Usual Therapeutic Diets In The Hospital}

usual THERAPEUTIC DIETS in the hospital

by

ARISTOTLE MANGULABNAN

1. Clear Liquid Diet

Purpose:

relieve thirst and help maintain fluid balance

Use:

post-surgically and following acute vomiting or diarrhea

Foods allowed:

carbonated beverages; coffee (caffeinated and decaff); tea; flavored drinks, strained fruit sugar; popsicles; commercially prepared clear liquids; and hard candy

Foods Avoided:

milk and milk products, fruit juices with pulp

2. Full-Liquid Diet

Purpose:

provide an adequately nutritious diet for patients who cannot chew or who are too ill to do so

Use:

acute infection with fever, GI upsets, after surgery as a progression from clear liquids

Foods allowed:

clear liquids, milk drinks, cook cereals, custards, ice cream, sherbets, eggnog, all strained fruit juices, creamed vegetable soups, puddings, mashed potatoes, instant breakfast drinks, yogurt, mild cheese sauce or pureed meat, and seasoning

Foods avoided:

nuts, seeds, coconut, fruit, jam, and marmalade

3. Soft diet

Purpose:

provide adequate nutrition for those who have troubled chewing

Use:

patient with no teeth or ill-fitting dentures; transition from full-liquid to general diet; and for those who cannot tolerate highly seasoned, fried or raw foods following acute infections or gastrointestinal disturbances such as gastric ulcer or cholelithiasis

Foods allowed:

very tender minced, ground, baked broiled, roasted, stewed, or creamed beef, lamb, veal, liver, poultry, or fish; crisp bacon or sweet bread; cooked vegetables; pasta; all fruit juices; soft raw fruits; soft bread and cereals; all desserts that are soft and cheeses

Foods avoided:

coarse-whole grain cereals and bread; nuts; raisins; coconut; fruits with small seeds; fried foods; high fat gravies or sauces; spicy salad dressings; pickled meat; fish, or poultry; strong cheeses; brown or wild rice; raw vegetables; as well as lima beans and corn; spices such as horseradish, mustard, and catsup; and popcorn

4. Soft-Restricted diet

Purpose:

reduce sodium content in the tissue and promote excretion of water

Use:

heart failure, hypertension, renal disease, cirrhosis, toxemia of pregnancy, and cortisone therapy

Modifications:

mildly restrictive 2g sodium diet to extremely restricted 200mg sodium diet

Foods avoided:

table salt; all commercial soups, including bouillons; gravy, catsup, mustard, meat sauce and soy sauce; buttermilk, ice cream, and sherbet; sodas; beet greens, carrots, celery, chard, sauerkraut and spinach; all canned vegetables; frozen peas.

all baked products containing salt, baking powder, or canned shellfish; all cheeses; smoked or commercially prepared meats; salted butter or margarine; bacon, olives; and commercially prepared salad dressings

5. Renal diet

Purpose:

control protein, potassium, sodium and fluid levels in the body

Use:

acute and chronic renal failure, hemodialysis

Foods allowed:

– high-biological proteins such as meat, fowl, fish, cheese, and dairy products – range between 20 and 60 mg/day

– vegetable such as cabbage, cucumber, and peas are lowest in potassium

– potassium is usually limited to 500 mg/day

– fluid intake is restricted to the daily volume plus 500 ml, which represents insensible water loss

– fluid intake measures water in fruit, vegetables, milk and meat

Foods avoided:

cereals, bread, macaroni, noodles, spaghetti, avocados, kidney beans, potato chips, raw fruit, yams, soybeans, nuts, gingerbread, apricots, bananas, figs, grapefruit, oranges, percolated coffee,, coca-cola, orange crush, sport drinks, and breakfast drinks such as Tang or Awake

6. High-Protein, High Carbohydrate diet

Purpose:

to correct large protein losses and raises the level of blood albumin. May be modified to include low-fat, low sodium, and low cholesterol diets

Use:

burns, hepatitis, cirrhosis, pregnancy, hyperthyroidism, mononucleosis, protein deficiency due to poor eating habits, geriatric patient with poor intake; nephritis, liver and gallbladder disorder

Foods allowed:

general diet with added protein

Foods avoided:

restrictions depend on modifications added to the diet. The modifications are determined by the patients condition

7. Purine-Restricted diet

Purpose:

designed to reduce intake of uric-acid producing foods

Use:

high uric acid retention, uric acid renal stones and gout

Foods allowed:

general diet plus 2-3 quarts of liquid daily

Foods avoided:

cheese containing spices of nuts, fried eggs, meat, liver, seafood, lentils, dried peas and beans, broth, boullion, gravies, oatmeal and whole wheat, pasta, noodles, and alcoholic beverages. Limited quantities of meat, fish and seafood allowed

8. Bland diet

Purpose:

Provision of diet low in fiber, roughage, mechanical irritants, and chemical stimulants

Use:

gastritis, hyperchlorhydria (excess hydrochloric acid), functional G.I. disorders, gastric atony, diarrhea, spastic constipation, biliary indigestion, and hiatus hernia

Foods avoided:

– fried foods, including eggs, meat, fish, and seafood; cheese with added nuts or spices; commercially prepared luncheon meats; cured meats such as ham; gravies and sauces; raw vegetables

– potato skins; fruit juices with pulp; figs; raisins; fresh fruits; whole wheat; rye bread; bran cereals; rich pastries; pies; chocolate; jams with seeds; nuts; seasoned dressings; caffeinated coffee; strong tea; cocoa; alcoholic and carbonated beverages and pepper

9. Low fat, Cholesterol-Restricted diet

Purpose:

reduce hyperlipedimia, provide dietary treatment for malabsorption syndromes and patient having acute intolerance for fats

Use:

hyperlipedimia, atherosclerosis, pancreatitis, cystic fibrosis, sprue, gastrectomy, massive resection of small intestine, and cholecystitis

Foods allowed:

nonfat milk; low-carbohydrate, low-fat vegetables; most fruits; breads; pastas; cornmeal; lean meats

Foods avoided:

– remember to avoid the five C’s of cholesterol-cookies, cream, cake, coconut, chocolate; whole milk or cream products, avocados, olives, commercially prepared baked goods such as donuts and muffins, poultry skin, highly marbled meats

– butter, ordinary margarines, olive olive, lard, pudding made with whole milk, ice cream, candies with chocolate, cream, sauces, gravies and commercially fried foods

10. Diabetic diet

Purpose:

maintain blood glucose as near as normal as possible; prevent or delay onset of diabetic complications

Use:

diabetic Mellitus

Foods allowed:

choose foods with low glycemic index compose of:

a. 45-55 fats

c. 10-25% CHON

– coffee, tea, broth, spices and flavoring can be used as desired

– exchange group include: milk, vegetable, fruits, starch/bread, meat (divided in lean, medium fat, and high fat), and fat exchanges

_ the number of exchanges allowed from each group is dependent on the total number of calories allowed

_ non-nutritive sweeteners (sorbitol) in moderation with controlled, normal weight diabetics

Food avoided:

concentrated sweets or regular soft drinks

11. Acid and Alkaline diet

Purpose:

furnish as well balance diet in which the total acid ash is greater than the total alkaline ash each day

Use:

retard the formation of renal calculi. The type of diet chosen depends on the laboratory analysis of the stone

Acid and Alkaline ash food groups:

a. Acid ash: meat, whole grains, eggs, cheese, cranberries, prunes, plums

b. Alkaline ash: milk, vegetables, fruits (except cranberries, prunes and plums)

c. Neutral: sugar, fats, beverages(coffee, tea)

Foods allowed:

– Breads: any, preferably whole grain; crackers; roll

– Cereals: any, preferable whole grains

desserts: angel food or sunshine cake; cookies made without baking powder or soda; cornstarch, pudding, cranberry desserts, ice cream, sherbet, plum or prune desserts; rice or tapioca pudding

– Fats: any, such as butter, margarine, salad dressings, crisco, spry, lard, salad oil, olive oil

– Fruits: cranberry, plums, prunes

– Meat, eggs, cheese: any meat, fish or fowl, two servings daily; at least one egg daily

– Potato substitutes: corn, hominy, lentils, macaroni, noodles, rice, spaghetti, vermicelli

– Soup: broth as desired; other soups from food allowed

– Sweets: cranberry and plum jelly; plain sugar candy

Miscellaneous: cream sauce, gravy, peanut butter, peanuts, popcorn, salt spices, vinegar, walnuts

Restricted foods:

no more than the amount allowed each day

1. Milk: 1 pint daily (may be used in other ways than as beverage)

2. Cream: 1/3 cup or less daily

3. Fruits: one serving of fruits daily ( in addition to the prunes, plums and cranberries)

4. Vegetable: including potatoes: two servings daily

5. Sweets; chocolate or candies, syrups

6. Miscellaneous: other nuts, olives, pickles

12. High-fiber diet

Purpose:

– soften the stool

– exercise digestive tract muscles

– speed passage of food through digestive tract to prevent exposure to cancer-causing agents in food

– lower blood lipids

– prevent sharp rise in glucose after eating

Use:

diabetes, hyperlipedimia, constipation, diverticulitis, anticarcinogenics (colon)

Foods allowed:

– recommended intake about 6g crude fiber daily

– all bran cereal

– watermelon, prunes, dried peaches, apple with skin; parsnip, peas, brussels, sprout, sunflower seeds

13. Low Residue diet

Purpose:

– reduce stool bulk and slow transit time

Use:

bowel inflammation during acute diverticulitis, or ulcerative colitis, preparation for bowel surgery, esophageal and intestinal stenosis

Foods allowed:

eggs; ground or well-cooked tender meat, fish, poultry; milk, cheeses; strained fruit juice (except prune): cooked or canned apples, apricots, peaches, pears; ripe banana; strained vegetable juice: canned, cooked, or strained asparagus, beets, green beans, pumpkin, squash, spinach; white bread; refined cereals (cream of wheat)

see related link in my Fundamentals labels

http://promdinurses.blogspot.com/

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usual THERAPEUTIC DIETS in the hospital }