THERAPEUTIC DIETS

- is a meal plan that controls the intake of certain foods or

nutrients. It is part of the treatment of a medical condition and
are normally prescribed by a physician and planned by a
dietician. A therapeutic diet is usually a modification of a
regular diet.
Principles of Diet Therapy

Symptom Control
When you're suffering from an illness brought on by a poor diet, your doctor
may suggest diet therapy before considering medical treatment, prescription
drugs or surgery. Certain conditions such as heart disease can be managed
more effectively when diet is under control. As the American Heart Association
points out, a healthy diet is one of the best ways to reduce heart problems and
lead a healthier lifestyle. Your doctor may even suggest diet therapy simply
because he notices you have precursors or red flags for heart disease, even if
you aren't currently diagnosed.

Diet Modification
When you indulge in unhealthy eating habits, like choosing fatty foods, eating
too many sweats or avoiding vegetables, you put yourself at risk for serious
health problems, notes Sumati R. Mudambi in the book, "Fundamentals of
Foods, Nutrition And Diet Therapy." After assessing your diet and risk, your
doctor may suggest a modified diet to help prevent further problems from
occurring. It's important that if you receive this type of advice from your
doctor, you follow through as you would a prescription medication. Changes
to your diet can take place in small and simple ways, yet add up to make a big
difference to your health.
Organ Rest
When you're about to undergo a surgery or your doctor is looking to isolate
health problems, you may be asked to use diet therapy to offer a clearer
picture of your health challenges or to help the surgery go more smoothly.
Some doctors will instruct you to go on an all-liquid diet or soft diet, which
can help give ailing organs a chance to rest in the digestive system. While diet
therapy is helpful for gastrointestinal disorders, it can also be used to build up
to a normal diet once again.

A. ALTERED CONSISTENCY DIETS

CLEAR LIQUID DIET –

Purpose is to rest GI tract and maintain fluid balance

- It provides adequate fluid/water, 500-1000 kcal of simple sugars, electrolytes
and is fiber free.
- It requires minimal digestion, as there is no residue or fiber
- It is recommended for short term use (3-5days)
- Not nutritionally adequate
- Transition feeding (IV- solid foods)

Indication:
a. Immediate post-operative period until bowel sounds have returned and
nausea and vomiting ceased.
b. Diarrhea
c. Nausea and vomiting
d. Bowel preps for bowel X-rays or bowel surgery ( Colonoscopy, barium
enema)

Foods allowed: “see-through foods”(foods that are liquid at room

temperature
a. Water
b. fat-free broth
c. c. apple/cranberry/grape juice
d. d. carbonated beverages
e. Tea
f. jello/plain gelatin
g. g. ginger ale

Foods not allowed:

a. Fruit juice w/ pulp, milk, fruits

Contraindication:
- Inadequate GI function and nutrient requiring parenteral nutrition
FULL LIQUID DIET
- contains food that turns to liquid at body temperature.
- It provides water, calories, protein, vit & min. and dairy products (contains
lactose) and is considered to be low in residue
- It can be considered to be transition diet (moving from one diet to another as
the client’s clinical status improves) as the client progresses post-operatively or
post procedure from liquid-solids.
- Can be nutritionally adequate

Indication:
a. Oral plastic surgery to the neck
b. Mandibular fractures
c. w/ difficulty chewing and swallowing but it is not indicated for a client
following a CVA
d. esophageal/GI strictures
e. diarrhea

Foods allowed: it consists of all foods found on clear liquid diet, plus milk,
pudding, ice cream, cream soups, yogurts and all prepared liquid formulas, veg
juices, refined/ strained cereals, milk, drinks and shakes

Foods not Allowed: jam, fruits, solid food, nuts and marmalade

Contraindication: dysphagia

SOFT DIET – this diet includes food items that contain small amounts of seasoning
and moderate fiber content but are easy to chew, digest and absorb
- It can be used as a progressive or transition diet and is a modification of a
regular diet
Indication – for debilitated patient unable to consume a regular diet
- Patients w/ mild GI problems
Foods Allowed: Mechanically soft plus easily digested, low fiber, and lightly
seasoned foods.
- Pastas, casseroles, moist tender meats and canned cooked fruits and veg.
- Desserts, cakes and cookies w/o nuts/ coconuts
Foods not Allowed: foods that are highly seasoned, fried, high in fiber, nuts,
coconuts and foods that contain seeds- bec they can cause GI symptom upset.

MECHANICALLY SOFT DIET – It can be used as both a long-term diet and as a

transition diet
- It is a modification of the regular diet w/ attention to texture
Indication: for client w/ problems of chewing/ swallowing difficulties
- Dysphagia
- Poor-fitting dentures
- GI strictures
 Foods Allowed: foods w/ soft texture, those that are tender and chopped food
items
- pureed diet + ground or finely dice meats
- flaked fish, cottage cheese, rice, potatoes
- pancakes, light breads, cookies
- vegs, cooked/ canned fruits, bananas
- soups and peanut butter

Foods not Allowed: foods that are tough in nature, foods containing seeds, nuts,
raw eggs and fruits w/ pits.

PUREED DIET – provides essential nutrients in a chopped, ground/pureed form for

client who are unable to chew /swallow.
- It can be used as a long-term diet
- The use of seasoning depends on individual client preference
- A blender or food processor is used to change foods into pureed/blended form
for use in the diet
Indication:- for neurologic changes and CVA
- Inflammation/ ulcerations of the oral cavity and or esophagus
- Edentulous(lacks natural teeth)patients
- Fractured jaw
- Head and neck abnormalities
Foods Allowed:- full liquid diet + scrambled eggs
- Pureed meats, veg, fruits, mashed potatoes and gravy
Foods not Allowed: - raw eggs, nuts, whole breads, raw fruits/veg. and foods
containing seeds

DYSPHAGIA DIET - consists of thickened liquids

- This diet is a modification of the soft diet w/ increased attention to the liquid
component due to possible aspiration concerns.
- Thickening agents can be added to foods to maximize texture and help
facilitate the swallowing process
- Positioning of the client to at least 30-45 degrees/ higher and monitoring of
feedings are critical during meals in order to decrease risk of aspiration and
evaluate client’s attempts at eating.
Indication: - provided for clients w/ swallowing problems and are at risk for
aspiration(such as post-CVA)

Foods not allowed: - stringy, raw, dry and fried foods due to potential aspiration
- Foods that are considered to be small in size or handheld, such as popcorn,
nuts, and small candies- due to risk of aspiration

PHENYLKETUNURIA Diet(PKU)
- Purpose is to control intake of phenylalanine, an amino acid that cannot be
metabolized
- Diet will be prescribed until age 6 or longer to prevent brain damage and
mental retardation
 - Avoid: breads, meats, fish, poultry, cheeses, legumes, nuts and eggs
- Give lofenalac formula as ordered
- Teach client the family to use low-protein flour for baking
- Sugar substitutes such as Nutrasweet (contain phenylalanine), must not be
used. Use the brand sweet ‘n’ low, w/ saccharin

 Clients w/ Peptic Ulcers, Diverticulitis,

IBD, Gastritis

BLAND DIET – low fiber, roughage

– promotes healing of the gastric mucosa
- Chemically and mechanically non stimulating
- For patients w/ gastritis, peptic ulcer
- Given in small, frequent feedings to assist in diluting or neutralizing stomach
acid protein foods are good at neutralizing acid)

Foods not Allowed:- Spices such as pepper and chili are eliminated.
- A soft diet w/o spices
- Fried, commercially prepared, strong tea, alcohol

LOW-RESIDUE DIET – consists of food items that minimize elimination patters by

reducing fecal volume
- 5-10mg of dietary fiber is intended to reduce the normal work of the intestines
- Residue is the indigestible material left in digestive tract after food has been
digested.
- it is not the same as fiber
- high fiber foods are high in residue
- other foods such as milk and milk products also leave a residue-increases stool
volume and prunes acts as laxative

Indication:
a. following a colon, rectal or pereneal surgery to reduce pressure on the
operative site
b. Prior to examination of the lower bowel to enhance
visualization(proctosigmoidoscopy)
c. Internal radiation for cancer of the cervix
d. Crohn’s disease (disorders called Inflammatory Bowel Disease. It is a
chronic, recurrent disease characterized by inflammation of any portion of
the digestive tract from the mouth to the anus, The first symptoms of
Crohn's disease are often abdominal pain and diarrhea. Pain is felt in the
area of the navel or on the right side. Joint pain, lack of appetite, weight
loss, fatigue and fever are common)
e. Diarrhea to rest the bowel
f. Diverticulitis -happens when pouches (diverticula) form in the wall of
the colon and then get inflamed or infected.
g. Ulcerative colitis-
 Foods not Allowed :
High fiber foods: fruits and veg
Milk and milk products
whole grain breads and cereals

Foods Allowed:
a. Clear liquids
e. Sugar, salt
f. Meats, eggs
g. Limited amounts of milk
h. Refined cereals
i. White breads
j. Peeled white potatoes

HIGH-RESIDUE DIET- for patients w/ constipation, hemorrhoids

Foods allowed - fresh fruits and veg

- Whole grain products

GLUTEN-FREE DIET– purpose is to eliminate gluten ( a protein ) from the diet

Indicated in malabsorption syndromes such as sprue or celiac disease

Eliminate all products that contain identified grain sources- barley, rye, oats
wheat, and malt
Avoid: cream sauces, breaded foods. Cakes, breads and muffins
- Allow: corn, rice and soy flour
- Teach client to read the labels of prepared foods.

 Clients w/ Diabetes, Overweight, Obese, w/ HTN,

Atherosclerosis and other Cardiac Problems

1. Low Calorie Diets

- A low calorie diet is an allowance of food and drink with an energy value below
that required for
maintenance in order to bring about weight reduction.
- With moderate calorie restriction, a wise choice of foods can make the diet
adequate in minerals and vitamins. However, very low calorie diets, 1200 kcal
or less, require vitamin and mineral supplementation.

Indication for Use

- When weight reduction is desirable as in obesity or in overweight cardiac,
hypertensive, arthritic or diabetic individuals.
- When energy requirements are reduced as in hypothyroidism, prolonged bed
rest or in elderly persons.
2. Low Cholesterol Diet
- This diet regulates both the amount and type of fat. It is planned to provide 15-
25% of the total calories of fat.
- The primary aim of the diet is to reduce blood levels of cholesterol, particularly
low density lipoprotein cholesterol

Foods not allowed: Sources of trans-fatty acids, such as hydrogenated

polyunsaturated oils (e.g. margarines) are omitted. Dietary cholesterol is kept at
less than 300 mg/day.

Indication For Use

Hypercholesterolemia
Coronary artery disease
Adults with family history of heart disease (as primary preventive measure)

3. DASH Diet (ditatary approaches to stop hypertension)

- Diet rich in fruits, veg and low fat milk products and low in total fat and
saturated fat
- This diet can significantly lower BP, total cholesterol and LDL cholesterol
- This diet should be in combination w/ limited intake of sodium

Diets For Treatment of Diabetes

a. Exchange List - use foods high in fiber and complex CHO
- Avoid simple sugars, jams, honey, syrup and frosting.
- Maintenance of as near-normal blood glucose levels as possible by balancing
food intake with insulin (endogenous or oxogenous) or oral hypoglycemic
agents.
- Achievement of optimal serum lipid levels.
- Provision of adequate energy to maintain/achieve reasonable body weight in
adults or normal growth and development rates in children and adolescents or
to meet increased metabolic needs during pregnancy, lactation and recovery
from catabolic illnesses.
- Prevention and treatment of the acute complications of insulin-treated diabetes
such as hypoglycemia, short-term illnesses and exercise-related problems, and
of long term and cardiovascular disease.
- Improvement of overall health through optimal nutrition.
use foods high in fiber and complex CHO

Indications for Use

Conditions characterized by elevated blood glucose levels such as diabetes
mellitus (insulin dependent and non-insulin dependent), impaired glucose
tolerance and gestational diabetes.

Note: When other medical conditions such as renal complications are present,
further modifications of the diet are required.

Distribution of Calories – protein – 12-20%

Carbohydrates – 55-60%
Fats – 2-30%;fats shld be unsaturated
 b. Glycemic Index- it refers to how fast and how much the food raises the
blood sugar level
- Persons w/ diabetes should eat foods w/ moderate to low glycemic index foods

• Client w/ cirrhosis, Pancreatitis,

Hepatitis, Pancreatitis, Cholelithiasis
1. Low Fat Diets
- A fat restricted diet is an allowance of food and drink in which fat
provides no more than 15% of total calories.
- Since the absorption of fat-soluble vitamins is impaired when fat intake
is low, supplementation of the diet with these vitamins, especially Vitamin A, is
desirable.

Indication for Use

- Cholecystitis, cholelithiasis
- Atherosclerosis
- Portal cirrhosis, hepatitis
- Pancreatitis, sprue -Celiac disease, or celiac sprue, is a chronic disorder
of the small intestine caused by sensitivity to gluten, a protein found in wheat
and rye and, to a lesser extent, in oats and barley.It
causes poor absorption by the intestine of fat, protein,
carbohydrates, iron, water, and vitamins A, D, E, and K.
- Fat malabsoprtion
- Weight reduction

2. Low Carbohydrate Diets

- A carbohydrate restricted diet is an allowance of food and drink in which
carbohydrates provide no more than 50% of total calories. Complex
carbohydrates are preferred.
- Restricted carbohydrate diets are higher in fat and protein than the
normal or regular diet.
- Non-fat milk and low fat meat exchanges are used in order to limit
cholesterol to about 300 mg. Cholesterol levels may be further reduced by
using fish and chicken without skin and fish more often than meats, and
limiting eggs to three to four week.
- A polyunsaturated to saturated fat ratio (P/S) of approximately 1:1 can
be obtained by using an appropriate mixture of corn oil and coconut oil
- If higher calorie levels are desired, monounsaturated fats like olive,
peanut and sesame oil may be used to provide extra calories.

3. High Fiber Diet /High Roughage diet- to increase bulk in the stool
Indication: - 30gms of dietary fiber would help prevent constipation,
diverticulitis, hemorrhoids
and colon cancer
 CLIENTS W/ RENAL PROBLEMS
1. Sodium Restricted Diets
- To lower body water and promote excretion
- These diets have varying levels of sodium that are lower than the usual sodium
content of the regular diet which is approximately 2800 to 6000 mg or the
equivalent of 7 to 15 grams of sodium chloride. The sodium in the regular diet
comes mainly from table salt, although appreciable amount may come from the
natural sodium content of foods. Thus sodium restricted diets limit the use,
not only of table salt, but also of foods naturally high in sodium.
- The diet follows the daily food plan of the regular diet, but the foods allowed are
those low in sodium. No salt is used in the preparation and service of meals.
- Restriction range from mild(3,000-4,000mg/day) to severe(500mg/day)

Indication For Use

Condition of sodium or saline excess as in:
Congestive heart failure with edema or hypertension
Liver disease with ascites
Glomerulonephritis
Nephrotic syndrome
Acute and chronic renal failure
PIH and HTN

2. Low Potassium Diet

- This is a diet in which the potassium content is reduced to about 1.0 to 1.8
grams (25-46 mEq) per day. The usual diet contains about 2 to 6 grams (51.3
to 153.6 mEq) daily, coming mainly from vegetables, cereals, fruits, meat, fish
and poultry. The low potassium diet therefore, contains prescribed amounts of
selected foods from of supplements.
- The diet should be used for limited periods as a supplement to medical
therapy.

3. Low Protein Diet

- This diet provides about 30 grams of protein per day. Sufficient calories are
provided for the maximum utilization of the limited dietary protein and to
prevent or minimize tissue breakdown. This is achieved with liberal use of
carbohydrates and fat.
- Cereals, beans and nuts are used in limited amounts as these contain
significant levels of low biologic value proteins. The diet is low in B-vitamins
and iron.

Indication for Use

Acute glomerulonephritis with impaired function
Chronic renal failure with impaired renal function without hypertension
Advanced liver disease with hepatic insufficiency

4. Acid Ash Diet – used to prevent Alkaline kidney stones

- for UTI
- cranberries, plums and prunes leave an acid ash and are encouraged
- Meats and breads are allowed
 -
5. Alkaline Ash Diet – Used to prevent acid kidney stones/ to retard growth of renal
calculi
- Avoid: proteins, cereals, prunes and plums, cranberries, meats , fish, eggs,
bread

6. Low-Purine Diet- purpose is to decrease the amount of purine, a precursor to uric

acid
- Indicated for Gout, uric acid kidney stones and uric acid retention/elevated
uric acid levels, multiple myeloma, tumor lysis syndrome
- Avoid: food containing purines like, organ meats, fowl, fish and lobster,
Lentils, dried peas and beans, Nuts, Oatmeal and Whole wheat

7. Low Protein Diet

- This diet provides about 30 grams of protein per day. Sufficient calories are
provided for the maximum utilization of the limited dietary protein and to
prevent or minimize tissue breakdown. This is achieved with liberal use of
carbohydrates and fat.
- Cereals, beans and nuts are used in limited amounts as these contain
significant levels of low biologic value proteins. The diet is low in B-vitamins
and iron.

Indication for Use

Acute glomerulonephritis with impaired function
Chronic renal failure with impaired renal function without hypertension
Advanced liver disease with hepatic insufficiency

8. Chronic Renal Insufficiency

- The diet for chronic renal insufficiency is also called the Predialysis diet. The
diet is restricted in two major nutrients: protein and phosphorus.
- Restrictions in sodium, potassium, fluid, and calories are based on individual
needs. Because of restrictions in certain foods, the diet is deficient in calcium,
iron, Vitamin B12, and zinc.
- A low protein diet may also be deficient in thiamin, rivoflavin, and niacin. The
need for vitamin and mineral supplementation should be assessed on an
individual bases.
- The diet aims to reduce the workload of the diseased kidney(s) by reducing the
urea, uric acid, creatinine and electrolytes (especially phosphates) that must be
excreted, prevent acceleration of nephrotic damage resulting from excessive
protein intake, prevent calcification secondary to renal dystrophy, prevent
renal osteodystrophy and at the same time, to promote a feeling of well being
and postpone the need for dialysis.

9. Chronic Renal Failure

- The diet here is called Renal diet
- The diet for chronic renal failure (CRF) is designed to meet nutritional
requirements, minimize uremic complications, maintain acceptable blood
chemistries, blood pressure and fluid status in patients with impaired renal
function, and at the same time, to promote well-being.
- Generally, the diet has controlled amounts of protein, potassium, sodium,
phosphorus, and fluids. Additional modifications of fat, cholesterol,
 triglycerides, and fiber may be necessary depending on individual
requirements.
- The diet is used for patients with CRF requiring hemodialysis or peritoneal
dialysis treatments.

10. Acute Renal Failure

- The diet for acute renal failure (ARF) aims to reduce the accumulation of the
uremic toxins, control electrolyte abnormalities, and correct fluid retention
while maintaining nutritional status. Dietary factors need to be controlled
include protein, sodium, potassium, phosphorus, and fluid with adequate
calories depending on individual needs and the frequency of dialysis treatment.

11. Nephrotic Syndrome

- The protein-and sodium-controlled diet for nephrotic syndrome (NS) is
designed to minimize edema and proteinuria, control hypertension of renal
disease, prevent muscle catabolism and protein malnutrition, and supply
adequate energy.
- The diet is for persons with NS who are not being dialyzed.

12. Urolithiasis (Kidney Stones)

- The dietary modifications for urolithiasis are designed to minimize the
supersaturation of components in the urine associated with the formation of
renal calculi. Generally, dietary intervention includes combining the restriction
of a specific dietary constituent associated with the formation of the stone with
a generous fluid intake. Most calculi contain variable amounts of calcium,
cystine or uric acid surrounded by calcium oxalate.

Indication for Use

- Diet modifications may be used with medical treatment to decrease the
predominant components in urine that cause stone formation.

Dietary Treatment for Clients w/ diff Renal Stones

a. Calcium Oxalate Stones – about 80% of the renal stones formed contain calcium
oxalate.
-formation of this kind of renal stone is caused primarily by a diet high in oxalate,
like, beets, wheat bran, chocolate, tea, rhubarb, strawberries and spinach,and
beer(high in oxalate but may have limited bioavailability and thus may be less
problematic
Deficiency in pyridoxine, thiamine and magnesium contribute to the formation of
oxalate stones.

b. Uric Acid Stones – Purine-rich foods are restricted in here

Purines are the end products of nucleoprotein metabolism and are found in all
meats, fish, poultry. Organ meats, anchovies, sardines, meat extracts and
broths.
-Uric acid stones are usually associated w/ Gout, GI disease that cause
diarrhea and malignant diseases.

c. Cystine Stones – Cystine is an amino acid. Formation of this stone is due to high
 concentration of cysteine in the urine secondary to some hereditary metabolic
disorder
- Recommendation is to increase fluid intake and an alkaline-ash diet(to retard
the growth of renal calculi)

d. Struvite Stones – this is composed of magnesium ammonium sulphate

- This is being called as infection stones bec they develop following a UTI
- A low phosphorus diet is often prescribed.

Indications for Use

Conditions characterized by elevated blood glucose levels such as diabetes mellitus
(insulin dependent and non-insulin dependent), impaired glucose tolerance and
gestational diabetes.

Note: When other medical conditions such as renal complications are present,
further modifications of the diet are required.

 Client w/ Infection, Fever, Underweight/PEM,

Hyperthyroidism, BURNS
1. High Calorie Diets
- A high calorie diet is an allowance of food and drink with an energy value of 50
to 100 percent above that required for maintenance.
- Its aim is to produce a gain in body weight, to meet increased energy needs, or
to prevent or minimize the catabolism of tissues.

Indication for Use

- Underweight
- Hypercatabolic conditions: hyperthyroidism, injury, burns, fever and infections
when a full diet can be tolerated.

2. High Protein Diets

- To re-establish anabolism and raise albumin levels in burns, infections,
hyperthyroidism
- A high protein diet is allowance of food and drink which provides 1.5 grams of
protein or more per kilogram of body weight per day or where the protein is
increased by 50 to 100 percent above the normal allowance.
- Its aim is to meet increased protein needs or replace proteins lost from the
body (see Indication for Use).
- The caloric value of the diet is usually increased in order to ensure the
maximum utilization of dietary protein or to minimize the catabolism of body
proteins as energy source.

Indication for Use

Protein deficiency, primary and secondary
Before and after surgery when a full diet can be tolerated
Hypercatabolic conditions (e.g. injury, burns, fever and infections) when a full diet
can be tolerated
Hepatitis, portal cirrhosis (no impending hepatic coma)
 Nephrosis, chronic nephritis with albuminuria and hypoprotienemia

Foods Allowed: roast beef, skimmed milk, meat, beans

Foods not Allowed: softdrinks, junkfoods

 OSTEOPOROSIS/OSTEOPENIA
1. High Calcium Diet- a high-calcium diet is indicated for clients who have
disease states that promote Calcium loss leading to bone mineralization,
endocrine abnormalities and kidney failure

 CANCER

1. High Calorie,High Protein – clients under this diets would tolerate the side
effects of therapy and higher doses of drugs.
- Energy demands are high bec of the hypermetabolic state.
- Calorie needs will vary from client to client
- But 45-50 calories/kg of body weight may be recommended
- Include their favorite foods
- If cachexia is extreme, enteral or total parenteral feedings may be necessary.

Enteral Nutrition – refers to a method of feeding clients who have a

functioning GI tract but are unable to take a diet orally or
whose diet is inadequate
-forms of feeding that bring nutrients directly into the digestive
tract when clients can’t or will not take food by mouth

a. via Tube feeding/NGT -for periods that do not exceed 6wks.- feeding by tube
directly into the stomach or intestine or
b. via a vein -If more than 6wks, gastrostomy, esophagostomy or
jejunostomy.

Indication:-
 mechanical alterations due to chewing or swallowing
problems.
 -Impairment in upper GI tract leading to digestion, transport
and absorption problems
 Alteration in intake pattern due to client’s inability to eat,
refusal to eat, or inability to ingest sufficient intake to meet
nutritional goals
 -functional GI tract
 -for stroke/CVA patients, severe malnutrion or extensive
burns, IBDs, Pancreatitis(mild), Parkinson’s
disease, Dementia, Cancer, Anorexia Nervosa, Severe
depression
 Formulas to be use: Polymeric Formulas(1-2 cal/ml)-containing intact CHON,
CHO and fats that require digestion
- Elemental/Hydrolyzed Formulas – (1.0cal/ml)-contain the products of
digestion of CHON, CHO and fats and are lactose-free
- Modular Formulas(3.8-4.0cal/ml)- for client having an extensive wound-
healing needs

Parenteral Nutrition – nutrition provided via a vein/intravenously

- it is used if the GI tract is not functional or if normal feeding is not adequate
for the client’s needs
TPN /hyperalimentation is used to provide total nutrition.Catheter is inserted into
the subclavian vein/super vena cava.(this is used bec the high blood flow
facilitates quick dilution of the highly concentrated TPN, thus reducing
phlebitis and thrombosis

Weaning-TPN-tube feeding-oral feeding.

- They can be administered via a central vein or for a period of 2wks/less is at
peripheral vein.

Monitor client for infection on the site and enters bloodstream causing
sepsis(infxn of the blood)

Formula: a dextrose- amino acid-fat solution

Indication: Clinical disease states such as malabsorption, surgical

interventions, trauma/stress and or related pathology of GI
tract/oncologic condition.
- Malnourished clients who require long-term nutritional support and
high nutrient requirements based on clinical deficiencies and for Non-
functional GI tract.
- Massive small bowel resection/GI surgery, Intestinal Obstruction,
Trauma to the abdomen, head/neck, Chemotherapy, radiation therapy
and bone marrow transplantation, IBD(exacerbation),Severe diarrhea,
Moderate-severe pancreatitis

FOODS THAT CAUSE GAS

- Cabbage, cauliflower, turnips, broccoli
- Dried peas, lentils,turnips,melons,cucumbers
- Peppers, asparagus, pickles,carbonated beverages
- Beer, chewing gum, alcohol and some fried foods

FOODS THAT MAY CONTRIBUTE TO DIARRHEA

- Prune juice, apple juice, coffee, coconut
- Highly seasoned /fried foods, high sugar foods, alcohol,
- broccoli, cabbage, cauliflower and popcorn

FOODS THAT PRODUCE ODOR

- Dried peas, beans, lentils, fish, garlic, onions
- Asparagus, turnips, eggs and some spices, strong cheeses,
- Medication and vitamin preparation
 FOODS THAT CONTROL ODOR
- Fresh parsley, yogurt and buttermilk

FOODS THAT MAY HELP CONTROL DIARRHEA

- Banana, smooth peanut butter, soda crackers, potatoes
- Oatmeal, oat bran, cheese, yogurt and boiled rice/barley/pasta