1. Chapter 24 Special Diets Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

2. Special Diets  Doctors may order special diets:  For a nutritional deficiency or a disease  For weight control (gain or loss)  To eliminate or decrease certain substances in the diet  The health team considers the need for dietary changes, personal choices, religion, culture, and eating problems.  Regular diet, general diet, and house diet mean no dietary limits or restrictions. Slide 2 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

3. Special Diets (cont’d)  The sodium-controlled diet  Sodium causes the body to retain water. The heart has to work harder. The extra workload can cause serious problems or death. The heart has to work harder. The extra workload can cause serious problems or death.  Sodium control decreases the amount of sodium in the body.  The doctor orders the amount of sodium allowed.  Sodium-controlled diets: Omitting high-sodium foods/salt used in cooking Omitting high-sodium foods/salt used in cooking Not adding salt to food at the table Not adding salt to food at the table Used for Hypertension, ht disease, kidney disease Used for Hypertension, ht disease, kidney disease Slide 3 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

4.  Diabetes meal plan  A meal plan for health eating is developed. Consistency is key-same amount of fat, protein, carbs Consistency is key-same amount of fat, protein, carbs  The meal plan involves: The person’s food preferences The person’s food preferences Calories needed Calories needed Eating meals and snacks at regular times Eating meals and snacks at regular times  You need to: Serve meals and snacks on time. Serve meals and snacks on time. Always check what was eaten. Always check what was eaten. Report what the person did and did not eat. Report what the person did and did not eat. Report changes in the person’s eating habits. Report changes in the person’s eating habits. Slide 4 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Special Diets (cont’d)

5.  The dysphagia diet  Dysphagia means difficulty swallowing.  Food/fluid thickness is changed to meet the person’s needs.  Thickened liquid-pureed with liquid until consistency of baby food  Medium thick (Nectar) consistency-thickness of nectar or V8 juice  Extra thick (honey) consistency-mounds a bit on spoon  Yogurt like-thick and holds its shape  Puree-no lumps, mounds on plate Slide 5 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Special Diets (cont’d)

6. Special Diets  Pureed diet  Used for persons with swallowing difficulties  Consistency like mashed potatoes Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 6

7. Dysphagia Diet  Doctor, speech-language pathologist, occupational therapist, dietitian, and nurse choose food thickness.  When feeding the person with dysphagia, you must: Follow aspiration precautions and the care plan. Follow aspiration precautions and the care plan. Report changes in how the person eats. Report changes in how the person eats. Observe for signs and symptoms of aspiration: choking, coughing, or difficulty breathing during or after meals, and abnormal breathing or respiratory sounds. Observe for signs and symptoms of aspiration: choking, coughing, or difficulty breathing during or after meals, and abnormal breathing or respiratory sounds. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 7

8. Special Diets  Clear Liquid diet  Include foods that are liquid at room temperature and leave small amounts of residues. They are non-gas forming and non-irritating.  Examples include: water, tea, coffee, sprite, gelatin, clear fruit juice, clear broth, popsicles  Used for person right after surgery or with nausea and vomiting Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 8

9. Clear liquid diet Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 9

10. Special Diets  Full-liquid diet  Includes foods that are liquid at room temperature or melt at body temperature  Used for persons advancing from a clear liquid diet post-operatively, for those unable to chew or swallow  Foods include: custard, eggnog, strained soups, strained vegetables, milk, strained cereal, ice cream, pudding, yogurt Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 10

11. Full liquid diet Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 11

12. Special Diets  Mechanical soft  Includes semi-solid foods that are easily digested  Used to advance from full liquid diet after surgery and for chewing problems or GI issues  Foods allowed: all liquids; meat, chicken or fish that is shredded; soft cheeses, soft bread without crust, pureed cooked vegetables, soft fruit, pudding Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 12

13. Mechanical soft diet Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 13

14. Special Diets  Bland diet  Mechanically and chemically non-irritating foods  Low in roughage, moderate temperature, no spices  Used for persons with GI disorders or after abdominal surgery  Includes pasta, white bread, cottage cheese, creamed soups, plain cereals Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 14

15. Special Diets  Other diets include high fiber, high calorie, calorie controlled, high iron, high protein, fat controlled.  Bonus: what type of patient do you think you might see a high protein diet used for? Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 15

16.  Common special fluid orders are:  Encourage fluids: the person drinks an increased amount of fluids.  Restrict fluids: fluids are limited to a certain amount.  Nothing by mouth (NPO): the person cannot eat or drink anything.  Thickened liquids: all fluids are thickened, including water. Slide 16 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Fluid Balance (cont’d)