Routine Hospital Diets

BASIC CONCEPTS AND Refers to the regular, soft and liquid diets commonly
PRINCIPLES OF DIET used in the hospitals, it differs from one another in
consistency and composition to suit individual needs
THERAPHY & dietary requirements.
DEFINITION OF TERMS:
Diet Therapy Regular Diet
 is the use of food as a factor in aiding recovery  It is frequently used for all the hospital diets.
from illness, relating the art & science of
 Also called Full diet, Normal diet or General
nutrition to the symptoms of the disease.
diet.
 Factors to consider in the Study of Diet
 It follows the principle of good meal planning
Therapy
and permits the use of all foods.
 Underlying disease conditions which
 Given to patients whose conditions do not
require change in the diet.
need dietary modifications or restrictions.
 The possible duration of the disease.
 The patients’ tolerance f0r food by Soft Diet
mouth.
 Diet that follows the pattern of regular diet,
with modification of the regular diet with
Purpose of Diet Therapy
modifications in consistency and texture.
 To maintain or restore good
 Usually prescribes when patients cannot
nutritional status.
tolerate the regular diets in the case of
 To correct nutritional deficiencies gastrointestinal disorders and infections and
which may have occurred. during convalescence.
 To afford rest to a particular organ or  Foods allowed are low in fiber and tough
to the whole body which may be connective tissues (skin, seeds) and are
affected. generally bland in flavor.
 To adjust the diet to the body to  Usually prepared by boiling, baking or
metabolize the nutrients. stewing.
 To bring about the changes in the  Fried foods are omitted.
body weight whenever necessary.
Liquid Diet
Dietetics 2 Types of Liquid Diet:
 the science & art of utilizing food and the 1. Full Liquid Diet
fundamental knowledge of nutrition & contains all foods that are liquid in
metabolism in various conditions of health & room temperature or could be liquefied at
disease. body temperature. (Melts in the mouth & in
the stomach).
Diet
 food and drinks regularly consumed. Sample:
o Breakfast - Hot tea with lemon juice
Diet Prescription or milk and 1 tsp sugar (no pulp);
 modification of the normal diet pattern Apple juice (8 oz); Gelatin 1 cup; Milk
indicated for a number of diseases. (1%)
o Lunch- Hot tea with lemon or cream
Principles of Dietary Management: (no pulp) and sugar; Grape juice (8
Liberalization oz); Ice Cream (1 cup); Strained Cream
 the diet should meet the body’s requirement of Potato Soup; Milk (1%)
for essential nutrients as generously as the o Snack - Fruit juice (apple, cranberry or
disease condition permits. grape, 8 oz); Pudding (1 cup)
o Dinner - Hot tea with lemon or milk
Individualization
and sugar; Apple juice; Strained
 the diet should take cognizance of the patient’s
Cream of Asparagus Soup (8 oz);
food intake habits, preference, economic
Sherbet (1 cup); Milk (1%)
status, religious practice & any environmental
factors that have bearing on the diet, such as
2. Clear Liquid Diet
where the meals are eaten, and who prepares
 consists of liquid without residue or
them.
fibers.
 Clear liquid is nutritionally
Simplification
inadequate, it consists mostly of
 the therapeutic diet should vary from the
carbohydrate with little of protein &
adequate normal diet as little as possible.
fats.
 It should not be used for more than 2
days.

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  It is often used just as immediately Characteristics of Tube feeding and Preparation:
after surgery. It aims to relieve thirst, 1. Tube feeding maybe prepared from liquid
maintain water balance and clear foods using calculated formulas from
colon of digested materials. commercial preparation or from regular
 It is indicated for acute infections, natural foods that are liquefied in a blender or
acute inflammatory conditions of the osteorized “blenderized feeding”.
gastrointestinal tract and fevers. 2. A satisfactory tube feeding must be
nutritionally adequate except for prescribed
Variations of the Routine Hospital Diets modification for specific nutrients.
Light Diet 3. It must be inexpensive, easily prepared &
 transition diet between the soft diet and the stored.
regular diet. 4. It should be well tolerated by the patient with
 Foods allowed under the regular diet are no reaction in the GIT.
permitted for the light diet except for fried 5. The mixture should pass the 2mm tube with
foods, or other foods with greasy preparation, relative ease.
pork & fibrous foods. 6. The preferred dilution is 1 kcal/ ml of the tube
feeding.
Mechanical Soft Diet 7. Total volume should not exceed 2,300 ml /
 this is similar to regular diet except that whole day or 100 ml / hr.
foods that are difficult to chew and swallowed
are modified by grinding, curing, chopping, Things to Observe in Preparing the Tube Feeding:
mincing, pureeing.  Use enough liquid for better blending and
 Indicated for patients with difficulty in liquefying.
mastication.  Plain pasteurized milk is not recommended
 Also called Dental Soft Diet. because the butterfat tends to clump in the
blender.
Cold Diet  Avoid course fibrous food that tends to clog
 sometimes called T & A (tonsillectomy & the blender. Use low fiber fruits and
Adenectomy) vegetables, strain after blending.
 Consist of cold smooth liquids, designed to  For convenience, baby foods in bottles maybe
minimize pain in the oral cavity and avoid used.
bleeding of the affected area.  Keep prepared blended foods refrigerated
until ready to use.
Tube Feeding  Discard formulas after 24 hours.
 also known as osteorized feeding.
 This type of diet requires consistency that can
pass through a polyvinyl tube. Occasionally Intervals of Feeding & Administration
feeding is by means of surgically constructed 1. Tube feeding maybe given as continuous drip
jejunostomy. Sometimes food is introduced by or at intervals throughout the day.
a syringe directly into the nasogastric tubing. 2. The feeding regimen should be adjusted to the
patient’s condition, nutriture and dietary
Indication for Use: prescription by the doctor.
 Tube feedings are used for total nourishment 3. To initiate tube feedings, use diluted mixture
or as supplements for the following: at first about half the required concentration.
 Several illnesses preventing food 4. Try 50 ml of the mixture at hourly intervals,
intake by mouth. and then gradually increase the concentration
 Comatose or semiconscious state & volume until patients can tolerate 200 ml at
 Surgery of the neck, face & throat 2 to 3 hours intervals.
 Anorexia Nervosa 5. Do not exceed over 300 ml per feeding of 3-4
 Esophageal Obstruction hours intervals.
 Severe burns & trauma 6. For continuous drip method, the flow of the
 Difficulties in chewing & swallowing tube feeding should be very slow at first, then
 Certain neurological and mental increased gradually but kept constant, steady
disorders rate.
 Terminal illness 7. Additional water should be given as needed to
 Any other conditions that necessitate meet fluid requirement.
rapid rehabilitation through nutrients.
 The dietary prescription for tube feeding Hyperalimentation Or TPN (Total Parenteral
should be specific in-kind amount dilution Nutrition)
and total volume from 24 hours. Their  Use for patients with severe tissue damage in
commended feeding intervals & volume per which a catheter is inserted into the superior
feeding should be clearly stated. vena cava.

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  Characterized by hypertonic solution  there should be an increase of 10-25% of
containing glucose, protein, hydrolysate, caloric requirement provided that there are no
vitamins and minerals are administered complications.
continuously through the catheter.  Vitamin C is required for tissue healing as well
 The nutrients are introduced directly to the as collagen formation.
blood stream.  Vitamin A for epithelialization, prevents
 The primary nutritional goal of TPN is to gastric stress and ulceration.
maintain nutritional equilibrium and conserve  Vitamin K for prothrombin formation.
lean body mass.  Zinc a mineral which helps in the process of
wound healing.
The Therapeutic Diet  Needed for amino acid metabolism and
a. Diabetic Diet synthesis of collagen precursors.
 a diet designed for patient who has  Fluids – the patient should be supplied with
diabetes mellitus. sufficient fluids to maintain normal water and
 All foods are sugar free. electrolyte balance.
 Food – the introduction of food following
b. Low Sodium Diet surgery will depend upon the condition of the
 prepared for patients with sodium or patient’s gastrointestinal tract.
saline excess.  As soon as bowel sounds returned after the
 Avoid dried fish and all salty foods. operation, the patient should be given clear
liquid diet for a few meals then full liquid diet
c. Low Protein Diet can be given for a day or so, then a regular diet
 designed for patients with kidney maybe given.
trouble or renal failure, hepatic coma.
 Avoid legumes, seeds, nuts & DIETARY MANAGEMENT FOR INFECTIONS
coconuts. AND FEVER
Infection
d. Low Purine Diet - the successful establishment and growth of
 designed to decrease elevated uric microorganism in the tissue of the host.
acid level.
Effect of infection on the Nutritional
 Used to patients with gout or uric acid
Requirements:
stone.
 Increase in Metabolic Rate – fever is usually
present with infection, there is an elevation of
e. Hypoallergenic Diet
approximately 13% in the metabolic rate for
 for patients with rashes and allergies
each rise of 1°C in the body temp. or more
and asthmas.
than 37.2° C.
 Foods to avoid: chicken, tomatoes,
dried fish, seafood’s, eggs
Fever
- an elevation of body temperature above
f. Low Fat Diet
normal.
 for patients with gallstone,
arteriosclerosis, hepatitis, fat Catabolism
malabsorption, weight reduction and - the series of chemical reaction in the living
diarrhea. body in which complex substances taken as
 Avoid: fried foods, creamed or soaked food are broken down into simpler ones
in fats, avocado, carabao milk, cheese, accompanied by the release of energy.
butter, oils, mayonnaise, chicharon,
chocolate bars, pies, pastries, and Nutritional Care:
other fat containing foods. 1. Calories & Protein
2. Fluids
3. Vitamins
4. Minerals

Meal Plan:
POST OPERATIVE NUTRITIONAL CARE 1. Frequent small liquid feedings are best
Nutritional care for post operative patient varies since tolerated.
it is individualized. 2. Give special attention to the selection of food.
3. Foods should be easily digested.
Elective Surgery 4. Meat & leafy vegetable should be given as
soon as tolerated.

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5. Give a high caloric beverage in between meals.
6. Additional meals could be given when
practical and advisable.
7. When the appetite is very poor, small meals
are concentrated supplements could be given.
8. The dietary and fluid intakes are important
concerns of those caring of patients with
infections and fever.

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