chapter 24 special diets copyright © 2012 by mosby, an imprint of elsevier inc. all rights reserved
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Chapter 24Chapter 24
Special DietsSpecial Diets
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Special DietsSpecial Diets
Doctors may order special diets:Doctors may order special diets: For a nutritional deficiency or a diseaseFor a nutritional deficiency or a disease For weight control (gain or loss)For weight control (gain or loss) To eliminate or decrease certain substances in To eliminate or decrease certain substances in
the dietthe diet The health team considers the need for The health team considers the need for
dietary changes, personal choices, religion, dietary changes, personal choices, religion, culture, and eating problems.culture, and eating problems.
Regular diet, general diet, and house diet Regular diet, general diet, and house diet mean no dietary limits or restrictions.mean no dietary limits or restrictions.
Slide 2Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Special Diets (cont’d)Special Diets (cont’d) The sodium-controlled dietThe sodium-controlled diet
Sodium causes the body to retain water.Sodium causes the body to retain water.• The heart has to work harder. The extra The heart has to work harder. The extra
workload can cause serious problems or workload can cause serious problems or death.death.
Sodium control decreases the amount of sodium Sodium control decreases the amount of sodium in the body.in the body.
The doctor orders the amount of sodium allowed.The doctor orders the amount of sodium allowed. Sodium-controlled diets:Sodium-controlled diets:
• Omitting high-sodium foods/salt used in cookingOmitting high-sodium foods/salt used in cooking• Not adding salt to food at the tableNot adding salt to food at the table• Used for Hypertension, ht disease, kidney diseaseUsed for Hypertension, ht disease, kidney disease
Slide 3Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Diabetes meal planDiabetes meal plan A meal plan for health eating is developed.A meal plan for health eating is developed.
• Consistency is key-same amount of fat, protein, carbsConsistency is key-same amount of fat, protein, carbs The meal plan involves:The meal plan involves:
• The person’s food preferencesThe person’s food preferences• Calories neededCalories needed• Eating meals and snacks at regular timesEating meals and snacks at regular times
You need to: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 4Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Special Diets (cont’d)Special Diets (cont’d)
The dysphagia dietThe dysphagia diet Dysphagia means difficulty swallowing.Dysphagia means difficulty swallowing. Food/fluid thickness is changed to meet the Food/fluid thickness is changed to meet the
person’s needs.person’s needs. Thickened liquid-pureed with liquid until Thickened liquid-pureed with liquid until
consistency of baby foodconsistency of baby food Medium thick (Nectar) consistency-thickness of Medium thick (Nectar) consistency-thickness of
nectar or V8 juicenectar or V8 juice Extra thick (honey) consistency-mounds a bit on Extra thick (honey) consistency-mounds a bit on
spoonspoon Yogurt like-thick and holds its shapeYogurt like-thick and holds its shape Puree-no lumps, mounds on platePuree-no lumps, mounds on plate
Slide 5Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Special Diets (cont’d)Special Diets (cont’d)
Special DietsSpecial Diets
Pureed dietPureed diet Used for persons with swallowing difficultiesUsed for persons with swallowing difficulties Consistency like mashed potatoesConsistency like mashed potatoes
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 6
Dysphagia DietDysphagia Diet
Doctor, speech-language pathologist, Doctor, speech-language pathologist, occupational therapist, dietitian, and nurse occupational therapist, dietitian, and nurse choose food thickness.choose food thickness.
When feeding the person with dysphagia, you When feeding the person with dysphagia, you must:must:• Follow aspiration precautions and the care Follow aspiration precautions and the care
plan.plan.• Report changes in how the person eats.Report changes in how the person eats.• Observe for signs and symptoms of Observe for signs and symptoms of
aspiration: choking, coughing, or difficulty aspiration: choking, coughing, or difficulty breathing during or after meals, and abnormal breathing during or after meals, and abnormal breathing or respiratory sounds. breathing or respiratory sounds.
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 7
Special DietsSpecial Diets
Clear Liquid dietClear Liquid diet Include foods that are liquid at room temperature Include foods that are liquid at room temperature
and leave small amounts of residues. They are and leave small amounts of residues. They are non-gas forming and non-irritating.non-gas forming and non-irritating.
Examples include: water, tea, coffee, sprite, Examples include: water, tea, coffee, sprite, gelatin, clear fruit juice, clear broth, popsiclesgelatin, clear fruit juice, clear broth, popsicles
Used for person right after surgery or with nausea Used for person right after surgery or with nausea and vomitingand vomiting
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 8
Clear liquid dietClear liquid diet
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 9
Special DietsSpecial Diets
Full-liquid dietFull-liquid diet Includes foods that are liquid at room temperature Includes foods that are liquid at room temperature
or melt at body temperatureor melt at body temperature Used for persons advancing from a clear liquid Used for persons advancing from a clear liquid
diet post-operatively, for those unable to chew or diet post-operatively, for those unable to chew or swallow swallow
Foods include: custard, eggnog, strained soups, Foods include: custard, eggnog, strained soups, strained vegetables, milk, strained cereal, ice strained vegetables, milk, strained cereal, ice cream, pudding, yogurtcream, pudding, yogurt
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 10
Full liquid dietFull liquid diet
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 11
Special DietsSpecial Diets
Mechanical softMechanical soft Includes semi-solid foods that are easily digestedIncludes semi-solid foods that are easily digested Used to advance from full liquid diet after surgery Used to advance from full liquid diet after surgery
and for chewing problems or GI issuesand for chewing problems or GI issues Foods allowed: all liquids; meat, chicken or fish Foods allowed: all liquids; meat, chicken or fish
that is shredded; soft cheeses, soft bread without that is shredded; soft cheeses, soft bread without crust, pureed cooked vegetables, soft fruit, crust, pureed cooked vegetables, soft fruit, puddingpudding
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 12
Mechanical soft dietMechanical soft diet
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 13
Special DietsSpecial Diets
Bland dietBland diet Mechanically and chemically non-irritating foodsMechanically and chemically non-irritating foods Low in roughage, moderate temperature, no Low in roughage, moderate temperature, no
spicesspices Used for persons with GI disorders or after Used for persons with GI disorders or after
abdominal surgeryabdominal surgery Includes pasta, white bread, cottage cheese, Includes pasta, white bread, cottage cheese,
creamed soups, plain cerealscreamed soups, plain cereals
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 14
Special DietsSpecial Diets
Other diets include high fiber, high calorie, Other diets include high fiber, high calorie, calorie controlled, high iron, high protein, fat calorie controlled, high iron, high protein, fat controlled.controlled.
Bonus: what type of patient do you think you Bonus: what type of patient do you think you might see a high protein diet used for?might see a high protein diet used for?
Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 15
Common special fluid orders are:Common special fluid orders are: Encourage fluids: the person drinks an increased Encourage fluids: the person drinks an increased
amount of fluids.amount of fluids. Restrict fluids: fluids are limited to a certain Restrict fluids: fluids are limited to a certain
amount.amount. Nothing by mouth (NPO): the person cannot eat Nothing by mouth (NPO): the person cannot eat
or drink anything.or drink anything. Thickened liquids: all fluids are thickened, Thickened liquids: all fluids are thickened,
including water.including water.
Slide 16Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Fluid Balance (cont’d)Fluid Balance (cont’d)
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