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Adult COPD Nutritional Education Protocol

DIRECTORS: Jassmine Bradley, Grant Belgarde, Lisa Mitchell, Dustin Stewart

MEDICAL DIRECTOR: Megan Schneider

PURPOSE:
Respiratory therapist to provide education to, when physician-ordered, adult COPD
patients that are admitted in a hospital setting. Breathing for COPD patients can require
more energy, especially during an exacerbation, therefore, proper nutrient intake is
crucial for muscle building and overall health. This protocol is to monitor and nutritionally
optimize patients with COPD.

Indications

● Patient admission with COPD

● SOB and/or difficulty taking in nutrition
● Significant weight gain or loss

Contraindications

● Patient is mechanically ventilated

● Patient is on ECMO support
● Patient is hemodynamically unstable

Nutritional Goals

● To prevent and/or reverse malnutrition

● To help improve respiratory function

POLICY:
A. Nutritional education and guidelines will be given with Physician order:
a. Patient evaluation by Dietician
b. Dietary guidelines
c. Physician order
d. RN involvement
B. Delivery of nutritional help pamphlet
a. Compose patient specific diet
b. Patient weight on admission
c. Evaluation of medication list
C. Goals for caregivers
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a. A dietician to see COPD patient within 24 hours of admission

b. Propose recommendations for the patient
c. Compose a diet plan which is patient specific
d. Keep track of daily weight
e. Documentation of occurrence in the chart
D. Nutritional Concerns and specific nutritional recommendations
a. Drink 6-8 8 ounce glasses of non-caffeinated beverages a day (keeps
mucus thin and easier to cough up)
b. Consume 20-30 grams of fiber a day
c. Keep sodium intake low
d. Wear O2 cannula while eating and especially if continuous O2 is
prescribed (eating requires energy and the body will need oxygen)
e. Special considerations for end stage COPD patients may be high protein
high calorie drinks (such as ensure)
PROCEDURE:
A. Adult dietary protocol for COPD Patient admissions will be initiated when:
A. Order is received for protocol “Dietician to evaluate”
B. Check order for protocol, medication list, and history and physical
B. Review of patient chart
a. Reason for current admission
A. Diagnostic information: ABG/SpO2, labs, sputum culture, glucose levels,
and chest x-ray
B. Daily weight of patient
C. Social history
C. Physician assessment and initial Dietician assessment:
D. After initial visit, follow up assessment will be done:
a. Follow up visit within 48-72 hours of initial meeting with dietician
b. If clinical status changes occur dietician will consult
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References

American Association & Dietitians of Canada. (2000). Manual of Clinical Dietetics

(6th ed.). Chicago, IL: American Dietetic Association.

American Association for Respiratory Care. (2002). Eating Right: Tips for the COPD

Patient. Retrieved from www.aarc.org.

Diet and Nutrition for Energy with COPD. (2018, September 14). Retrieved from

https://my.clevelandclinic.org/health/articles/9451-nutritional-guidelines-for-people-

with-copd.

Nutrition and COPD. (2018, March 13). Retrieved from https://www.lung.org/lung-

health-and-diseases/lung-disease-lookup/copd/living-with-copd/nutrition.html.

Schols, A. M., Ferreira, I. M., Franssen, F. M., Gosker, H. R., Janssens, W.,

Muscaritoli, M., … Singh, S. J. (2014). Nutritional assessment and therapy in

COPD: a European Respiratory Society statement. European Respiratory Journal,

44(6), 1504–1520. doi: 10.1183/09031936.00070914