Therapeutic

Nutrition
Presentation by : Advento
Geñoso
Pansacola
BSN 2A - Group 7
HO HO HO
Spot this gingerbread man
hiding amongst us!
all are required to submit 1/4 sheet of paper with
the total number of gingerbread men spotted at
the end of the presentation

closest to the total gets a prize

Illness and
Nutrition
Illness have many effects on our
body's ability to use nutrients based
upon the specific requirements. Lack
of appetite, vomitting, and pain often
prevent the intake of a sufficent
amount of nutrient
Illness and Food
acceptance
A sick person faces added problems related
to meals.

Diet is related to both the comfort and

treatment of the px, but sometimes, it is
necessary to take therapeutic measures that
may distress rather tham provide comfort.
During the time of his/her illness,
the px often becomes more
self-centered, irritable, or even
angry.

He/she may complain

incressantly about his/her food
in order to get more atention
Responsibilities of Nursing Department
1. The nurse is usually the first person who sees the
patient’s feeding problems

2. The nurse immediately tell the diet prescription

to the dietary department

3. Nursing aide makes sure that the patient is ready

to consume the food served.

4. Nursing aide records leftovers, if there is any

The Role of Nurses in Nutritional Care
Three important functions performed by the nurse
in nutritional care:

1. Observing
2. Listening
3. Reporting
The Role of Nurses in Nutritional Care (cont’d)

The Nurse performs nutritional care by

OBSERVING .
Nurse observes how well the patient
eats his/her foods
Nurse observes the kinds and amounts
of food refused
Nurse observes the patient’s
attitudes towards his/her food
The Role of Nurses in Nutritional Care (cont’d)

The Nurse performs nutritional care by

LISTENING .
Nurse helps patient express his/her
feelings, perhaps “Blow off steam”
Nurse becomes aware of the
concerns the patient may have
about the diet he/she will have
when at home
The Role of Nurses in Nutritional Care (cont’d)

The Nurse performs nutritional care by

REPORTING .
Nurse acts upon the information
and come up with the best care.
Nurse reports to the nursing
supervisor, dieticians, or physicians
depending on the circumstances
DIET THERAPY
An appropriate diet is essential in the total
care plan developed for every patient.

- to supplements medical and surgical care

- for specific treatment for the disease
 DIET THERAPY
Accomplishes these aims:
1. Maintains normal nutrition
2. Corrects nutritional deficiency
3. Changes body weight
4. Adjusts the body’s ability to use one or
more nutrients
5. Permits maximum rest to the body or
an organ
Factors in Planning a Modified Diet
Disease state, its nature, duration, intensity

Food form or nutrient modifications

required by the disease

Patient’s individual food

tolerances and food habits

Nutritional adequacy of modified diet

Patient’s physical ability and home situation

STANDARD HOSPITAL DIETS
A. Liquid Diets
1. Clear Liquid Diet
2. Full Liquid Diet
B. Soft Diets
C. Test Meals
CLEAR LIQUID DIET
This is an allowance of tea, coffee or coffee
substitute and fat-free broth.
Ginger ale, fruit juices, gelatin, fruit ices, and water
gruels are sometimes also given.
Small amounts of fluid are offered every hour or two
to the patient.

every

LIQUID DIETS 1 to 2
hours
CLEAR LIQUID DIET (Cleaveland clinic)

Clear, nonfat broths clear nutritional drinks pulp-free popsicle coffee and tea
without milk or
nondairy creamer

strained, pulp-free fruit sodas and sports drinks gelatin

and vegetable juices

every

LIQUID DIETS 1 to 2
hours
CLEAR LIQUID DIET
The diet is used for 24-48 hours following acute
vomiting, diarrhea, or surgery.
The primary purpose of this diet is to relieve thirst and
to help maintain water balance.

LIQUID DIETS: WHAT FOR?

CLEAR LIQUID DIET
Broth provides sodium.
Broth and fruit juices contribute potassium.
Carbonated beverages, sugar, and fruit juices, when
used, furnish a small amount of carbohydrate.

CHO NA K

LIQUID DIETS
FULL LIQUID DIET
This is a nutritionally adequate diet consisting of
liquids and foods that liquefy at body temperature. It
is used for acute infections and fever of short
duration and for patients who are too ill to chew.

LIQUID DIETS
FULL LIQUID DIET
It may be ordered as the first progressive from the
clear fluid diet following surgery or in the treatment of
acute gastrointestinal (GI) upsets.
The diet is offered in 6 feedings or more. Initially,
amounts smaller than those represented by the plan
may be given.

LIQUID DIETS
FULL LIQUID DIET
To increase the calorie intake, one pint of light cream
may be substituted for one pint of milk.
The protein level of the full fluid diet may be increased
by approximately 30 g by including 3 oz of non-fat
dry milk each day. This may be added to fresh milk,
cream soups, cereal gruels, or custards.

LIQUID DIETS
FULL LIQUID DIET
Strained meat may be added to broth or hot tomato
juice.
Raw eggs are sometimes a source of Salmonella
infection. Therefore, only pasteurized dried egg
powder should be used.

LIQUID DIETS
FULL LIQUID DIET
Food Allowance for One Day: ½ cup strained cereal
2 servings dessert: soft
6 cups milk
custard, plain ice cream,
2 eggs
sherbet, or plain gelatin
1-2 oz strained meat
2 tbsp sugar
1 cup strained citrus juice
1 tbsp butter
½ cup tomato juice Protein: 85 g
½ cup vegetable puree Calories: 1,950

LIQUID DIETS
FULL LIQUID DIET
Sample Menu: AM Snack
Orange juice
BREAKFAST
Soft custard
Grapefruit juice
LUNCH
Strained oatmeal with butter,
Broth with strained beef
hot milk, and sugar Tomato juice
Milk Vanilla ice cream
Coffee with cream and sugar Milk

LIQUID DIETS
FULL LIQUID DIET
PM Snack BED TIME
Chocolate malted milk
Milk
DINNER
Cream of asparagus soup
Eggnog
Strawberry gelatin with
whipped cream Tea with lemon
and sugar

LIQUID DIETS
A nutritionally adequate diet differs from the normal diet in
terms of having reduced fiber content, soft consistency,
and bland flavor. It is used immediately between the full
fluid diet and the regular diet following surgery, in acute
infections and fevers, and in GI disturbances.

SOFT DIETS
The normal diet is modified in the following ways:
1. Meat and poultry are minced or ground. Fish is usually
sufficiently tender without further treatment.
2. Vegetables, diced or chopped, are cooked. They may be
cooked a little longer than usual to be sure they are soft.
3. Soft raw fruits may be used.

SOFT DIETS
4. Soft rolls, breads, or biscuits are used instead of crisp
rolls, crust breads, and toast.
5. All desserts on a normal diet may be used including pies
with tender crusts, cakes, and puddings.

SOFT DIETS
Sample Menu: PM Snack
BREAKFAST Chicken arroz caldo
Fried hotdog and egg Kalamansi juice
Rice DINNER
Almondigas with patola
Milk and sugar
Rice
Ripe papaya
Ripe mango
AM Snack
BEDTIME
Pineapple juice
Milk
Chicken pie

SOFT DIETS
1. Fecal Fat Determination Test - It measures fat globules in
the stools to detect fat absorption as in cases like cystic
fibrosis. It consists of 100 g of fat ingested daily for 3 days
prior to fecal collection. Food items included are as follows:
2 cups whole milk 10 exchanges of fat
8 oz lean meat 1 egg

TEST MEALS
2. Meat-free Test- It is used to determine GIT bleeding. A 3-
day diet excludes ingestion of meat, poultry, and fish.
3. Calcium Test - It is used to determine urinary calcium
excretion to diagnose hypercalciuria. The diet requires 1,000
mg calcium intake-400 mg from food sources and 600 mg
from oral supplements.

TEST MEALS
4. Serotonin Test - It is used to detect calcinoid tumors of
the intestinal tract. Food rice in serotonin is excluded from
the diet

TEST MEALS
Normal Diet
and its
Modifications
The normal diet..
or sometimes called regular, general, or
house diet.. is the mosy frequent used in
all diets.

Like a modified diet, it has a great

importance when it comes to therapeutic
sense. WIth a satisfatory food intake, the
body tissues are continuously
maintained and there is an opportunity
for repair from the effects of illness.
The normal diet..
May be modified for:
consistency and texture
flavor
energy value
nutrient level such as fats, proteins,
carbohydrates, sodium, and others;
food categories such as types of
fats or elimination diet for allergies
often, a combination of
modifications is required: 500 mg
sodium, 1200 calorie soft diet.

In modifying diets the normal diet

should always be used as the frame
of reference. The aim should always
be to keep as many characteristics
of the normal diet as possible.
Good Tray
Service
9 essential good tray service
 The essentials of a good
tray service are as follows..
1. A tray of sufficient size for uncrowded arranged of dishes
2. A clean, unwrinkled tray cover and napkin of linen or good quality paper
3. An attractive pattern of spotless chinaware without chips or cracks; clean glassware
and shining silverware
4. An orderly arrangement of all items on the tray so that everything can easily be
within arm's reach of the px.
5. Portions of food suitable for the px's appetite
6. Food attractively arranged with appopriate garnishes
7. Meals served on time
8. Hot food served on warm plates and kept warm with food cover; cold foods served
on chilled dishes.
9. Trays promptly served to the px so that food is at its best
 1 2 3

10

4 6

5
7 8 9
Therapeutic
Diets
 Obesity, a condition in which the natural
energy reserve is increased, is a hazard
to health. It is not surprising that obese
people are prone to heart disease,
gallbladder disease, diabetes, or other
chronic diseases. An obese pregnant
woman is more likely to have
complications than a woman of normal
weight.
NUTRITION THERAPY
FOR OBESITY AND
WEIGHT CONTROL
 The degree of obesity is often judged by
comparing what one weighs with the
height-weight table. If one weighs
10%-19% more than the average for
his/her height and body frame, he/she is
overweight; if he/she weighs 20% or
more, he/she is, therefore, considered
obese.
NUTRITION THERAPY
FOR OBESITY AND
WEIGHT CONTROL
 Losing weight simply means balancing
food calorie intake with the body's needs
for calories. One pound of fat is equal to
about 3500 calories. If one has 500
calories less everyday, he/she will lose
about 1 lb/week.

NUTRITION THERAPY
FOR OBESITY AND
WEIGHT CONTROL
 The state of being overweight and obese
is a condition in which the body's stores
of fat are enlarged.

Underweight or undernutrition results

when intake does not meet the energy
requirement. Usually, an underweight
person weighs 10%-20% below the

NUTRITION THERAPY
desirable weight.

FOR OBESITY AND

WEIGHT CONTROL
Some Reasons
for Excessive
Calorie Intake
1. Family pattern of rich, high-calorie foods; the mother or any
household member being a good cook
2. Good appetite; likes to eat; likes many rich foods, may dislike fruits
and vegetables
3. Ignorance of calorie value of foods
4. Skips breakfast; is a frequent nibbler; takes coffee break with high-
calorie snacks
5. Pattern of living
a. Sedentary occupation; idleness
b. Riding to work or school
c. Little exercise during leisure
d. Often sleeps more as person becomes older
 6. Emotional outlet: eats to overcome worries and
problems, boredom, loneliness, or grief
7. Many social events serving rich foods; frequent
eating at restaurants
8. Lower metabolism with increasing age, but
failure to reduce intake
9. Lower metabolism with increasing age, but
failure to reduce intake
Prevention of Obesity
1. Follow recommended calorie intake by putting
changes in eating patterns of families
2. Encourage children to exercise and perform
some chores requiring daily physical activity
3. Preschool children should not be bribed or
rewarded with food.
Put off mind in excessive pleasure of eating
 Planning for weight loss
1. Planning for weight loss should be
directed by a physician.

2. It should set a reasonable goal

3. It must keep a weekly weight chart

4. It must include an exercise regimen

 LOW-CALORIE DIET
Women usually lose weight satisfactorily on diets
restricted to 1,000-1,500 calories whereas men lose
weight satisfactorily on diets Janishing 1,200-1,800
calories, Bed patients, such as those with heart
disease, are often placed on diets restricted to 800-
1,000 calories and sometimes less.
 LOW-CALORIE DIET
The daily food allowances for the 1,000- 1,200- and
1,500-calorie diets are somewhat higher in protein
than normal. This is desirable because it provides most
people with a feeling of satisfaction. Also it helps
correct the greater losses of muscle tissues that occur
during reducing. The extra protein is provided from the
meat group, with some restriction on the bread-cereal
group.
 LOW-CALORIE DIET
Usually, the food allowances are divided into 3
approximately equal meals. Skipping breakfast is not a
good idea.
Meals with a low-calorie diet should be attractive and
palatable. Herbs and spices may be used to give variety to
vegetable and/ or meat preparation. Meat, fish, and poultry
should be lean and prepared by boiling, broiling, roasting,
and stewing. Fresh fruits or canned unsweetened fruits are
used.
 LOW-CALORIE DIET
Low-calorie diets should not include alcoholic beverages,
sweetened carbonated beverages, cakes, candies, cookies,
cream, fried foods, sweetened fruits, pastries, pies, potato
chips, pretzels, puddings, and others.
 LOW-CALORIE DIET
Sample Menu (1200 calories):
BREAKFAST DINNER
Half banana Roast beef
Soft cooked egg Boiled vegetables
1 slice toast Rice
1 tsp butter Tea with lemon
Coffee without cream and sugar BEDTIME
LUNCH 1 apple
Salad (tomato, tuna fish, diced celery, French dressing, Cheese
lettuce, sliced hard-boiled egg)
1 cup rice
1 cup skim milk
1 slice papaya
UNDERWEIGHT

Reveals low body mass

relative to chronological age
which is influenced by both of
the child’s height and weight.
BMI < 18.5
UNDERWEIGHT

If a person is underweight, their

body may not be getting the
sufficient nutrients it needs to build
healthy bones, skin, and hair.
 What are the possible risk of
being UNDERWEIGHT?
Getting sick frequently Impaired growth
They may also not be Not getting enough calories
getting enough nutrients could mean a person may
to fight off infections. not develop as expected.

Osteoporosis Anemia
A person who is
Bones will be brittle and
underweight is more likely
more prone to breaking.
to have low blood counts
Underweight
Meal Planning
Tips
 Meal Planning tips are as follows..
Eat at least five small meals and snacks each day.
Drink healthy beverages that add calories. For example, have
juice, milk, or shakes.
Drink nutritional supplements.
Try high-calorie, high-protein recipes.
Sweeten foods and beverages with sugar, jam, jelly, or
honey.
Choose higher-calorie starchy vegetables such as potatoes,
corn, and peas. Add cream, butter, margarine, cheese
sauce, olive oil, or salad dressing to get more calories.
 Meal Planning tips are as follows..
Eat fruit canned in heavy syrup.
Choose foods high in protein. These include milk, eggs, cheese, meat, fish,
poultry, and beans. You may also use
protein powders and meal replacement shakes and bars.
Add high-fat foods to meals and snacks:
a. Choices include butter, regular margarine, vegetable oils, peanut butter, and
mayonnaise.
b. Whole milk, half-and-half, and cream have more calories than skim or low-fat
milk.
c. Higher-fat meats and whole-milk cheeses provide more calories than lean or
low-fat types.
Underweight
Sample Meal
Plan