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Nursing Pharmacology Instruct client to take one short deep breath after
each instillation and to remain position for 3-5
The seven rights of medication administration minutes.
RIGHT DRUG For oral medication:
RIGHT CLIENT Do not crush or chew enteric coated tablets.
RIGHT DOSE Many oral medications require administration with
RIGHT TIME milk or food
RIGHT ROUTE Schedule first doses of new medications on
RIGHT REASON different hours from other medications
RIGHT DOCUMENTATION For Pediatric Patients
General Principles in Drug Administration If drugs are being mixed with food or liquid, use
Whoever prepares the medication, administers and only small amount
charts it Medicine can also be given through nipples or
Consult a drug reference manual or pharmacist for droppers
information on unfamiliar drugs Toddlers: allow to choose on method of delivery-
For elderly clients: use devices like calendars, daily spoon, dropper, syringe, and allow to help
pill dispensers Position: Semi-Fowler’s or sitting
For pediatric clients, use syringe Instruct client to place tablets/ capsules at the back
Obtain assistance of parents to hold child in position of the throat and to follow with enough liquid
Assess client’s allergy Administer liquid medications after pills
Check drug’s expiry date Remain with the client until all the medications are
Read labels three times before administration taken. Check the client’s mouth
Wash hands before and after administration Check client 30-60 minutes later for effects of
Do not let the tip of the tube/dropper touch the medication.
client
Document administration on medication record and For buccal and sublingual medication
client’s response to medication. Place under the tongue (sublinggual) and between
For eye medication: cheek and gum (buccal)
Position: supine or sitting position with forehead If client’s mucous membranes are dry, offer a sip of
tilted back slightly water
Medication is administered into the conjunctival sac DRUGS
For ointments, apply from inner to outer canthus 1.Local anesthetics:
ending it with a twisting motion -blocks nerve conduction
Let the client close his eyes -metabolized by hepatic enzymes
For liquid medications, press firmly nasolacrimal -produces temporary loss of sensation and
duct for at least 30 seconds motion in a limited area of the body.
If medication temporarily affects vision, instruct E.g: Procaine (novocain),Benzocaine
client not to move until vision is clearer (americaine),mepivacaine (carbocaine)
Lift side rails and place call light within reach Nursing implications:
For ear (otic) instillation: a. force fluids
Wash ear if excess wax in noted b. keep side rail-up
Position: Side-lying, sitting, or semi-Fowler’s LIDOCAINE TOXICITY
position SLURRED SPEECH
For adults: pull auricle of ear up and back ALTERED CNS
For children: down and back (<3 years) MUSCLE TWITCHING
Instruct client to remain in position for 3-5 minutes SEIZURES
For nasal instillation 2. Non narcotic analgesics and antipyretics
Cleanse nares Aspirin
Position: Sitting with head tilted slightly backwards, -analgesia
or supine with head tilted back in hyperextended -antipyretic
position -anti-inflammatory
Hold dropper ¼ to ½ inch above nares -anti-platelet
Acetaminophen/Tylenol
-Analgesic,antipyretic
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-Antidote: acetylcysteine (mucomyst) Acetazolamine (diamox)/ Tegretol

-monitor liver/kidney function and CBC. -diuretics,absence,tonic-clonic or myoclonic
SALICYLATE POISONING seizures.
TINNITUS LETHARGY/EXCITABILITY, Nursing Implications
HYPERVENTILATION HYPERTHERMIA -7-10 days therapeutic level
METABOLIC ACIDOSIS -turn urine pink, red or red-brown.
NONNARCOTIC ANALGESICS AND -not given IM
ANTIPYRETICS -gingival hyperplasia
Nursing Implications -caution use in pregnancy
Monitor CBC, PT, kidney and liver function studies ENDOCRINE DRUGS
Additive effects if with use with anticoagulants 1. ANTIDIABETIC AGENTS
Drink plenty of fluids Insulin
Take with food or fluids. Adverse Effects:
Never given with children/adolescents with flu/ Allergy
chicken pox Hypoglycemia
Don’t crush enteric-coated tablets. Lipodystrophy
Avoid intake of alcohol Nursing Implications:
stop therapy one week before surgery Do not inject cold insulin.
3. Narcotic analgesics Discard discolored solutions or those with
Codeine precipitates. Do not shake vial.
hydromorphone (dilaudid), meperidine (demerol), Draw up clear insulin first.
methadone, Rotate injection sites
oxycodone HCL Monitor blood glucose levels regularly.
-induces sedation, analgesia and euphoria. Inform patients regarding signs of hypoglycemia
-relief of moderate to severe pain in MI. and appropriate treatment.
- relief of dyspnea in Pulmonary edema or Left If ill continue taking insulin and drink freely
ventricular failure. nancaloric liquids.
Nursing Implications: Inform regarding avoidance of smoking.
-assess pain before giving Oral Hypoglycemic agents
-monitor RR a. Sulfonylureas
-change position slowly promotes inc. insulin secretion from pancreatic beta
-check urinary retention cells
-nalaxone (narcan) available First-Generation Agents:
4.Sedative and Hypnotics Tolbutamide, Acetohexamide, Tolazamide,
Eg. Phenobarbital-luminal Chlorpropamide
Diazepam-Valium Second-Generation Agents
Hinders movement of impulses from thalamus of Glypizide, Glyburide
the brain cortex. b. Biguanides
Creates depression in the CNS reduces hepatic production of glucose by inhibiting
Nursing Implications: glycogenolysis
Deep IM decrease the intestinal absorption of glucose and
IV adm. monitor insertion sites for extravasation improving lipid profile
Tablet can be crushed and mixed with food/fluids Agents
Teratogenic Phenformin , Metformin , Buformin
5. Anticonvulsants c. Alpha-glucosidase inhibitors
Barbiturates (phenobarbital) Inhibits alpha-glucosidase enzymes in the small
-for gen. and absence seizures intestine and alpha amylase in the pancreas
Benzodiazepines (valium) Decrease rate of complex carbohydrate metabolism
-drug of choice for status epilepticus resulting to a reduced rate postprandially.
Hydantoins (dilantin) Agents
-prevents dissemination of electrical discharges in Acarbose (precose), Miglitol (glyset)
motor cortex area of the brain Nursing implications:
Succinimides (zarontin)/valporic acid (delpakene) Tablets should not be crushed
-absence seizures Monitor for signs of hypoglycemia
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Use other forms of contraception aside from OCPs Agranulocytosis

Alcohol can trigger a hypoglycemic effect. Hepatitis
Cover body is sunshine. Use of sunscreen. Myalgia
Sulfonylureas are best taken before meals Headcahe
Monitor for drug to drug interactions. Hypoprothrombinemia
CORTICOSTEROIDS hypothyroidism
Cortisol, hydrocortisone, prednisone, prednisolone, Nursing considerations
methylprednisone, triamcinolone, dexamethasone Give the drug with meals to reduce GI effects
Mineralocorticoid (fludrocortisone) Watch for signs of hypothyroidism
Uses: WOF: Agranulocytosis
Replacement therapy for adrenocortical Instruct patient to report for skin eruptions
insufficiency The drug should be stopped if severe rash develops
Anti-inflammatory agent or cervical lymph nodes become enlarged
Adverse effects: Advise patient to avoid foods high in iodine or
1. Altered protein metabolism potassium
Muscle wasting Warn the patient against the use of the over-the-
Osteoporosis counter medication
Easy bruisability Store the drug in a light-resistant container
2. Altered fat metabolism Monitor for weight and PR regularly.
Moon facies SSKI/Lugol’s solution
Buffalo hump Potassium or sodium iodide (potassium iodide
Truncal obesity SSKI), strong iodine solution (Lugol’s solution)
hyperlipidemia Treatment for thyrotoxic crisis
3. Altered carbohydrate metabolism
Hyperglycemia Mechanism of action:
Altered immune response Inhibits the release and synthesis of thyroid
Sodium and water retention hormones
Hypertension Decreases the vascularity of the thyroid gland
7. Hypokalemia, metabolic alkalosis Decreases thyroidal uptake of radioactive iodine
8. Emotional instability following radiation emergencies or administration
9. Excessive androgen activity of radioactive isotopes of iodine
10. Gastric irritation Adverse Effects:
Nursing Implications: Unpleasant tase
Review patient’s medical history prior to giving the Hypersalivation
drug Acne
Administer in light-resistant containers Rashes
Observe for mental changes. angioedema
Monitor for BP, weight, I and O, glucose, Burning sensation
electrolytes. THYROID HORMONES
Take with food or milk. Levothyroxine
Take drug before 9 AM. Liothyronine
Never abruptly stop taking the drug Thyroglobulin (Proloid)
Teach patient ways to prevent infection. Adverse Effects:
Restrict sodium, alcohol and caffeine intake. Signs of hyperthyroidism
Increase intake of foods high in potassium. Nursing Implications:
Rinse mouth after using inhaled steroids Different brands of levothyroxine may not be
Teach patient to avoid strenuous activities and falls bioequivalent
ANTITHYROID DRUGS Warn the patient (especially the elderly) to tell the
Propylthiouracil (PTU) and methimazole doctor if with signs of hyperthyroidism
Mechanism of action Instruct the patient to take thyroid hormones at the
Blocks thyroid hormone synthesis same time each day to maintain constant hormone
Adverse effects: levels.
Skin rash Nursing Implications:
Urticaria Medications taken in the morning
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Monitor apical pulse and blood pressure. If pulse is -increases force of myocardial contraction (+
>100 bpm, withhold the drug inotropic effect
Store in air-tight and light-resistant containers - improves blood supply to vital organs and
Monitor prothrombin time; a patient taking these kidneys, providing a diuretic effect.
hormones usually requires less anticoagulant -decreases rate of contraction (- chronotropic
OXYTOCIN effect)
Uses: -CHF,Atrial fibrillation, atrial flutter,paroxysmal
Promotion of uterine contractions atrial tachycardia.
Control of bleeding Cardiovascular Drugs
Release of milk from breast Nursing Implications:
Oxtocin-related drugs: -avoid high Na, increase K
Methergine -Antidote: digoxin immune Fab (digi-bind)
Ergonovine Hold if apical pulse:
Adverse Effects: -infants: below 90 beats
Tachycardia -children/adolescence: below 70
Water intoxication -adults: below 60 or above 120.
Uterine rupture Monitor serum digoxin levels: 0-5 to 2.0ng/ml.
Nausea and vomiting Anti anginal Drugs
Cardiovascular collapse Nitrites & Nitroglycerin
Anaphylaxis -dilates the peripheral vascular smooth muscles of
Hypertension (oxytocin-related drugs) small vessels.
Nursing Implications: -decreases cardiac pre load and after load.-
Use infusion pump for administration. Never give decreased myocardial oxygen needs
IM -dilates large coronary arteries,which helps decrease
Monitor BP, heart rate and I and O. anginal pain & hypoxia of the myocardium
Regularly monitor for uterine contractions and Anticoagulants
FHR. Heparin
Discontinue if: -blocks conversion of prothrombin to
With note of tetanic uterine contractions. thrombin and fibrinogen to fibrin
Signs of fetal distress Warfarin (coumarin)
Urinary flow is less than 30 ml/hour -blocks prothrombin synthesis
Signs of abruptio placenta and uterine rupture -takes 2-5 days –effect
For ergonovine/methergine- C/I for patients with Thrombolytic Drugs
vascular, renal and hepatic problems Streptokinase
Ophthalmic Drugs Activase, urokinase
A. Mydriatics and Cycloplegics -when use in treatment of MI, start therapy
-Atropine, Cyclogyl within 6 hours of attack.
-causes mydriasis (dilatation) and - corticosteriods -given to decrease allergic
cyloplegia, w/c paralyzes the lens and eye muscles. reaction
Nursing Implications: -Reconstitute it with normal saline or 5%
-sunglasses dextrose solution
-artificial tears -Avoid IM route
-elderly caution to atropine-IOP -Antidote: Aminocaproic acid
B. Miotics Antihypertensives
Acetylcholine (miochol) ACE INHIBITORS - CAPOTEN/CAPTOPRIL,
Carbachol (isopto carbachol) VASOTEC/ENALAPRIL,
Pilocarpine LOTENSIN/BENZAPRIL
-causes miosis (contraction) of pupils and BETA – BLOCKERS- INDERAL/PROPANOLOL,
ciliary muscles TENORMIN/ATENOLOL
-decreases IOP CALCIUM ANTAGONIST- CALAN
Cardiovascular Drugs ISOPTIN/VERAPAMIL,
Cardiac Glycosides CARDIZEM/DIALTIZEM,
Digoxin (Lanoxin) PROCARDIA/ NIFEDIPINE
Nursing Implications
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-avoid alcohol & hot showers -Signs of E-

-low Na diet Respiratory Drugs
-change position gradually A. Antiasthmatic Drugs
-monitor CBC,E+,urinalysis Theophylline,Aminophylline
Diuretics -relaxes bronchial smooth muscles cells
Thiazides: hydrochlorothiazide (Hydrodiuril) -increases renal blood flow, producing
Chlorathiazide (Diuril) diuretic effects and acts as CNS stimulant.
- Blocks Na reabsorption in the distal Respiratory Drugs
convoluted tubule,which prevents H20 reabsorption Nursing Implications
-increases urine output -theophylline level: 10-20 mcg/ml
-decrease blood volume -with milk or meals:GI upset present
-K excretion -not present give 1-2 hours before meals
-use in HPN, edema with CHF with water
Nursing Implication: -avoid excessive caffeine
-take early am & after meals
-agranulocytosis B. Cromolyn sodium
-take high K diet -acts on lung mucosa to prevent histamine
-change position gradually release
-daily weights
Loop Diuretics C. Mucolytics
Furosemide ( lasix ) -reduces the viscosity of mucus in the
-Acts by inhibiting reabsorption of Na and bronchial tree
CL at the proximal portion of the ascending loop of GIT Drugs
Henle,increasing H2O excretion. A.Histamine (H2) antagonists
-use in HPN, Pulmonary edema, cirrhosis, Cimetidine (Tagamet)
renal disease -Decreases stomach acidity by impending
Nursing Implications the action of histamine
-take with meals -Competes with Histamine for occupancy of
-monitor for hearing loss H2 receptors site on the parietal cells in the stomach
-use with 5 % dextrose in water, NaCL & -Suppresses the release of gastric acid
LR
-incorporated lasix should be use in 24 hours Nursing Implications:
-take dose in am -antacids decreases absorption
-diet high in K -4-6 weeks treatment ,ulcer disease.
-stay out of sun, use sunscreen -toxic effect: confusion

K-sparing diureticss B. Antidiarrheals agents

spironolactone ( aldactone ) Absorbent
-blocks aldosterone receptors in the kidney -Pepto-bismol
tubules,thus causing excretion of water & sodium & -kaopectate
K retention Opiate
Nursing Implications: -Imodium
- may last 2-3 days after drug is stopped -Lomotil
-avoid high K diet -Paregoric
Nursing Implications:
Osmotic Diuretics (mannitol)
-acts by increasing osmotic pressure of the -not taken with CNS depressants
glomerular filtrate inside the renal tubules -
-this causes less reabsorption of F & E+ by C. Laxatives
tubules & increase loss of Fluid,CL & Na. -use to promote movement of feces
Nursing Implications: Ex. Dulcolax, Lactulose, Metamucil
-warm solution to dissolve crystal Nursing Implications:
-used IV filters -not given with nausea, vomiting, abd’l pain,
-I&O q 30 minutes s/s appendicitis or intestinal obstruction
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Nursing Implications:
D. Ipecac Syrup -do not crush enteric coated tablet
-irritates the GIT to induce vomiting / -take in empty stomach ,full glass of water
delaying the absorption time of toxic substances -do not give w/ antacids
-GI s/s are dose related
Nursing Implications: E. Tetracyclines
-emesis should occur w/in 20-30 min -Bactericidal
-repeat dose Nursing Implications:
-less than 10 yrs old,one dose only -avoid with pregnant women
-not given: corrosive,petroleum based or Nursing mothers, Children under 8 y/o as
cyanide drug binds to calcium in teeth & new bone growth
-lead to tooth discoloration of permanent
E. Anti gout teeth & retarded bone growth.
Allopurinol (Zyloprim) - prevents production of -Avoid taking w/ dairy products, antacids,
uric acid vitamins, minerals.
Nursing Implications: -take 1 hr before meals,2 hrs after meals.
-force fluid:2-3 liters -report diarrhea episodes
-take after meals F. Urinary-Anti-infectives
-monitor Liver function test/CBC Nitrofurantoin (Macrodantin)
-Bacteriostatic
Colchicine (Novocolchine) Nursing Implications:
-drug of choice for acute gouty attacks -monitor pulmonary ,neurologic status
-decreases the inflammatory response to -give w/ milk or meals
deposits of monosodium urate crystals -avoid crushing tablet: tooth staining
Nursing Implications: -dilute suspension
-acute attack: given 1-2 hrs until pain ceases -rinse mouth
Antimicrobials -nausea/vomiting common effect
A. Aminoglycosides: G.Vancomycin HCL (Vancocin)
Gentamicin (Garamycin) -Exhibit bactericidal & Bacteriostatic effect.
-bactericidal Nursing Implications:
Nursing Implications: -monitor renal/auditory function test
-caution with decreased renal function, -adm.IV slow 60 minutes: prevent phlebitis,
reduced hearing, dehydration,neuromuscular extravasation, red-neck syndrome ( fever, hives,
disorders rash & redness of the face)
-adequate hydration
B.Penicillin G Potassium (Pentids) H. ciprofloxacin (Cipro)
-Bactericidal -Bactericidal
Nursing Implication: Nursing Implications:
-check allergic reactions -adm. with large glass of water
-Skin test -do not give with antacids
-give oral tablet empty stomach, -give 2 hours after meals
with full glass of water I. Antitubercular Drugs
-monitor CBC, BUN, Creatinine Isoniazid (INH)
C. Cephalosporins: -Bacteriostatic, If high concentration
-Bactericidal becomes Bactericidal
Nursing Implications: Nursing Implications:
-IM: rotate sites -assess neuromuscular function
-Assess for hx.of penicillin allergy: cross allergy -give B6 pyridoxine
between cephalosporin & penicillin -empty stomach-single daily dose
-reduce dose with renal/liver problems. -with meals & divide daily dose into 3 equal
-Thrombophlebitis: long IV administration. parts: GI upset.
Report diarrhea,rash,hives,dyspnea, bleeding Ethambutol (Myambutol
D. Erythromycin: -report any s/s blurring of vision
-Bacteriostatic (unable to see red or green)
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-Caution with renal impairment Infuse 1 liter of 0.9 NACl over 8 hours using 10 gtt
factor.
.Rifampin (Rifadin, Rimactane) Infuse 500ml of .45 NaCl over 12 hours to a 3-year-
-expect orange tinged body fluids old child.
-report anorexia,nausea/vomiting, jaundice, Milliliters per Hour (ml/hr)
malaise,dark urine Formula: Volume in ml
Computations Total # of hours= ml/hr
Preparing Solutions Infuse 1000 ml Lactated Ringer’s (LR) solution
1. Liquid to Drug Solutions over 10 hour.
Determine the strength of the solution, the strength 1000 ml  10 hour = 100 ml/hr
of the drug on hand and the quantity of the solution
required Drugs ordered in Units per Hour or Milligrams per
Formula Hour
Dose = Amount of Solution Doctor’s order: mix 10,000 U heparin in 1000 ml
Strength on hand D5W; infuse 80 units per hour
Example 1000 ml : 10,000 units :x ml : 80 U/hr
You have a 100% solution of hydrogen peroxide on 10,000 units x =80,000 ml-U/hr
hand. You need a liter of 50% solution. 10,000 U 10,000 U
x= 8 ml/hr
50 X 1000 ml = 500ml milliliters per hour
100 Mix 10,000 U heparin in 1000 ml D5 W; infuse at
Solid Dose of Oral Administration 15 ml/hr. How many units of heparin are being
Physician orders patient to have 1.0 g of ampicillin. delivered per hour?
The ampicillin bottle states that each tablet in the 1000 ml : 10,000 U : : 15 ml : x U
bottle contains 0.5 g. 1000 ml X = 150,000 U-ml
2 Methods 1000 ml 1000 ml
dosage desired = 1.0 g = 2 x= 150 U
dosage on hand 0.5 g Calculation of Flow Rates
Exercise Milliliters per Hour (ml/hr)
The physician order 1000 mg of ampicillin. Formula: Volume in ml
On hand: 0.25 grams per tablet. Total # of hours= ml/hr
X= Infuse 1000 ml Lactated Ringer’s (LR) solution
Liquid Dose of Oral Administration over 10 hour.
30 ml = 1 oz 1000 ml  10 hour = 100 ml/hr
Physician orders 60 ml of a liquid medication. How NUTRITION
many ounces will be given? Food Pyramid
Physician orders 45 ml. How many ounces will be Bread, cereal, rice, pasta- 6-11
given? Fruit- 2-4
Liquid Dose of Oral Administration Vegetable- 3-5 servings
Order: 500 mg;Dose at hand: 250mg/5 ml. How Milk- 2-3 servings
many ml will be given? Meat, poultry, fish, dry beans, eggs,
Formula: D/H x Q nuts- 2-3 servings
500/250 x 5 ml= 10 ml Fats- use sparingly
Order: 250 mg; dose at hand: 125 mg/ml K Caloric Values
Order: 500 mg; dose at hand: 125 mg/ml Carbohydrates 4
Calculation of Flow Rates Protein 4
Drops/ min Lipids (Fats) 9
Formula: Vitamin B1, (Thiamine)
vol in ml x gtts (ugtts)/ml = drops/min Vitamin B2, (Riboflavin)
time in minutes Vitamin B3, also Vitamin P (Niacin)
Infuse 1000 ml Lactated Ringer’s (LR) solution Vitamin B5, (Pantothenic acid)
over 10 hour to a 40 year old male. Vitamin B6, (Pyridoxine)
1000ml x 15 gtts/min = 25 gtts/min Vitamin B7, also Vitamin H (Biotin)
10 hrs x 60 min/hr Vitamin B9, (Folic acid)
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Vitamin B12, (Cyanocobalamin) Vitamin D

Thiamine (B1) Enhance absorption of calcium
A coenzyme Deficiency:
Need increases as metabolism increases Rickets
Sources: lean pork, whole grains, legumes, seeds, Osteomalacia
nuts Osteoporosis
Deficiency: Beri-beri Toxicity: hypercalcemia
Wernicke-Korsakoff syndrome Vitamin E
Riboflavin (B2) Anti oxidant
Coenzyme aphrodisiac
Sources: enriched grain, broccoli, asparagus, dark Sources:
leafy vegs, milk, meat, fish, poultry vegetable oil; margarine
Deficiency: Ariboflavinosis Whole grains, seeds, nuts, wheat germ, green leafy
Niacin (B3) vegetable
Active vitamin percursor May interfere with Coumadin
Sources: meat, poultry. Fish, legumes. Milk, coffee Primary deficiency: rare
ands tea Vitamin K
Def: Pellagra ( diarrhea, dermatitis, dementia Cofactor in synthesis of blood clotting
Pyridoxine (B6) Sources:
deficiency causes blood, skin, and nerve changes. bacteria in GIT
This vitamin is unique in that both deficiency and Liver production
excess can cause peripheral neuropathy Sources: green, leafy vegetable
Biotin (B7) Lesser amt in cereals, dairy products, meats and
Assist in transfer of carbohydrate from one a fruits
compound to another Calcium
Deficiency: dry scaly rash, hair loss, loss of Nerve impulse
appetite, depression, glossitis Muscle contraction and relaxation
Sources: liver, kidney, peanut, egg yolk Blood clot
Folic Acid (B9) Blood pressure regulation
Coenzyme Sources:
Sources: green leafy vegs, fruits, juice, legumes Milk and milk products
deficiency: in pregnant women, can lead to neural except cream cheese and butter
tube defects Broccoli
Cyanobalamin B12 Small fish with bones
Coenzyme +Tea and tannins reduce absorption of calcium+
Sources: meat, chicken, fish, pork, Deficiency: osteoporosis
eggs, dairy products Toxicity: urinary stone
Deficiency: Pernicious anemia iron
Vitamin C Responsible to distribute oxygen throughout our
Anti oxidant; collagen formation body
Enhances absorption of iron Found in RBC, muscles
RDA 90-125mg/day Spleen and liver
Deficiency: scurvy Deficiency: anemia
Vitamin A Toxicity: hemosiderosis
Maintains skin and mucous membranes throughout zinc
the body Growth processes, taste, smell, healing process,
Vision, immune system, bone growth immune system, carbohydrate metabolism by
Sources: assisting insulin function
Whole milk, butter, liver, egg yolks, fatty fish Found in: meat, fish, poultry, whole grains,
Carotenoids: deep green, yellow, orange fruits legumes, eggs
Deficiency: Xeropthalmia Deficiency: related to function
night blindness Dwarfism, hypogonadism, hypogeusia, hyposmia
keratomalacia poor wound healing, reduce immunity
Toxicity: Hypervitaminosis A
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toxicity: Vomiting, diarrhea, Atonic constipation, Atherosclerosis,

fever, exhaustion diverticulosis, DM
iodine Full diet with emphasis on long fibered vegetables ,
Part of thyroxine raw fruits and vegetables, whole grain cereals and
Increase in hypothyroidism coarse breads
Decrease in hyperthyroidism High caloric
Water Underweight, protein energy malnutrition, fevers
Fluid in which the substances can be use by the and infections, hyperthyroidism, burns, growth
body pregnancy and lactation
Provides a means of transportation for nutrients to 3 meals with in between feeding – gradual rather
and from cells than drastic. Vitamins and minerals at or above
8 glasses of water/day RDA. Contains greater amount of total energy
Clear liquid diet Cereals, bread, butter , cream and other fats and
Illness or surgery, acute inflammatory conditions of sugar
the GIT, for conditions requiring decreased fecal Low caloric
material Obesity and those cases where excess weight is a
Inadequate in nutritional essentials complicating factor as DM, CVD, renal, HPN, gout,
liquid at room temperature; Use for 1 -2 days only gall bladder and preceding surgery
Clear fat free broths , strained juices, tea and coffee Contains reduced amount of energy to effect a
, salabat, plain gelatin , sugar plain, hard candies negative energy balance
Full liquid diet Sufficient bulk , low in calories . Avoid high fat
Post –op , acute infection, acute inflammatory foods and high CHO foods
conditions of the G.I.T. for patients too ill to eat
solid or semi solid foods, impaired chewing and
swallowing ability
Liquid at room temp. and free from cellulose and
irritating spices and condiments. 6-8 small feedings
recommended
Strained cream or soups, pureed strained meat and
fish, strained fruit juices ,plain ice cream and
custard, cornstarch pudding and milk and cocoa
Soft Diet
Patients who are unable to chew, swallow or digest
foods
Modification in consistency and texture
Foods low in cellulose content, low in fiber free
from connective tissues and strong flavors, simple
and easily digested
Low residue diet
Dysentery , diarrheas , pre-op and post –op when it
is desired to reduce fecal residue, as in colostomy,
ileostomy , and bowel resection
foods which form least amount of fecal matter;
may require supplementation
Cereals strained soups, chicken
Bland diet
Gastric and duodenal ulcers, gastritis , ulcerative
colitis
Foods are non irritating
Mildly flavored foods without fiber, connective
tissue
avoid – alcohol , coffee black pepper and chili
powder
High fiber diet