THE REGULAR DIET

Also called as general, house, full hospital diet. it is a normal diet planned to provide the recommended daily allowances for the essential nutrients and to meet the caloric needs of a bedridden or an ambulatory patient whose general condition does not require general modification or dietary restrictions. MEAL PATTERN Breakfast Fruit or juice Egg or substitute Rice or bread substitute Butter or margarine Hot beverage Lunch Soup Fish, meat or substitute Vegetables Rice or substitute Dessert, preferably fruit in season Beverage (optional) Supper Soup Fish,meat or substitute Vegetables Rice or substitute Dessert, preferably fruit in season Beverage(optional) Snacks: As desired to adjust caloric need. *** Adjustment in caloric needs for a particular patient is accomplished by varying the number of exchanges of rice , fat, calorie rich beverages and snacks. THE SOFT DIET Rice Banana Pochero (includes soup, meat, vegetables) Broiled fish with tomatoes Clam soup with sili leaves Meat omelet Vegetable Chopsuey Rice Fruited gelatin Orange juice Scrambled egg Toast-butter-jam Enzaymada (optional) Coffee with cream,sugar SAMPLE MENUS

-this diet follows the pattern of the regular diet with modifications in consistency and texture. FOOD GROUP Beverages physician Cereals cereals, FOODS ALLOWED All (milk, juices, etc). FOODS AVOID As restricted by

Refined well cooked such as: lugao,

Coarse unrefined

bread,whole malagkit, bran Meat, fish or (except Substitute gristles,

Soft cooked rice, white bread, puffed

whole wheat

Rice, soda crackers, noodles, potato

kernel corn,

Without skin, cornflakes, plain biscuits

graham crackers,

And cookies or cake.

Containing breads and Cookies.

Tender,loin: pork, liver, chicken,brain,

Fried meats or fish

tongue, fish prepared by boiling, baking,

bacon). Tough

Fruits indicated

Broiling. Bacon and mildly cured meats Mild cheese. Eggs(soft or hard cooked, Poached, scrambled, plain omelet). Beans and other legumes without skin (strained); tokwa, taho. Ripe avocado, banana, melon, atis pulp,

spicy meats Strong sharp cheese Fried eggs

All other fruits not

column. fibrous berries,

Chico,caimito, seedless and skinless grapes

in the allowed

Orange sections (other ripe fruits should be Pureed or strained). Canned or stewed: santol, peaches, guava, Canned or cooked: all

Prunes, cherries, apricots(all skinless and

fruits(like pineapple,

 gas Fats foods;excessive Vegetables

Seedless). Whole or sliced,well cooked: carrots, Sayote, squash, upo, young patola, green

Langka). All raw vegetables Strong flavored or

Beans, young peas, asparagus tips, beets, Short stem mungo sprouts, ampalaya Fruit, peeled young eggplant (no seeds) Tender well cooked leaves of kangkong, Sili, spinach, ampalaya; pureed or strained Beans, tomatoes, corn. Butter , margarine, cream; mayonnaise

forming vegetables Fibrous vegetables

All fried

Desserts containing

(some do not allow salad dressing and mayo) greasy or fatty items Smooth, plain peanut butter Plain cakes, cookies, frozen dessert puddings Nuts and rice pastries Malagkit

pastries Miscellaneous flavored soups

Gelatin, canned fruits as allowed under FRUIT desserts, rich

Others made with allowed items in this Column.

nuts, fibrous fruits

All soups free from excess grease and

Spicy strong

Made with ingredients under this column; Moderately seasoned and simply prepared. Seasoning and sugar in moderation INDICATIONS(soft diet) A soft diet is used for clients with dental problems, clients with poor fitting dentures, and clients who have difficulty chewing or swallowing. The diet is used for clients who have ulcerations of the mouth or gums, oral surgery, a broken jaw, plastic surgery of the head or neck, dysphagia or for the client who had a stroke. The diet is therapeutic for clients with impaired digestion or absorption as a result of conditions such as ulcerative colitis and Crohns disease.

INDICATIONS(soft diet) A soft diet is used for clients with dental problems, clients with poor fitting dentures, and clients who have difficulty chewing or swallowing. The diet is used for clients who have ulcerations of the mouth or gums, oral surgery, a broken jaw, plastic surgery of the head or neck, dysphagia or for the client who had a stroke. The diet is therapeutic for clients with impaired digestion or absorption as a result of conditions such as ulcerative colitis and Crohns disease. NURSING CONSIDERATIONS (soft diet) Clients with mouth sores should be served foods at cooler temperature. Clients who have difficulty chewing and swallowing because of a reduced flow of saliva can increase salivary flow by sucking on sour candy. Encourage the client to eat a variety of foods. Provide plenty of fluids with meals to ease chewing and swallowing of foods. Sucking fluids from a straw maybe easier than drinking them from a cup or glass. All foods and seasoning are permitted; however, liquid, chopped, or pureed foods or regular foods with a soft consistency are best tolerated. Avoid foods that contain nuts or seeds, which easily can become trapped in the mouth and cause discomfort. VARIATION : MECHANICAL SOFT DIET This is also called the dental soft diet. It is used for clients with difficulty in chewing due to poor dental condition, lack of teeth or presence of sores and lesions in the mouth following head and neck Injury, for those who are debilitated and too ill to eat the regular diet. THE LIQUID DIETS FULL LIQUID DIET contains all foods that are liquid at room temperature or could be liquefied at body temperature (can be melt in the mouth and stomach). INDICATIONS maybe used as a second diet after clear liquids following surgery or for a client who is unable to chew or swallow. Prescribed for clients who cannot tolerate solid foods due to any of the following: fever, infections, lesions in the mouth, GI disturbances, nausea and vomiting.

NURSING CONSIDERATIONS(LIQUID DIET) A full liquid diet is nutritionally deficient in energy and most nutrients. The diet includes clear and opaque liquid forms and those that liquefy at body temperature. Foods include all clear liquids and items such as plain ice cream, sherbet, breakfast drinks, milk, pudding and custard, soups that are strained and strained vegetable juices. CLEAR LIQUID DIET INDICATIONS Serves a primary function of providing fluids and electrolytes to prevent dehydration. The diet is used as an initial feeding after complete bowel rest. The diet is used initially to feed a malnourished person or a person who has not had any oral intake for some time. The diet also is used for bowel preparation for surgery or tests. The diet is a post - operative diet. A clear liquid diet is used in cases of diarrhea. NURSING CONSIDERATIONS(CLEAR LIQUID DIET) Clear liquid is deficient in energy and most nutrients. The body digests and absorbs clear liquids easily. Clear liquid contributes to little or no residue in the GI tract. Clear liquid can be unappetizing and boring. Client should not stay on a clear liquid diet for more than a day or two. It consists of food that are relatively transparent to light and are clear and liquid at room and body temperature. Foods include items such as water, bouillon, clear broth, carbonated beverages, gelatin, Hard candy, lemonade, popsicles, and regular or decaffeinated coffee or tea. The nurse should limit the amount of caffeine consumed by the client because it can cause stomach upset and sleeplessness. Client mat have salt or sugar. Dairy products are not allowed. MEAL PATTERN AND SAMPLE MENU FOR LIQUID DIETS TIME 6 am CLEAR LIQUID Hot tea FULL LIQUID Strained fruit juice

Breakfast oatmeal with cream

Strained fruit juice

Strained

Black coffee and sugar or popcicles cooked egg

and sugar Four minute soft

10 am

Plain gelatin Ice tea Vanilla milkshake Cream of pea soup Plain Pudding Milk/ Coffee/ Tea Plain Ice Cream

Lunch

Fat free broth Gelatin Hot tea

3pm

Strained Fruit Juice or Carbonated Beverages

Supper strained

Same as lunch

Cream soup or

coffee/tea 9pm (Bedtime snack) Strained fruit juice

Cereal with milk; Soft Custard; milk/

Plain sherbet

(Client should be encouraged to drink water in between feedings). VARIATIONS OF ROUTINE HOSPITAL DIETS LIGHT DIET transition between the soft and regular diets. Consists of food that are easily digested and readily emptied in the stomach. Indicated for patients especially elderly who cannot tolerate rich and heavy foods. Diet is given in 3 small meals with between meal feedings Fatty foods, rich pastries, concentrated desserts and fibrous fruits and vegetables are restricted or given as tolerated. VARIATIONS OF ROUTINE HOSPITAL DIETS COLD DIET Sometimes referred to as T and A diet (after tonsillectomy and adenectomy diet)

Consists of cold smooth liquids. Designed to minimize pain in the oral cavity and avoid bleeding in the affected area.

VARIATIONS OF ROUTINE HOSPITAL DIETS DIET AS TOLERATED diet regimen may range from full liquid to regular diet allowing preference at the dietitians discretion. This type of order should be a temporary measure, lasting no more than one day until a more specific diet is ordered based on results of diagnostic tests and medical examinations. Ultimate goal will still be the same as for soft and regular diets Foods must be nourishing and given in small feedings. VARIATIONS OF ROUTINE HOSPITAL DIETS ENTERAL NUTRITION provides liquefied foods into the GI tract via a tube. Necessary when the GI tract is functional but oral intake is not feasible. Used for clients with swallowing problems, burns, major trauma, liver failure or severe malnutrition. Nursing Consideration: Clients with lactose intolerance need to be replaced on lactose free formulas VEGETARIAN DIETS Diet is designed to utilize a combination of vegetable protein providing a similar quantity and quality of protein as animal protein. CLASSIFICATION Semi-vegetarian Fruits, grains, legumes, nuts and seeds, vegetables, milk and milk products, eggs, chicken and fish are included in the diet. All other animal meats are excluded CLASSIFICATION Vegan diet -also called the strict vegetarian diet. - Foods allowed are strictly of plant origin devoid of any animal product.

- Products included are: fruits, vegetables, legumes and nuts breads, cereals and processed foods made from these items: ex. Peanut butter, soy milk, meat like gluten. -Foods avoided are: all animal and animal products like milk, cheese and ice cream, eggs, fish and poultry red meats etc. CLASSIFICATION Lacto vegetarian in this diet milk and milk products are allowed in addition to food items of plant origin.

Pesco-vegetarian in this diet, fish and fish products are added to the list of items of plant origin, all animals meat are excluded. CLASSIFICATION OVO vegetarian eggs and eggs products are allowed aside from plant origin Lacto ovo- vegetarian eggs, milk and their products are both allowed in addition to food from plants. NURSING CONSIDERATIONS Ensure that the client eats a sufficient amount of varied foods to meet normal nutrient and energy needs. Protein intake can be increased by consumption of a variety of vegetable protein sources based on whole grains, legumes, seeds, nuts and vegetables combined to provide all of the essential amino acids. Adequate energy intakes are important to ensure that dietary protein is used for protein synthesis. THERAPEUTIC DIETS BLAND DIET INDICATION: client with gastritis, ulcers, reflux esophagitis or other GI disorders, congestive heart failure(CHF) or myocardial infarction(MI). NURSING CONSIDERATIONS: Bland foods are less likely to form gas than regular diets. Eliminate foods that stimulate gastric acid secretions. Eliminate foods that are irritating to gastric mucosa.

Foods to be avoided include alcohol; caffeine and caffeine containing beverages such as cola, cocoa, coffee and tea. Fried foods pepper and spicy foods. B. LOW RESIDUE/ LOW FIBER DIET INDICATIONS: The diet supplies foods that are least likely to form an obstruction when the intestinal tract is narrowed by inflammation or scarring or when GI motility is slowed. The diet is used for inflammatory bowel disease, partial obstructions of the intestinal tract, enteritis, diarrhea or other GI disorders. NURSING CONSIDERATIONS: Foods high in carbohydrate are usually low in residue and include white bread, cereals and pasta. Foods to be avoided are raw fruits (except bananas), vegetables, seeds, plant fiber and whole grains. Dairy products are limited to two servings a day. THERAPEUTIC DIETS C. HIGH RESIDUE / HIGH FIBER DIET INDICATIONS: Diet is used for clients who has constipation. Diet is used for irritable bowel syndrome when the primary symptom is alternating constipation and diarrhea and for asymptomatic diverticular disease. The diet helps regulate blood glucose in client s with Diabetes Mellitus(DM). The diet helps control blood cholesterol in clients with heart disease. HIGH RESIDUE / HIGH FIBER DIET NURSING CONSIDERATIONS; The diet provides 20 to 25 gm of dietary fiber daily. The diet adds volume and weight to the stool and speeds the movement of undigested materials through the intestine. The diet consists of fruits and vegetables and whole grain products. THERAPEUTIC DIETS D. FAT CONTROLLED DIET INDICATIONS:

The fat controlled diet is indicated for atherosclerosis, DM, hyperlipedemia, hypertension, MI, nephritic syndrome and renal failure. The diet reduces the risk of heart disease. NURSING CONSIDERATION: Limit the total amount of fats and amounts of polyunsaturated, monounsaturated, and saturated fats and cholesterol. THERAPEUTIC DIETS E. HIGH CALORIE DIET INDICATIONS: Persons with severe stress, burns, cancer, HIV infections, AIDS, COPD, respiratory failure or any other type of debilitating disease require a high calorie diet. NURSING CONSIDERATIONS: The high calorie diet also should be high in protein because the purpose of the diet is to build or maintain lean body mass. Add fats to food whenever possible. Add nuts and dried fruits such as raisins to desserts or cereals if the client can tolerate and eat these foods. Add sugar to food, and provide high calorie desserts. Encourage snacks between meals such as milkshakes and instant breakfasts. THERAPEUTIC DIETS SODIUM (Na) RESTRICTION DIET INDICATIONS: Persons with hypertension, CHF, kidney diseases, cardiac diseases and cirrhosis of the liver require a sodium restriction diet. NURSING CONSIDERATIONS: This type of diet includes 2000 to 4000 mg of sodium daily (mild restriction), 1000 mg of sodium daily (moderate restriction), or 500 mg of sodium daily (strict and seldom prescribed). Cereals allowed on a sodium restricted diet include dried or instant cereals, puffed wheat, puffed rice and shredded wheat. All spice, almond extract, bay leaves, caraway seeds, cinnamon, curry powder, garlic powder or garlic, ginger, lemon extract, maple extract, marjoram, mustard powder, nutmeg. THERAPEUTIC DIETS

G. PROTEIN (CHON) RESTRICTION DIET INDICATIONS: Persons with acute renal failure, chronic renal disease, cirrhosis of the liver and hepatic coma NURSING CONSIDERATIONS: Provide enough protein to maintain nutritional status but not an amount that will allow the build up of waste products from protein metabolism. (40 to 60 gm of protein daily). The smaller the amount of protein allowed, the more important it becomes that all protein included in the diet of high quality . (CONTINUATION) NURSING CONSIDERATIONS:(CHON RESTRICTED DIET) An adequate total energy intake from food is critical for clients on protein restricted diets ( protein will be used for energy, rather than for protein synthesis). Special low protein products such as pastas, bread, cookies, wafers, and gelatin made with wheat starch, can improve energy intake and add variety to the diet. Carbohydrates (CHO) in powdered or liquid forms also can provide additional energy. Vegetables and fruits contain some protein, and for very low protein (CHON) diets these foods must be calculated into the diet. Foods are limited from the milk, meat, bread and starch exchange THERAPEUTIC DIETS H. HIGH PROTEIN DIET INDICATIONS: High protein diets are for tissue building , burns, liver disease and older clients. NURSING CONSIDERATIONS: High protein diets correct protein loss or assist with tissue repair. Increase foods such as meat, fish, and dairy products. The client may need protein supplements. THERAPEUTIC DIETS I.LOW CALCIUM DIET INDICATIONS: A low calcium diet maybe prescribed to prevent renal calculi in a client at risk for forming calculi composed of calcium.

NURSING CONSIDERATIONS: Decrease the total intake of calcium to prevent further stone formation; Avoid whole grains, milk and dairy products and green leafy vegetables. THERAPEUTIC DIETS J. HIGH CALCIUM DIET INDICATIONS: -Calcium is needed during bone growth and in adulthood to prevent osteoporosis. NURSING CONSIDERATIONS: -Primary Dietary sources are dairy products Clients experiencing lactose intolerance need to incorporate sources of calcium other than dairy products into their dietary patterns regularly. THERAPEUTIC DIETS K. LOW PURINE DIET INDICATION: Diet is used to treat gout. NURSING CONSIDERATIONS: Purine is a precursor for uric acid that forms stone and crystals. The client needs to avoid consuming fish such as anchovies, herring , mackerel sardines and scallops. The client needs to avoid consuming glandular meats, gravies, meat extracts. THERAPEUTIC DIETS L. HIGH IRON DIET INDICATION: Diet is used for clients with anemia. NURSING CONSIDERATIONS: The high iron diet replaces iron deficit from inadequate intake or loss. The diet includes organ meats, meat, egg yolks, whole wheat products, leafy vegetables, dried fruit, legumes. THERAPEUTIC DIETS M. DIET FOR DIVERTICULAR DISEASE

Symptomatic Diverticulitis The client avoids fiber because a high fiber diet is irritating to the bowel. Asymptomatic Diverticular Disease The client consumes a high fiber diet to prevent constipation. The client should maintain a liberal fluid intake of 2500 to 3000 ml/day, unless contraindicated. The client should avoid seeds and nuts because they become trapped in the diverticula and cause irritation. The client should avoid gas forming foods. THERAPEUTIC DIETS N. FLUID RESTRICTION DIET INDICATIONS: Acute renal failure-oliguric phase, chronic renal disease, cirrhosis of the live, congestive heart failure and other cardiac disorders and hepatic coma. NURSING CONSIDERATIONS: Usually this diet restricts food that are composed largely of water such as carbonated beverages, coffee, juices, milk, tea water frozen yogurt, gelatin, ice cream, ice milk, popsicles, sherbet, soup, cream and liquid medications. *** MEASURES TO RELIEVE THIRST: Chew gum or suck hard candy. Freeze fluids so they take longer to consume. Add lemon juice to water to make it more refreshing. Gargle with refrigerated mouthwash. THERAPEUTIC DIETS O. CARBOHYDRATE CONTROLLED DIET INDICATIONS: The diet helps maintain normal glucose levels in clients with disorders that cause blood glucose levels to rise or fall abnormally. The diet is used for client with diabetes mellitus, hypoglycemia, lactose intolerance, galactosemia, and obesity. NURSING CONSIDERATIONS: Exchange System for Meal Planning

The Exchange System for Meal Planning is a food guide used to control diabetes mellitus and control weight. The Exchange System group foods according to the amounts of the carbohydrates, fats and proteins they contain. Major food groups include carbohydrate group, meat and meat substitute group and fat group.