chapter 24 special diets copyright © 2012 by mosby, an imprint of elsevier inc. all rights reserved

Chapter 24Chapter 24

Special DietsSpecial Diets

Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.


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


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.


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


Special Diets (cont’d)Special Diets (cont’d)


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.



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


Clear liquid dietClear liquid diet



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


Full liquid dietFull liquid diet



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


Mechanical soft dietMechanical soft diet



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



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?


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.


Fluid Balance (cont’d)Fluid Balance (cont’d)

chapter 24 special diets copyright © 2012 by mosby, an imprint of elsevier inc. all rights reserved

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special diets contd

special diets copyright

sodiumcontrolled diet

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kidney disease slide

special diets pureed

sodiumcontrolled diets

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