By Sari Bornstein Objectives Describe the most used therapeutic diets and their restrictions Demonstrate your understanding of therapeutic diets by accurately assembling and delivering the correct food items and their quantities in relation to diet order on a daily basis ID: 531172
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Slide1
Therapeutic Diets
By: Sari BornsteinSlide2
Objectives
Describe the most used therapeutic diets and their restrictions
Demonstrate your understanding of therapeutic diets by accurately assembling and delivering the correct food items and their quantities in relation to diet order on a daily basis.Slide3
Therapeutic d
iets to discuss:
Renal/Kidney Care
Dysphagia Diets
I, II, III
Dental SoftBariatric Stage 1
Low Microbial/
Neutropenic
Safety Trays
Fluid Restrictions
1:1 AssistanceSlide4Slide5
Renal/Kidney Care
Restricted in potassium, phosphorus, sodium, (protein, fluid)
Minimizes work put on the kidneys
Poor choices: salty foods, dairy, fresh fruit and vegetables, acidic foods
Good choices: Processed, white items
Novasource
® Renal supplementSlide6
Pureed: Dysphagia Level I
Difficulty chewing or
swallowing food
or liquids
Blended, whipped, mashed to pudding-like texture, no lumps
No garnish
May be accompanied with
thickened liquids
Thickened liquids
easier to swallowSlide7
Ground Meat/Diced Fruit and Vegetables: Dysphagia Level II
Difficulty swallowing or chewing due to poor dentition
Meat ground or diced < ¼ inch
Well moistened with
gravies
Fruit/vegetables/starches chopped < ½ inchSoft cooked vegetables, choppedSoft/canned fruit only, chopped
No bread or rice
Garnish OKSlide8
Dice/Chop All Foods: Dysphagia Level III
Food broken down for poor dentition with slight swallowing difficulty
All food chopped to < ½ inch
Meats well-moistened, chopped
Vegetables soft cooked, chopped
Most items compliant if chopped Salad: Shredded lettuce & chopped tomato OKSoft bread OK, no rice
Sandwiches/burgers OK if cut into quarters
Deli meat OK
No sandwich fillingsSlide9
Dental Soft
Restricts hard to chew, fibrous foods
Mouth pain, poor-fitting dentures
No raw vegetables and limited fresh fruit
No tough, fibrous
meats
No hard, sticky or
crunchy food
Patient preference =
many exceptionsSlide10
Bariatric Stage 1
Post bariatric surgery, clear liquids only
Sugar-free
Diet, clear liquids
caffeine-free
Decaf coffee or teaNo carbonated beveragesSlide11
Low Microbial/
Neutropenic
Restricts bacterial exposure for
immunocompromised
patients
Well-washed fresh fruit and vegetables OKNo uncooked tofu or deli meats
No garnishSlide12
Safety Tray
Harm to self or
others
Restricts sharp objects, glass,
saran wrap
Foil OK
No hot beverages or soup
No metal utensils, glass
dishes, soda cans, saran
wrap, hot plates or domes
Do not deliver to patientSlide13
1:1 Assistance
Patients need assistance with eating
At risk for aspiration
Call RN before tray
delivery
May deliver into room, but not within reach of the patientSlide14
Enteral Fluid Restriction
Prevents fluid retention
Heart or kidney failure
Dry, 1000, 1200, 1500, 1800, 2000 mL per day
Total includes fluid allowance from the floor
Includes: all beverages,
jello
, popsicles, ice cream, milk, soup/broth, ice, supplements
Example: 1 cup coffee = 6 oz. coffee
Small paper cup = 12 oz.
Be aware of hot fluid amounts dispensed Slide15
Looking at the ticket:
Diet order may not match food consistency
Example: Dice/Chop All Foods
Pear Halves
pears chopped to ½ inch
Squash
and Carrot
Medley
chopped to ½ inch
Grilled
Cheese on
White
cut into quarters
Angel
food
cake
chopped Angel food cake to ½ inch
EVERYTHING
chopped
Assuming
tray line staff
&
cooks look at
diet
Always pay attention to service notesSlide16
Considerations & Conclusion:
There may be exceptions
Always follow service notes first
If it’s questionable, ask diet clerks
Expeditors double check tickets
Hosts dispense correct liquid portions appropriateness of additional condimentsDiet manualSlide17
Empower yourself to…
O
ne
thing you can do to improve tray line accuracy
All food items present
All portions are correctAll consistencies are correctPresentableDelivered within 45 minutesDietary restriction knowledge
Cheat sheet
Diet manual Slide18
THANK YOU