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Adonis K. Lomibao, R.N. 12/20/11. Nutritional Needs & Diet Modification. Introduction. Nutrition:process by which the body takes in food for growth and repair and uses it to maintain health. Signs of good nutrition: -shiny hair -clear skin & eyes -well-developed body -an alert expression

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Adonis k lomibao r n 12 20 11

Adonis K. Lomibao, R.N.


Nutritional Needs & Diet Modification


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

  • Signs of good nutrition:

    -shiny hair

    -clear skin & eyes

    -well-developed body

    -an alert expression


Normal nutrition essential nutrients
Normal Nutrition & Essential Nutrients

  • Digestion:process of breaking down foods into simple substances that can be used by body cells for nourishment

  • Substances are essential nutrients:


  • Supply heat & energy

  • Build & repair body tissue

  • Regulate body functions


  • The basic material of every body cell

  • Only nutrient that can make new cells & rebuild tissue

  • Made of amino acids

  • Foods:


  • Complete proteins:contain all the amino acids the body can't manufacture

  • Incomplete:DO NOT contain all the essential amino acids

Carbs fats
Carbs & Fats

  • Energy foods used to produce heat & energy

  • Excess stored at fat

  • Foods: fruits, vegetables, grains

  • Supply body with fiber or roughage(cellulose) to maintain bowel regularity

  • Fat: comes from plants & animals

  • Ex: Pork,nuts,butter,cheese,egg yolk


  • Vitamins regulate body processes:

    -build strong teeth & bones

    -promote growth

    -aid normal body functioning

    -strengthen resistance to disease

  • Vitamins A,B-Complex,C,D,E,K


  • Help build body tissues, esp. bone & teeth..also regulate chemistry oof the body fluids

  • Minerals include:







The five food groups
The Five Food Groups

  • Food Guide Pyramid Groups:


    -Vegetables-2 ½ cups/Daily

    -Fruits-2 cups/Daily


    -Milk-3 cups/Daily

    -Meat & beans-5.5oz/Daily

Discretionary calories
Discretionary Calories

  • An extra calorie that can be used on solid fats, added sugars, alcohol, or extra food.

  • Essential calories-the minimum calories required to meet your nutrient needs.

  • It is possible to use more calories than the amount required to meet your nutrient needs


  • Necessary for life and all the cellular functions in the body

  • 2-3 Quarts Daily

  • required to replace fluids lost through urine, stool, sweat, and evaporation through the skin

Basic facility diets
Basic Facility Diets

  • Four common diets


    -Full liquid

    -Clear liquid


Regular house

  • Normal or full diet based on 5 food groups


  • Excludes very rich foods

  • Lower caloric count

  • May select from a menu

Clear liquid diet
Clear Liquid Diet

  • Temporary b/c inadequate

  • Replaces fluids lost by vomiting or diarrhea

  • Consists of liquids that do not irritate, cause gas formation, or encourage bowel movements

  • Examples:

    -fat-free meat broths

    -ginger ale,7UP, clear juices



Full liquid diet
Full Liquid Diet

  • Supplies nourishment and may be used for longer periods of time...but still temporary.

  • Given to patients with:

    -Acute infections

    -conditions involving digestive tract

  • Examples:

    -strained cereal

    -strained soups

  • p.432

Soft diet
Soft Diet

  • Usually follows the full liquir diet

  • Nourishes body:between-meals feedings can be given to increase calorie count

  • Low-residue,mildly flavored,easy to digest

  • Given to pts with: infection/fevers,difficulty swallowing, conditions affecting digestive tract,on progressive post-op dietary regime

  • Examples on p.432

Special diets
Special Diets

  • Religious practices may change diet for some pts.

  • i.e. Jewish:

    -shellfish & nonkosher meats prohibited

    -foods can't be prepared with utensils used in non-kosher foods


The diabetic diet
The Diabetic Diet

  • For patients with Diabetes Mellitus

  • Proper diet and administration of insulin

  • Diets aim is to maintain the level of blood sugar WNL

  • Exchange List-method of balancing the diabetic diet based on household measurements, excludes high content sugar, divides food into 6 groups

  • Milk,veg,fruit,bread,meat,fat...

Sodium restricted diet
Sodium-Restricted Diet

  • May be ordered for pts. With chronic renal failure & cardiovascular disease

  • Different levels of sodium: Table 26-2

  • Average American 2-6g/day

  • Select low-sodium foods

  • Low in sodium:

    -some cereals



Calorie restricted

  • 3,500 calories=1 lb.

  • Prescribed for pts. That are overweight

  • Take consideration energy output, gen. Nutritional state, & weight goal

  • Balance between:

    -proteins: 20%

    -fats: 25-35%

    -carbs: 45-65%

Low fat low cholesterol diet
Low-Fat/Low-Cholesterol Diet

  • For patients suffering from vascular, heart, liver, or gallbladder disease...or difficulty with fat metabolism

  • Foods baked, roasted, broiled...

  • Fats limited & calories balanced by increasing proteins & carbs.

  • Foods included: p.435

Mechanically altered diets
Mechanically Altered Diets

  • Consistency & texture are modified to make food easier to chew & swallow.

  • Mechanical soft: those who have no teeth or with serious dental problems. “consistency of ground beef”

  • Pureed diet: blended with gravy or liquid till its pudding consistency

Supplements nourishments
Supplements & Nourishments

  • Ordered by physician or dietician to have a therapeutic value...i.e. High-protein to facilitate healing.

  • Not nutritionally comlete

  • Nourishments are substancial food items given to patients to increase nutrient intake. “between meals”

  • “snacks” prevent or eliminate hunger between meals

  • p.436

Calorie counts food intake studies
Calorie Counts & Food intake Studies

  • Food intake is analyzed for nutritional adequacy and number of calories consumed.

  • Info used to plan a diet to meet patient's special medical needs.

  • Food documentation for is prepared

  • Food may be weighed or measured

  • Inform staff & visitors


  • Difficulty swallowing food & liquids

  • May occur in those who have:

    -had a stroke

    -neuro studies



    -those who take meds that cause sedation or reduce saliva production

S s dysphagia
S&S Dysphagia

  • Taking a long time before beginning to swallow

  • Swallowing 3-4x per bite of food

  • Lack of gag reflex or weak cough

  • Wet, gurgling voice

  • Unintentional weight loss

  • p.437- inform nurse


  • Speech language pathology consult

  • Treated with swallowing exercises \, practice of proper swallowing techniques, alteration of consistency of food & beverages

  • Thickeners may be used

    -juice, nectar, honey, pudding (consistency)

Fluid balance
Fluid balance

  • Balance between liquid intake & liquid output

  • Intake-2,600-3,000ml/D

  • Edema-excessive fluid retention

  • Dehydration-inadequate fluid intake

  • Output- 2,500ml/D




Fluid balance cont
Fluid Balance Cont.

  • Record I&O

  • Push fluids/force fluids-encourage fluid intake

  • Fluid output includes: urine,emesis, drainage.

Alternative nutrition
Alternative Nutrition

  • Patients that may be:


    -disease of GI tract

    -persistent vomiting


  • TPN- IV Nutrition-concentrated nutrients

  • Enteral feedings- tubes inserted into digestive tract.

Alternative nutrition cont
Alternative Nutrition Cont.

  • NG Tube feeding

  • Gastrostomy- through abdominal skin into stomach

  • Jejunostomy tube-tip ends in small intestine

    -through nose, or surgically inserted

    -long term...those who don't have stomach or risk for aspiration

  • PEG Tube-Percutaneous Endoscopic Gastrostomy-surgically inserted