Emily Sinn
ND 568
Marywood University
Academy Nutrition Care Manual Assignments # 1
Consistency Altered Diets
Log on to the NCM. Go to the NCM Tab at the top and select Conditions. On the side
menu, selected Dysphagia. Under Dysphagia select Modified Consistency and then
select Clear Liquids.
What is an indication [what does indication refer to?
An indicator refers to a sign or symptom that gives reasoning for something. For
example, indicators, or signs of why dysphagia is occurring include: poor fitting
dentures or missing dentures, slow eating process, poor appetite, avoidance of
specific food groups (meat, bread, fresh fruit/vegetables), reported swallow or
chewing difficulty, recent or history of choking incidents and complaints of food
getting stuck in throat. If any of the previously listed symptoms are occurring
in a patient they may be at risk for dysphagia.
Summarize 3 reasons why use of the clear liquid diet has declined?
To avoid underfeeding and maintain adequate nutrition intake, the clear liquid
diet is used only when absolutely necessary. Calorie and protein supplements
may be ordered for patients on clear liquids for more than 3 or 4 days, but these
are not widely accepted by patients.
Understanding of time and required for gastric emptying has increased.
Recommendations for oral intake before surgery have been revised and often only
one clear liquid meal is needed preoperatively.
A clear liquid diet and clear liquid supplement beverages are unpalatable,
prompting patient complaints and reducing patient satisfaction scores.
Guidelines for pre-op fasting?
Fasting from clear liquids for 2 or more hours before procedures that require
general anesthesia.
Appropriate to fast from intake of any light meal or nonhuman milk at least 6
hours before elective surgery requiring general anesthesia.
Guidelines for patients with diabetes?
Sugar-free liquid diets are not appropriate for patients with diabetes
Patients with diabetes given clear liquid diets should receive approximately 200 g
carbohydrate spread equally throughout the day
Sample Menu: What foods are included?
Breakfast: orange juice, oatmeal, low-fat milk, muffin, butter, scrambled egg
Lunch: tomato soup, slurried crackers, moist potatoes, well-cooked carrots and
peas, tomato sauce, moist cookie, vanilla pudding
Dinner: potato soup, slurried crackers, well-cooked green beans, apple pie with
moist crust and ice cream.
How much protein provided in the sample menu? 36
Is this adequate? No, this number is pretty low. Protein foods should be added to
improve the nutritional quality of this diet.
Calories provided in the sample menu? 1,689
Is this adequate for someone requiring 2000 calories? The patient would benefit
from consuming extra calories each day. If this individual follows the plan, after
a week they would be 2,177 under the 14,000-kcal/week recommendations.
Those extra calories are essential for this patient battling dysphagia to regain their
strength and absorb essential nutrients and be fulfilled.
Look for Full Liquid. You will find it on the side menu under Dysphagia and then
select Modified Consistency.
Summarize description and indications:
Dysphagia
Level 1 Pureed: nectar (homogenous, very cohesive, pudding-like, requiring very
little chewing ability)
Level 2 Mechanically Altered: honey (cohesive, moist, semisolid foods, requiring
some chewing)
Level 3 Advanced: pudding (soft foods that require more chewing ability)
Contraindications? Is this diet evidence based? Yes.
McCullough, G., Pelletier, C., & Steele, C. (2003, November 01). National
Dysphagia Diet: What to Swallow? Retrieved November 04, 2017, from
http://leader.pubs.asha.org/article.aspx?articleid=2292328
Go to the Client Ed/Diets Tab at the top. On the side menu, selected Gastrointestinal.
Select Esophageal Surgery Nutritional Therapy.
Stated goals of this diet?
Nutrition therapy to aid recovery from surgery.
Avoid complications such as pain, obstruction, nausea, gas, bloating and diarrhea.
As healing begins, eating softer or more tender and nutritious foods.
Summarize recommended foods.
Proteins: tender, cooked meats without skin or bones, eggs, tofu, dried beans and
peas, smooth peanut butter
Grains: oatmeal, cream of wheat, grits and other cooked cereals, pasta or rice
Fruits: all cooked, fresh and soft fruits without skins or seeds and fruit juices
without pulp
Vegetables: all cooked, soft vegetables without skins or seeds and vegetable
juices/sauces
Fats and oils: oils, butter, margarine and smooth salad dressings
Beverages: all except alcohol, carbonated beverages, hot drinks and juices
containing pulp
Summarize NOT recommended foods.
Proteins: tough, chewy, or fatty meats; fried meat, poultry, fish or eggs, crunchy
peanut butter or nuts
Grains: high-fiber cereals and bran, chewy or crusty breads, crackers
Fruits: crunchy raw fruits and hard edges, dried fruits or coconuts, cooked fruit
with skin or seeds, juices with pulp
Vegetables: raw, stringy, or crunchy vegetables and cooked vegetables with skins
or seeds
Beverages: alcohol, carbonated beverages, hot beverages
Other: crunchy or chewy foods (deep-fried foods), foods with hard edges (chips),
popcorn, foods with nuts, seeds or dried fruit
Used with permission: Pauli Landhuis, MS, RD, LD; University of Missouri
