplementation

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Kidney Failure Peritoneal Dialysis
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Kidney Failure Hemodialysis

• Hemodialysis Machine