Assist the client in meeting for

nutritional needs

DID Senevirathna (BSc, DIP)

Supra grade Nursing Officer
Divisional Hospital, Type A,
Kandana
Nutritional needs
Nutrition - Definition
 The process of providing the foods
necessary for health and growth
 There are 03 main category of our foods
are Energy giving foods, Protective foods
and Body building foods
Nutritional needs
At every stage of life we need many
different nutrients to maintain good health
and also to avoid diet deficiency diseases.
The amount of each nutrient needed by the
body is called the nutritional requirement.
Nutritional needs ctd…
 As we age, our nutritional requirements
continue to change according to the need
of calories, proteins, vitamins, and
minerals.
 Let us consider the nutritional needs
through various stages of life: infancy,
childhood, teenage, adulthood, and old
age.
Nutritional needs ctd…
 For a long and healthy life, a balanced diet
should be maintained from infancy.
 Mother's milk is one of the best sources
of nutrients and antibodies for growing
babies.
 When breast milk is not available for a
baby, bottled formula milk is given as an
alternative.
Nutritional needs ctd…
 When the baby is 6 months old, solid
foods are introduced based on the advice
of a nutritionist.
 A preschool child's diet must contain
carbohydrates, fruits and vegetables, milk,
dairy foods, proteins, and good fats.
Balanced diet with calcium, iron, and
vitamins is a must.
Important of nutrients in illness
 To recover patient from the illness
 There are five types of main nutrients.
1. Carbohydrate
2. Protein
3. Fats
4. Vitamins
5. Minerals
6. Fiber
7. water
Balanced Diet
 Rice, serial, potatoes,
 Fruits
 Vegetables
 fish /meat/egg/seeds
 Milk and milk product
 Fat and fat products
Carbohydrates
There are three types of carbohydrates

 Monosaccharides
 Disaccharides
 Polysaccharides
Carbohydrates ctd…
Monosaccharides- Smallest units of
carbohydrates
Classified by number of carbon atoms ( C3
to C7)
 Glucose
 Fructose
 Galactose
Carbohydrates ctd…
Carbohydrates ctd…
1.Glucose – The major sugar in blood
Primary energy source for cells
Glucose solution = Dextrose

2. Fructose – Found in fruit, honey, &high

fructose corn syrup, Sweeter than glucose

3.Galactose - Found in lactose, the sugar in

milk
Carbohydrates ctd…
2. Disaccharide

 Sucrose – Glucose +Fructose

 Maltose – Glucose + Glucose
 Lactose – Glucose+ Galactose
Carbohydrate ctd…
3. Polysaccharides - long chain polymers of
monosaccharides
❑ Digestible
 Starch/ dextrin – Carbohydrates storage form in
plants
 Glycogen - Carbohydrates storage form in
animals

❑ Indigestible
 Cellulose – Structural polysaccharides in plant
cell wall
 Gum, pectin - gelatine-like carbohydrate in the
cell walls of plants.
Functions of carbohydrates
 Energy production
 Energy storage
 Building macromolecules
 Sparing protein
 Assisting in lipid metabolism
Proteins
 Proteins are made of small molecules
called amino acids
 There are 20 amino acids that are
considered essential for humans
 Nine of these amino acids cannot be
made by the body and must be obtained
from the diet.
Proteins ctd…

 These essential amino acids are histidine,

isoleucine, leucine, lysine, methionine,
phenylalanine, threonine, tryptophan, and
valine.
Protein ctd…
 Amino acids
 Building blocks of proteins
 Made or C, H, O, N and side chain ®
Protein
 Complete proteins
 Partially complete proteins
 Incomplete proteins
Protein ctd…
Complete proteins
 A complete protein is one that contains
all nine essential amino acids. These
amino acids are essential because our
bodies can’t produce them on their own.
Therefore, we must get them from our
diet. Protein is essential for many
processes in the body, including immune
function, cellular repair, and metabolism.
Protein ctd…
 In a complete protein, all nine amino acids
are present. Beef, poultry, fish, eggs,
dairy, soy, are examples of foods that meet
these requirements
Protein ctd…
Partially complete proteins
proteins do not contain all 9 of the essential
amino acids but a limited amount of one or
more of them. Partially complete amino
acids provide normal maintenance but will
not support growth.
Eg - plant-based diet.
Protein ctd…
Incomplete proteins
 Some plant foods contain protein, but do not
have all the essential amino acids the human
body needs. They are called incomplete
proteins.
 foods include nuts, seeds, beans and some
grains
 If you follow a vegetarian or vegan diet, you
need to include several types of incomplete
proteins in order to ensure you’re consuming
all nine essential amino acids.
Protein – roles in the body
• Break down food.
• Grow and repair body tissue.
• Make hormones and brain chemicals
(neurotransmitters).
• Provide an energy source.
• Maintain healthy skin, hair and nails.
• Build muscle.
• Boost your immune system.
• Sustain a normal digestive system.
Lipides
 A group of hydrophobic (relatively water
insoluble) organic molecules
 Made of C,H & O
 Types are – simple lipids, complex lipids
& sterols
 Includes fat, oil &cholesterol
Lipids ctd…
 Simple lipides – Also called Triglycerides
(fat & oil)
 Storage form of energy & the primary
energy source during fasting
 Hypertriglyceridemia- high blood levels
of triglycerides
Lipids ctd…
1. Saturated fatty acids – more fats, eg –
coconut oil, butter
2. Unsaturated fatty acids – eg – olive oil
3. Trans fatty acids – Not a natural food
component eg Margarine, Increase the
risk of heart disease
Lipids ctd…
 Complex lipid – eg- Avocado, cashew
nuts, Peanuts, Walnuts, Coconut

 Sterols- Vegetables, fruits, wheat germ,

whole grains, beans, sunflower seeds, and
many vegetable oils contain plant sterols
Function of lipids
 lipids function as an energy reserve,
regulate hormone
 transmit nerve impulses
 cushion vital organs, and transport fat-
soluble nutrients
 Fat in food serves as an energy source
with high caloric density, adds texture and
taste, and contributes to satiety.
Vitamins
 Vitamins are organic compounds that
people need in small quantities
 Most vitamins need to come from food
because the body either does not produce
them or produces very little
Vitamins
1. Water soluble
2. Fat soluble

❑Minerals don’t have special types.

Vitamins ctd…
 Vitamins A, D, E, and K are fat-soluble
 The body storesTrusted Source fat-
soluble vitamins in fatty tissue and the
liver, and reserves of these vitamins can
stay in the body for days and sometimes
months.
Vitamins ctd…
 Water-soluble vitamins do not stayTrusted
Source in the body for long and cannot be
stored
 They leave the body via the urine.
Because of this, people need a more
regular supply of water-soluble vitamins
than fat-soluble ones.
 Vitamin C and all the B vitamins
are water-solubleTrusted Source.
Vitamins ctd… - Functions
 essential for overall health, normal cell
function, growth and development
 vitamins are so vital to good health, it is
important to understand their roles and
functions
 All essential vitamins can be found in
food sources as well as supplemented in
various forms.
Therapeutic diet
 This is a meal plan that control the intake
of certain foods or nutrients. Sometime
therapeutic diet describe as special diet. It
also a modification of regular diet an
modifying according to nutritional needs.
 It is modify for;
➢ Nutrients
➢ Texture
➢ Food allergy/ food intolerances
Purpose of ordering therapeutic diet
1. To maintain nutritional status
2. To restore nutritional status
3. To correct nutritional status
4. To decrease calories for weight control
5. To provide extra calories for weight gain
6. To balance amounts of carbohydrates, fat
and protein floor control of diabetes
7. To provide a greater amount of a nutrient
such as protein.
Purpose of ordering therapeutic diet
8. To decrease the amount of a nutrients
such as sodium.
9. To exclude foods due to allergies of food
intolerance
Types of diet
1. Clear fluid diet
2. Fluid diet/ liquid diet
3. Semi solid diet
4. Normal diet
4. Special diet
 High protein diet
 Low protein diet
 Low fat diet
 Low roughing diet
 High calory diet
 Low salt diet
 Diabetic diet
 Light diet
5. Balanced diet
 FF- Fresh Fish
 ND- Normal
 DF- Dry Fish
 S1/S2/S3- Scale Diet
 E- Extra
 ND-No Diet
6. Clear fluid diet
 King coconut juice
 Lime juice
 Fruit juice
 Low concentrate soup
 Tea – plain
 Jeewanie
Indications
 After surgery- specially G1tract
 Before some investigation ( colonoscopy)
low nutrients & give one or two days
Liquid diet

 Milk/soup/marmite/Sustagen/albumin/
water
 This diet should be prepared according to
patients’ taste. Should maintain fluid
balance chart
 Required amount should be maintained
 consider mouth care.
Semi solid diet
 After liquid diet semi solid diet started. If
patient is suffering with swallowing
difficulties gastroenteritis, fever, digestive
problems
 Jelly
 Custard
 Half boiled egg
 Boiled potatoes
High protein diet
 Chronically ill patient, TB, malnutrition,
anemia, burn chronic wound
 Milk
 Egg
 Calcium
 Fish
 Meat
 Low protein diet
 Chronic nephritis

 Low fat diet

 Heart disease, liver failure
 To this condition avoid butter, cheese, oily
foods, animal protein

 High roughage foods

 Stimulate peristalsis/ patients suffering eith
constipation
 High carbohydrate diet
❑Patient with liver disease, liver failure,
inflammation easy digestive diet
➢ E.g.-glucose, fruits, jam, soya

 Low salt diet

 Patient have odema, heart failure, renal
disease eclampsia, high BP patient needs
low salt and salt free diet
 Diabetic diet
 Carbohydrate, fat restricted
 Normal protein, fruits, vegetable

 Balanced diet
 This diet is specially
Food serving - consider
 What is the diagnose- appetite, Allowed or
not allowed
 Medication - before, after or with meal
 Age, sex, BMI
 Size of the body
 Exercise
 Culture
 Habits
Food serving - consider ctd…
 Occupational characteristics
 Hesitation to take breaks
 Influence of unhealthy food, and
organizational and industry policies
 Perceived inability to take breaks was due to
patient load
 unpredictability of patient needs
 Reluctance to burden other nurses
 A tendency to prioritize patient care over
self-care
Needs of nutrition
 High nutrition
 New, clean, easy to digest
 Less stimulation
 Increase appetite
 Varity of foods
 good Smell and color
 Low sugar and fat
 Reduce junk foods
Choosing the foods
 According to disease condition
 More natural foods
 Check expiry date, Assurance certificate,
ingredients
 Fresh fruits ,vegetables, meet and fish
 Avoid artificial foods
Increase Appetite
 Appearance, smell, colour and taste
 Clean and pleasant environment
 Time of the taking meals
 Physical, mental freedom
 Exercise
 Habits
 Personal attitudes
Nurses responsibility
 Identify disease condition and nutritional
needs
 Assess the patient- can take oral, if not
arrange NG tube feeding or IV
 Plan the diet with necessary knowledge
 Arrange the therapeutic diet as needed
 Identify the amount of foods and encourage
the patient
 If patient cant take the meal alone, help to
the patient to take meal or fed the patient
Nurses responsibility ctd…
 Identify the patient’s culture, religion,
economic status, mental and physical status,
appetite
 Give the meal on time
 Introduce a variety of foods
 Identify hot foods and cool foods
 Assess any pain or uncomfortable condition
before giving the meal
 Prepare the environment
 Correct position
Nurses responsibility ctd…
 Give necessary knowledge about healthy
foods while taking meal
 Give water after meals
 Use serviettes
 Protect the patients cloths
 Give medicines as ordered
 While taking meals avoid any procedures
 If patients desire provide spoon and fork
Nurses responsibility ctd…
 Do the documentation- kind of food,
amount of food, date and time ,response
of the patient
 If give the NG feed enter the fluid balance
chart
 Avoid infection
 When you are preparing the food, feeding
the patient, touching the food you should
wash your hand as necessary
 Eg – Before taking /fed the foods
 When preparing meals
 After using the wash room
 Before touching the foods
 When sneezing or cough
 After touching garbage bags or dustbin

Protection of foods
 Hand washing before food procedure
 Identify all instruments are cleaned or not
 When preparing the food, wear apron, cap
and mask, gloves as needed
 Trim the nails
 After cooking protect the meal from
insects
 Keep necessary temperature cool or hot
 Wash the vegetables, meet, fish and fruits
as necessary
Food allergy
 Immunity system responses to certain
foods. Eg- milk, fish, pineapple, prunes,
tomatoes
 Before ordering the meal you should
know any allergy history
Symptoms of allergy
 Skin – Itching, redness
 Swelling – face, tongue, lips, eye
 Abdomen pain, vomiting, nausea,
diarrhoea
 Difficult in breathing, Asthma
Nutrition problems
 Anorexia (Anorexia nervosa)
 Constipation
 Dehydration
 Anaemia
 Difficult in swallow
Anorexia (Anorexia nervosa)

 Anorexia nervosa is an eating

disorder and a serious mental illness.
 The restriction in energy intake severely
restrict the amount of food they eat.
 can cause a significant amount of weight
loss in a short period of time
 a person having a very low weight.
Anorexia nervosa -Symptoms
 Symptoms are related to starvation
 Can be occurred low body weight
 Irritability
 Fear of weight gain
 Thin appearance
• Abnormal blood counts
• Fatigue
• Insomnia

Anorexia nervosa –Symptoms ctd
• Dizziness or fainting
• Bluish discolouration of the fingers
• Hair that thins, breaks or falls out
• Soft, downy hair covering the body
• Absence of menstruation
• Constipation and abdominal pain
• Dry or yellowish skin
Anorexia nervosa –Symptoms ctd…
• Intolerance of cold
• Irregular heart rhythms
• Low blood pressure
• Dehydration
• Swelling of arms or legs
Complications
• Anaemia
• Heart problems, such as mitral valve
prolapse, abnormal heart rhythms or heart
failure
• Bone loss (osteoporosis), increasing the
risk of fractures
• Loss of muscle
• In females, the absence of a period
• In males, decreased testosterone
Complications ctd…
• Gastrointestinal problems, such as
constipation, bloating or nausea
• Electrolyte abnormalities, such as low
blood potassium, sodium and chloride
• Kidney problems
Prevention –Anorexia nervosa
 no way not to develop anorexia nervosa or
another type of eating disorder
 However, they suggest some ways to help
foster healthy habits and thought
processes.
constipation
 When a person has uncomfortable bowel
movements or infrequent bowel
movements
 Symptoms -passage of small amounts of
hard, dry stool, usually fewer than three
times a week
 However, normal stool elimination may
consist of having a bowel movement three
times a day or three times a week,
depending on the person.
Causes of constipation
• Medications
• Lack of exercise
• Not enough liquids
• Not enough fibres in the diet
• Irritable bowel syndrome
• Ignoring the urge to have a bowel movement
• Changes in habits or lifestyle, such as travel,
pregnancy, and old age
• Problems with intestinal function
• Abuse of laxatives
symptoms of constipation

• Difficult and painful bowel movements

• Bowel movements fewer than three times
a week
• Feeling bloated or uncomfortable
• Feeling sluggish
• Abdominal pain
How to prevent constipation
• Eat plenty of fruits, vegetables, and whole
grains.
• Eat high fibres foods and ask a healthcare
professional about using fibres
supplements.
• Include bran cereal in your diet.
• Drink plenty of water.
Dehydration
 When you don’t have enough water in
your body
• Symptoms –Infant or child -Extreme
thirst
• Less frequent urination
• Dark-coloured urine
• Fatigue
• Dizziness
• Confusion
Dehydration - Symptoms
The adult
• Dry mouth and tongue
• No tears when crying
• No wet diapers for three hours
• Sunken eyes, cheeks
• Sunken soft spot on top of the skull
• Listlessness or irritability
Prevention
 Take advice from primary care physician
 If you identify a low self-esteem person
with anorexia you have to explain
healthier behaviour or treatment regime
Anaemia
 Anaemia is a decrease in the total amount
of red blood cells (RBCs) or haemoglobin
in the blood, or a lowered ability of the
blood to carry oxygen.
Anaemia - Symptoms
• Fatigue
• Weakness
• Pale skin
• Cold hands and feet
• Dizziness
• Reduced immunity - more prone to
infections
• Shortness of breath
Causes of Anaemia
 Anaemia results from reduced red blood cells
 Reduced production of red blood cells as in
iron deficiency anaemia or megaloblastic
anaemia
 Excess blood loss
 Eg- 1. in road traffic accidents
2. Internal bleeding as in hookworm
infection
3. Excess bleeding during periods
(menstruation)
4. Long-term use of drugs like aspirin or
painkillers, etc
Causes of Anaemia ctd…
• Destruction of the red blood cells: Haemolytic
anaemias
• Autoimmune conditions like rheumatoid
arthritis, systemic lupus erythematosus, etc
 Malnutrition - low iron diet, Vitamin B12 and
folate
 Problems in the absorption of nutrients due to
conditions like Crohn's disease or Celiac disease
• Lack of balanced diet during pregnancy
• Family history

Prevention
• Consuming a healthy diet rich in iron
• Consuming Vitamin B12 and folic acid
• Increasing the intake of vitamin C, as it
helps in better absorption of iron from
food
• Reducing tea and coffee intake as it
reduces the absorption of iron from food
Complications
 If untreated, it may lead to severe fatigue
that interferes with the daily activities
 Anaemia, especially due to foliate
deficiency - defective development of the
baby and premature delivery
 rapid or irregular heartbeat
 This leads to an increase in the size of the
heart or heart failure (the heart has to
pump more blood to compensate for the
lack of oxygen in the blood)
Complications ctd…
 Loss of excess blood, as in road traffic
accidents can lead to very severe anaemia
and can be fatal
Difficulty in swallow -Dysphagia

 Acid reflux and gastroesophageal reflux

disease (GERD) – (stomach contents flow
up from the stomach back into the
oesophagus)
 Heartburn- Heartburn is a burning
sensation in your chest that often occurs
with a bitter taste in your throat or mouth
 Epiglottitis- inflamed tissue in your
epiglottis and it is medical emergency
Difficult in swallow ctd…

Causes
 Esophagitis. Esophagitis is inflammation
of the oesophagus
 Oesophageal cancer
 Thyroid nodule
 Zenker’s diverticulum- A rare instance in
which a pouch-like structure forms
between the pharynx and the oesophagus,
Causes –Other medical condition
• stroke
• dementia
• head, neck, or throat cancer
• history of radiation or chemotherapy in
the neck or throat for cancer
• head injury
• neurological disorders, such
as Parkinson’s disease
• muscular dystrophy
symptomes
• drooling
• hoarse voice
• feeling like something is lodged in your throat
• regurgitation
• unexpected weight loss
• heartburn
• coughing or choking when swallowing
• pain when swallowing
• difficulty chewing solid foods
• recurrent pneumonia
• food may come out of the nose
These sensations may cause a person to:
• Avoid eating
• Skip meals
• Lose their appetite
Children who have difficulty swallowing
• refuse to eat certain foods
• have food or liquid leaking from their
mouths
• regurgitate during meals
• have trouble breathing when eating
• lose weight without trying
Diagnose of Dysphagia
 Barium X-ray
 Video fluoroscopy –A type of X-ray
 Endoscopy
 Manometry -will insert a tube into the
oesophagus to measure the pressure in the
muscles when they contract.
Dysphagia - Prevention
• dietary changes
• oropharyngeal swallowing exercises to
strengthen muscles
• alternative swallowing strategies
• posture changes that you should follow
while eating
Dysphagia – Prevention ctd…
Achalasia
 A procedure called oesophageal dilation
may be used to expand the oesophagus
 During this procedure, a small balloon is
placed into the oesophagus to widen it
 The balloon is then removed.
Dysphagia – Prevention ctd
 Abnormal growths in the oesophagus -
surgery may be necessary to remove them
 Acid reflux or ulcers. Given prescription
medication to treat these conditions and
encouraged to follow a reflux diet
 Medications. If related to GERD
(gastroesophageal reflux disease)
prescription oral medications
Eg -Corticosteroids, smooth muscle
relaxants
Dysphagia – Prevention ctd
 In severe cases or acute cases of swallowing difficulty -
may be admitted to the hospital

 Feeding tube. You may receive enteral feeding which is

when you receive food through a tube that goes directly
into the stomach and bypasses the oesophagus

• Modified diets - A dietary change, such as a liquid diet

• prevent dehydration and malnutrition until your
swallowing difficulty improves.
NG Tube feeding
 This is a small tube that goes into the
stomach through the nose
NG Tube feeding
 To whom – Unconscious patients
The patients who don’t like to take
foods
Dysphagia patients
Coma patients
Severe burn patients
Critical ill patients
Severe anorexia patients
Recurrent aspiration patients
NG Tube feeding procedure ctd…
Articles
 Formula feed
 Measuring cup or any container
 Large syringe – 50 cc or 60 cc
 Water in a container (gally pot)
 Warm water in the cup
 Stethoscope
 Kidney tray
 Towel
 Clean gloves
NG feed - procedure
 Identify the patient’s need and explain the
procedure
 Identify any food allergies, last feeding
time, bowel opened or not, bowel sounds
are there
 Position the patient (semi-fowlers)
 Wash the hands
 Spread the towel and the mackintosh over
the patient’s chest
NG feed – procedure ctd…
 Wear gloves and connect the syringe to
the nasogastric tube
 Aspirate stomach contents or push some
air to the stomach by syringe and hear the
sound
 If there is any doubt you have to take x-
ray to confirm
 If the tube placement is correct in the
stomach pinch the NG tube and attach the
barrel to the NG tube
NG feed – procedure ctd…
 Fill the syringe barrel with water and
allow to fluid flow in by gravity
 Then pour feed into syringe barrel and
allow it to flow by gravity
 Keep on pouring feed formula to barrel
when it is three-quarters empty
 Pinch the tube whenever necessary to stop
when pouring
NG feed – procedure ctd…
 After completing the feeding, you should
flush the tube with at least 30 cc of water
 After cleaning the tube you can close the
tube
 Wash all equipment and dry
 Keep the bed elevated for 30-60 minutes
after feeding
 Wash your hands
NG feed – procedure ctd…
 Do the documentation
 Date and time
 Kind of feed, amount of feed
 Maintain fluid balance chart
 Tolerance or not
 Monitor breath sounds, bowel sounds,
gastric distention, diarrhoea, constipation
etc
 Observe nausea and vomiting
Assessment
 1. Why do we need nutrition?
 2. What are the main nutrients?
 3. What foods include macro and
micronutrients?
 4. What is the meaning of a balanced diet?
 5. Give an example of a balanced diet…?
 6. What is the importance of vitamins?
 7. What do you consider about ordering a
therapeutic diet?
 8.what kind of diet can you order for the
patients?
 9. What can you do with more appetite?
 10. What is the nurse’s responsibility for
preparing food?
 11.what do you consider when giving NG
feeds?
 12. What problems can occur when you
are giving NG feeds?
Answers
 1. for our health and growth
maintain good health and also to avoid diet
deficiency diseases.
To get the amount of each nutrient (
nutritional requirement)
We have to get nutritional needs through
various stages of life: infancy, childhood,
teenage, adulthood, and old age. We have to
complete them as needed
Question 02/03
Macronutrients
Carbohydrates – rice, hoppers, jack ….
Protein- meat, egg, fish….
Fat - butter, cheese, oily foods
Micronutrients are vitamins and minerals
needed by the body in very small amounts.
Vitamins – fresh fruits and vegetables
Minerals – nuts, beans, mushrooms,
whole grains, low-fat dairy, beef, avocados,,
dark chocolate, cheese, and dried fruits
 04. A diet consisting of different kinds of
food and it will be included adequate
amounts of the nutrients necessary for
good health
1. Eg- Carbohydrate
2. Protein
3. Fats
4. Vitamins
5. Minerals
6. Fiber
7. water
 rice
 Fish
 Dhal
 Green leaves
 Beans
 Papaya/ mango/banana etc
 Water as needed.
 6. essential for overall health, normal cell
function, growth and development
 vitamins are so vital to good health
 Develop the immunity system
7 This meal plan controls the intake of
certain foods or nutrients. Sometimes
therapeutic diet describes as a special diet.
We have to consider
Disease condition- appetite
Nutrient
Texture
Food allergy/ food intolerances
Question 08
1. Clear fluid diet
2. Fluid diet/ liquid diet
3. Semi-solid diet
4. Normal diet
5. Special diet
6. Balanced diet
Question -09
 We can give a good appearance, good smell and
difference colour and taste
 Prepare clean and pleasant environment
 Give meals on time
 If the patients have Physical, mental freedom,
they have more appetite. Then we have to
observe and help for that
 Give a chance for Exercise
 We have to identify their Habits and consider
about that
 We have to identify Personal attitudes and
attention about that
Question -10
 Identify disease condition and nutritional
needs
 Assess the patient- can take oral, if not
arrange NG tube feeding or IV
 Plan the diet with necessary knowledge
 Arrange the therapeutic diet as needed
 Identify the amount of foods and encourage
the patient
 If patient cant take the meal alone, help to
the patient to take meal or fed the patient
Question -10 ctd…
 Identify the patient’s culture, religion,
economic status, mental and physical status,
appetite
 Give the meal on time
 Introduce a variety of foods
 Identify hot foods and cool foods
 Assess any pain or uncomfortable condition
before giving the meal
 Prepare the environment
 Correct position
Question -11
 I st we have to explain the procedure to the
patient
 Do hand washing
 prepare equipment correctly
(Eg- Formula feed, Measuring cup or any
container, Large syringe – 50 cc or 60 cc,Water in
a container (gally pot), Warm water in the cup,
Stethoscope, Kidney tray, Towel, Clean gloves)
Identify disease conditions and nutritional needs
 Identify the patient’s need and explain the
procedure
 Identify any food allergies, last feeding
time, bowel opened or not, bowel sounds
are there
 Position the patient (semi-fowlers)
 Wash the hands
 Spread the towel and the mackintosh over
the patient’s chest for protect the clothes
 Check and confirm NG tube is in situ (it is in the
correct position)
 Give the feed carefully
 After completing the feeding, flush the tube with
at least 30 cc of water
 After cleaning the tube you can close the tube
 Wash all equipment and dry
 Keep the bed elevated for 30-60 minutes after
feeding
 Wash your hands
 Do the documentation correctly
 Question -12
• Cough
• Not going the feed by gravity
• abdominal cramping
• abdominal swelling
• diarrhoea
• nausea
• vomiting
• regurgitation of food or medicine
• Patient is restless