Transcript Presentation

Therapeutic
Diets
By: Sari Bornstein
Objectives
 Describe
the most used therapeutic diets
and their restrictions
 Demonstrate your understanding of
therapeutic diets by accurately
assembling and delivering the correct
food items and their quantities in relation
to diet order on a daily basis.
Therapeutic diets to discuss:
 Renal/Kidney
 Dysphagia
 Dental
Care
Diets I, II, III
Soft
 Bariatric
Stage 1
 Low
Microbial/Neutrop
enic
 Safety
 Fluid
 1:1
Trays
Restrictions
Assistance
ICE BREAKER ACTIVITY
Renal/Kidney Care
 Restricted
in potassium, phosphorus, sodium,
(protein, fluid)
 Minimizes work put on the kidneys
 Poor choices: salty foods, dairy,
fresh fruit and vegetables, acidic
foods
 Good choices: Processed, white
items
 Novasource® Renal supplement
Pureed: Dysphagia Level I
 Difficulty
chewing or swallowing food or
liquids
 Blended, whipped, mashed to puddinglike texture, no lumps
 No garnish
 May be accompanied with
thickened liquids
Thickened liquids
easier to swallow
o
Ground Meat/Diced Fruit and
Vegetables: Dysphagia Level II
 Difficulty
swallowing or chewing due to
poor dentition
 Meat ground or diced < ¼ inch

Well moistened with gravies
 Fruit/vegetables/starches
inch


chopped < ½
Soft cooked vegetables, chopped
Soft/canned fruit only, chopped
 No
bread or rice
 Garnish OK
Dice/Chop All Foods:
Dysphagia Level III
 Food
broken down for poor dentition with slight
swallowing difficulty
 All food chopped to < ½ inch



Meats well-moistened, chopped
Vegetables soft cooked, chopped
Most items compliant if chopped
 Salad:
Shredded lettuce & chopped tomato OK
 Soft
bread OK, no rice
 Sandwiches/burgers OK if cut into quarters


Deli meat OK
No sandwich fillings
Dental Soft
 Restricts

hard to chew, fibrous foods
Mouth pain, poor-fitting dentures
 No
raw vegetables and limited fresh fruit
 No tough, fibrous
meats
 No hard, sticky or
crunchy food
 Patient preference =
many exceptions
Bariatric Stage 1
 Post
bariatric surgery, clear liquids only
 Sugar-free

Diet, clear liquids
 caffeine-free

Decaf coffee or tea
 No
carbonated
beverages
Low
Microbial/Neutro
penic
•
•
•
•
Restricts bacterial
exposure for
immunocompromised
patients
Well-washed fresh fruit
and vegetables OK
No uncooked tofu or deli
meats
No garnish
Safety Tray
 Harm
to self or others
 Restricts sharp objects, glass, saran wrap

Foil OK
 No
hot beverages or soup
 No metal utensils, glass
dishes, soda cans, saran
wrap, hot plates or domes
 Do not deliver to patient
1:1 Assistance
 Patients

need assistance with eating
At risk for aspiration
 Call
RN before tray delivery
 May deliver into room, but not within
reach of the patient
Enteral Fluid Restriction
 Prevents

fluid retention
Heart or kidney failure
 Dry,
1000, 1200, 1500, 1800, 2000 mL per day
 Total includes fluid allowance from the floor
 Includes: all beverages, jello, popsicles, ice
cream, milk, soup/broth, ice, supplements
 Example: 1 cup coffee = 6 oz. coffee

Small paper cup = 12 oz.
 Be
aware of hot fluid amounts dispensed
Looking at the ticket:

Diet order may not match food consistency


Example: Dice/Chop All Foods

Pear Halves pears chopped to ½ inch

Squash and Carrot Medley  chopped to ½ inch

Grilled Cheese on White  cut into quarters

Angel food cake  chopped Angel food cake to ½ inch

EVERYTHING chopped

 Assuming tray line staff & cooks look at diet 
Always pay attention to service notes
Considerations & Conclusion:
 There

may be exceptions
Always follow service notes first
 If
it’s questionable, ask diet clerks
 Expeditors double check tickets
 Hosts dispense correct liquid portions

appropriateness of additional condiments
 Diet
manual
Empower yourself to…
 One
thing you can do to improve tray line
accuracy






All food items present
All portions are correct
All consistencies are correct
Presentable
Delivered within 45 minutes
Dietary restriction knowledge
 Cheat
sheet
 Diet manual
THANK YOU