Ch 15 hospital nutrition pt 2

what are the categories of hospital diets?

regular, NPO, consistency modified, therapeutic (last 2 can be combined)

what is a regular diet?

no special dietary restrictions, able to order anything on the menu

describe an NPO diet

Nil Per Os (latin for nothing by mouth)

Pt is unable to consume any solids/liquids by mouth

may be able to consume meds or sips of water if specified in diet order

commonly used for a pt before having a procedure/surgery

may be prescribed for a pt who has chewing or swallowing issues until they are able tp be evaluated by a SLP

what are consistency modified diets?

used for dysphagia

consistency of diet is altered in some way

SLP performs bedside swallow eval or modified barium swallow study to determine most appropriate diet consistency

many considerations when feeding a pt on this diet

aspiration precautions: upright position, chin down when swallowing liquids, small bites, dry swallowing to clear

what are the types of therapeutic diets?

clear liquids/ full liquids

caridac

consistent carb

GI (easy to digest)

gluten free, kosher

low fat

renal

low sodium or phosphorus or potassium

neutropenic, vegetarian

describe the clear liquid diet

commonly used before GI procedures

used as first diet after surgery or procedure to evaluate tolerance

all items at room temp that are translucent: gelatin, apple/cranberry juice, ginger all, broth, water

what is the full liquid diet like?

used as next diet after clear liquid before advancing to solids

all at room temp: milk cream soup, OJ, ice cream , sherbet, cream of wheat, pudding

what is the cardiac diet like?

used for pts w/ ischemic stroke or transient ischemic stroke w/ cardiovascular disease, hemorrhage stroke, and cerebrovascular complication, etc.

low sodium: 3000-4000 mg

low fat: <35% cal from fat

describe the constant carb diet (CCHO)

used for pts w/ DM or med induced hyperglycemia

provides consistent amount of carb at each meal

no carb snacks unless ordered by MD or RD

what are the types of consistent carb?

low: 45g/meal

standard: 60g/meal

high: 75g/meal

liberalized: 45-75 g/meal

describe the GI easy to digest diet

recommended for pts w/GI distress, disorders, or surgery

reduces frequency and volume of stools, lessens irritation in GI tract to let heal

low fiber: no dried or fresh fruits, no raw veggies, no whole grains

no gassy veggies like cabbage, cauliflower, broccoli

no nuts/seeds/coconuts/raisins

limit fat content in food

what are gluten free and kosher diet like?

gluten free: used for celiac disease in order to help heal intestine, not gluten (wheat, rye, barley)

kosher: dependent on religious or personal belief of pt

must meet requirements laid out by Jewish law

describe the low fat and very low fat diets

a fat restricted diet can help if having trouble digesting or absorbing fat

low: 40-50 g/day (pancreatitis, gallbladder disease)

very low: <20 g/day (chyle leaks or chylous ascites)

what is the renal diet like?

may be recommended for patients w/ chronic kidney disease and/or acute kidney injury

renal non dialysis

renal dialysis

low potassium

low phosphorus

what is the low sodium diet like?

recommended for pts w/ HTN, heart failure, cirrhosis, kidney disease

help prevent extra water build up in body

2000 mg/day

what is the gastric bypass diet?

used for pts post gastric bypass

clear liquids to pureed to GI to stabile/regular

describe the Nissan diet

for pt w/ nissan fundoplication or certain GI surgeries

clear liquid to full to soft

no carbonated beverages for 6-8 weeks, no straws, avoid chocolate, alcohol, citrus, tomato, concentrated sweets

when are nutritional supplements recommended?

pts w/ high metabolic demands, inadequate po intake, poor appetite