| Clear liquid diet | Nonirritating diet that consists of liquids that are easily digested and absorbed with little residue in GI tract |
| Possible purpose for liquid diet | used prior to diagnostics, before and after surgery(until peristalsis returns) and sometimes in episodes of vomiting or diarrhea |
| Full liquid diet | Used as a transition diet from clear liquid diet. It is more nutritional and complete but lacking nutrients such as iron, zinc and fiber. Supplements may be added to account for nutritional deficit. |
| Foods included in clear liquid diet | Bouillon, Fat-Free Broth, Gelatin, Ginger-Ale, Lemon-Lime Soda, Popsicles, Tea or Coffee, White Grape, Apple and Cranberry Juice |
| Foods included in full liquid diet | All Clear liquids, custard, fruit and vegetable juices, ice cream, sherbet, milk, milkshakes, pudding, strained cereal, strained soups, supplemental formulas |
| How frequent are meals in liquid diets? | every 2-3 hours |
| Soft diet | Often and intermediate step from liquid to regular diet. A low residue, generally low fiber diet used for reasons such as diverticulitis, inflammatory bowel disease, gastritis and esophageal varices, and during times of indigestion and diarrhea. Mechanical soft may be used with difficulty swallowing or chewing |
| Foods included in soft diet | Includes foods from all food groups but avoids strong spices |
| Low Residue diet | Similar to soft diet but with restrictions on mil and milk products due to their leaving more residue in the colon |
| High-Fiber Diet | Variation of regular diet used in treatment of constipation, reducing need for laxatives. Also indicated for diverticulitis and helps lessen the severity of its symptoms and inflammation |
| Considerations with High-Fiber Diet | Promoting high fiber options such as whole grains
Increase fiber intake gradually to help preen gas formation
Fresh fruits and vegetables over processed will promote improved nutrition |
| BMR | Basal Metabolic Rate |
| Define Basal Metabolic Rate | Bodies use of energy to maintain necessary, involuntary body functions |
| Zero Energy Balance | Equilibrium between energy intake and energy output |
| Positive Energy Balance | Energy Intake is greater than energy output |
| Negative Energy Balance | Energy intake is less than energy output |
| High Kilocalorie and high protein diet | Diet which has potential to increase BMR, Increase body energy and protein necessary for healing and promotes weight gain. Indicated for times of great stress, bone fracture, burns, pressure injuries, sepsis, anorexia or cancer |
| Statistically how many people in the US are obese | 38% adults and 17% children and adolescents |
| Risks involved with obesity | Increased risk of hypertension, coronary artery disease, stroke, type 2 diabetes, dyslipidemias, osteoarthritis, gallbladder disease, some cancers and sleep apnea. Overall quality of life and life expectancy also decreases |
| BMI | Body Mass Index |
| How is BMI calculated? | Determined by dividing body weight in kilograms by height in meters squared |
| BMI for underweight | below 18.5 |
| Normal BMI | 18.5-24,9 |
| Overweight BMI | 25-29.9 |
| Obese BMI | Over 30 |
| Body Composition | percentage of weight that comprises body versus lean tissue, as well as BMI |
| What is a better predictor for weight related health risk? | BMI in combination with location and amount of body fat |
| Factors which contribute to obesity | Genetic, hormonal, metabolic factors, as well as lifestyle and disease processes |
| Interventions to promote weight loss | Treat the patient with empathy and without predjudice
Help the patient to set realistic and achievable weight loss goals
Help to promote exercise(Such as aerobics, resistance training)
Help patient to seek psychological intervention to compliment their treatment |
| Bariatric Surgery Candidate | Morbidly obese(BMI>40), or BMI 35 or greater with precipitating medical conditions such as cardiovascular disease and diabetes |
| Risks of Bariatric Surgery | Nutrient Deficiency(Commonly Iron, folic acid and b12), dumping syndrome and diarrhea |
| Type 1 Diabetes Mellitus | Commonly diagnosed in children and young adults in which the body does not produce insulin. These people are required to take insulin for life |
| Type 2 Diabetes Mellitus | Metabolic disorder resulting from bodies inability to make enough or properly use insulin. The number of people diagnosed with Diabetes mellitus has increased as sedentary lifestyle and obesity has become more prevalent |
| Goals of Diabetes diet management | controlling blood glucose and lipid levels to control and prevent complications |
| Interventions to help maintain diabetes | Carbohydrate intake must be monitored more closely, timing of meals and snacks must be timed appropriately with insulin administration, Promotion of diet containing whole grains, fruits, vegetables and low-fat milk, and limiting fat intake |
| Meal planning approaches for diabetes(Describe each) | -Exchange lists present foods in categories and a patient is instructed to eat a certain portion of each category. This allows better control of carb, fat and kilocalorie intake. This system is considered long and overcomplicated however
-Carb Counting focuses on total carbs eaten at meals and snacks. This is simpler as is focuses on just one nutrient and allows the patient to see a direct correlation between carb intake and blood glucose level |
| Interventions for acute hypoglycemia | 15-15 rule: take 15g of carbs, wait 15 mins and test blood glucose. If the patient is unresponsive intravenous glucose administration is necessary |
| Dumping Syndrome | Following surgeries in which portion or all of stomach is removed or after bariatric surgery contents of stomach may empty into small intestine too quickly. The partially digested foo draws excess fluid into the small intestine causing nausea, cramping, diarrhea, sweating, lightheadedness and palpations |
| Interventions for dumping syndrome | -Give small but frequent meals that are higher in protein and fat and lower in carbs
-Encourage to avoid concentrated sweets and drink fluids 30-60 mins before or after meals.
-Encourage the patient to lie down for 30-60 mins following a meal may help slow stomach emptying. |
| Lactose Intolerance | Occurs when the digestive enzyme lactase is not present in the GI tract. This leaves the GI tract unable to breakdown lactose(mild sugar). This condition is hereditary and is more common in African American, Hispanic, Asian American and Native American origins |
| s/s lactose intolerance | nausea, cramps, bloated feeling, flatulence and diarrhea |
| Fat modified diet | Diet indicated to reduce risk of heart and vascular disease and some cancers. Includes Low-fat and fat controlled diets |
| Low fat diet | Limits amount of total fat, saturated fat and trans fatty acids consumed. Necessary to prevent atherosclerosis, heart disease and hyperlipidemia. |
| Promoting low fat diet | Encourage the patient to choose low fat dairy, lean meats, skinless poultry and fish, advise limiting eggs to 4 or less per week and limit organ meat. Also limit use of butter, stick margarine, mayonnaise, cream and sour cream. |
| Fat controlled diet | Used to treat symptoms of diarrhea, steatorrhea and flatulence or disease of the hepatobiliary tract, pancreas, intestinal mucosa and lymphatic system and malabsorption. Restrict fat to as little as 25g/day depending on severity of symptoms. No visible fats are allowed, only nonfat dairy, lean meats, fish and poultry in increments of no more than 5oz per day. Promotion of grains, cereals, fruits and vegetables is essential |
| Metabolic syndrome | group of metabolic risk factors that occur together and increase risk for coronary artery disease, strike and type 2 diabetes. These include abdominal obesity, dyslipidemia, elevated blood pressure and insulin resistance |
| Goal of treatment for metabolic syndrome | to reduce risk of heart disease and diabetes |
| Protein restricted diets | In presence of defects in protein metabolism or excretion, it is necessary to reduce ore control protein intake. Such conditions include chronic renal failure and cirrhosis of the liver. |
| Azotemia | Damage to the kidneys. In renal failure caused by a buildup of waste products in the blood stream. |
| Focus of protein restricted diet | Complete proteins found in eggs, meat, poultry, fish and milk products. Avoidance of incomplete proteins including dried beans, and whole grains which contribute to azotemia |
| Cirrhosis | chronic degenerative disease of the liver in which scar tissue develops and hinders the livers ability to eliminate ammonia. Ammonia builds up in the bloodstream leading to hepatic coma, brain damage and death |
| DASH diet | Dietary Approaches to Stop Hypertension |
| Sodium Restriction diet | Diet indicated most often for hypertension, heart failure, edema and water retention. Sodium reduction is necessary to reduce pulmonary and peripheral edema and reduce workload of heart. Sodium restrictions vary in degree allowing 2000-3000mg/day. |
| Potassium modified diet | Increased Potassium intake may help to control blood pressure when in direct proportion to sodium intake. this diet emphasizes fruits and vegetables and low fat dairy.
Decreased potassium intake is indicated in end-stage renal disease and other kidney diseases. |
| Fluid modified diet | During end-stage renal disease, congestive heart failure and directly after myocardial infarction fluid restriction of 500-750mL/day may be necessary. This is divided between nursing and dietary departments in a facility. |
| Interventions to alleviate thirst in fluid restriction patient | Rinse mouth with cold mouthwash, putting a lemon in cold water to make it more refreshing, freeze fluid to make it last longer, eating cold fruits and raw vegetables, chewing gum, sucking on mints or hard candies, brushing teeth more often or limiting sodium intake |
