Diet Progression
- Clear Liquid
- Full Liquid
- Pureed
- Mechanical Soft
- Low Residue (Fiber)
- High Fiber
- Regular
Therapeutic Diets
- High Fiber
- Low Residue (Fiber)
- Low Sodium
- Low Cholesterol
- Diabetic
- Renal
- Dysphagia
- Diet Education
Dysphagia
- Neurological Disorders
- Muscular Disorders
- Structural Abnormalities
- Gastroesophageal Reflux Disease (GERD)
- Inflammatory Conditions
- Difficulty Swallowing
- Choking or Coughing
- Regurgitation
- Clinical History and Physical Examination
- Fiberoptic Endoscopic Evaluation of Swallowing (FEES)
- Videofluoroscopy (Modified Barium Swallow Study - MBSS)
- Treat Underlying Cause
- Therapy
- Dietary Modifications
- Medications
- Surgery
Religion and Dietary Preferences Overview
- Buddhism
- Natural Foods of Earth
- Hinduism
- Cow is Sacred
- Islam (Muslim)
- Halal Foods
- No Alcohol
- Judaism
- Kosher Meals
- No Pork or Shellfish
- Mormonism (Latter Day Saints)
- The Word of Wisdom
Total Parenteral Nutrition (TPN)
- Nutrition Given Outside GI
- Hyperglycemia
- Hyperlipidemia
- Refeeding Syndrome
- Nausea and Vomiting
- Slow IV Infusion
- Use Large Central Vein
- No Added Meds to TPN Line
Tyramine Containing Foods
- Aged Cheeses
- Pepperoni
- Pickled Foods
- Wine
Food Allergies and Restrictions
- Gluten-Free
- Lactose-Free
- Plant-Based
- Diabetic and Sugar-Free
- Nut Allergy
- Soy Allergy
Vitamin A (Retinol)
- Maintains Mucous Membranes
- Eyes and Skin
- Dietary Deficiency
- Skin Disorders
- Hepatosplenomegaly
- Jaundice
- Increased ICP
- Vomiting
- Teratogen
- Animal Food Products
- Dark Green and Orange Fruits/Vegetables
Vitamin B1 (Thiamine)
- Carbohydrate Metabolism
- Dietary Deficiency
- Beriberi
- Wernicke-Korsakoff
- Alcoholics Highest Risk
- Give Before Glucose
- Give IM or IV
- Enriched Whole Grains
- Pork
Beriberi (Thiamine Deficiency)
- Thiamine Deficiency
- Dry Beriberi
- Polyneuritis
- Muscle Wasting
- Wet Beriberi
- Dilated Cardiomyopathy
- Edema
Vitamin B3 - Niacin (Nicotinic Acid)
- Decreases Triglycerides
- Decreases LDL
- Increases HDL
- Dyslipidemia
- Pellagra
- Diarrhea
- Dermatitis
- Dementia
- Flushing
- GI Distress
- Hepatotoxicity
Vitamin B6 (Pyridoxine)
- Amino Acid and Protein Metabolism
- Heme Synthesis
- Neurotransmitters
- Adjunct to Isoniazid
- Dietary Deficiency
- Premenstrual Syndrome (PMS)
- Ataxia
- Peripheral Neuropathy
- Levodopa
- Cereals and Meats
Cobalamin (Vitamin B12)
- Vitamin B12
- Vitamin Deficiency
- Pernicious Anemia
- Hypokalemia
- Arthralgia
- Dizziness
- IM Injection for Pernicious Anemia
- Never Give IV
Vitamin C (Ascorbic Acid)
- Antioxidant
- Collagen Formation
- Steroid Synthesis
- Dietary Deficiency
- Scurvy
- GI Distress
- Citrus Fruits
- May Improve Healing
Ergocalciferol (Vitamin D2)
- Vitamin D2
- Hypoparathyroidism
- Rickets
- Hypophosphatemia
- Fatigue
- Constipation
- Hypercalcemia
- Kidney Stones
Vitamin E (Alpha-tocopherol)
- Antioxidant
- Fat Malabsorption Syndrome
- Alpha-TTP Deficiency
- Bleeding
- Increased Risk Hemorrhagic Stroke
- Limit Doses < 200 IU per Day
- Nuts and Whole Grains
- Vegetable Oils
Vitamin K1 (Phytonadione)
- Synthesizes Clotting Factors II, VII, IX, X
- Hypoprothrombinemia
- Newborn Prophylaxis
- Bleeding from Warfarin Overdose
- Shock
- Kernicterus
- Cardiac Arrest
- Bile Salts required for Intestinal Absorption
- Increased Risks with IV Administration
Iron (Ferrous Sulfate)
- Ferrous Salts
- Anemia
- GI Distress
- Nausea and Vomiting
- Dark Stools
- Take Between Meals
- Liquid can Stain Teeth
- Keep out of Reach from Children
- Caution with GI Disorders
- Avoid Antacids
Cholecalciferol (Vitamin D3)
- Vitamin D3
- Dietary Supplement
- Vitamin D Deficiency
- Fatigue
- Constipation
- Hypercalcemia
- Kidney Stones
- More Effective Than Ergocalciferol
- Hypervitaminosis D
Marasmus
- Deficiency of all Nutrients
- Body Weight < 60% of Normal
- Tissue and Muscle Wasting
- Loss of Subcutaneous Fat (Buttocks and Thighs)
- Variable Edema
Kwashiorkor
- Protein Deficiency
- Swollen Belly
- MEALS
- Malnutrition
- Edema
- Anemia
- Liver Malfunction
- Skin Lesions
Hypoglycemia Assessment
- Too much insulin
- Decreased glucose
- < 70 mg/dL
- Change in LOC
- Lethargic
- Confusion and Irritability
- Tremors
- Diaphoresis
- Tachycardia
- Vision Changes
- Weakness
- Seizures
Hypoglycemia Intervention
- Mild to Moderate Hypoglycemia
- Simple Carbohydrate (Oral Dextrose, Fruit Juice, Candies)
- Complex Carbohydrate (Whole Grains, Vegetables)
- Severe Hypoglycemia or Unconscious
- 50% Dextrose
- Glucagon
- Monitor Blood Glucose Q 10-15 Minutes
- Give Small Meal After Intervention
- Hypoglycemia Prevention
- Encourage Self-Monitoring
Hyperglycemia
- Insulin Resistance
- Too Little Insulin/Medication
- Infection/Illness
- Corticosteroids
- Elevated Blood Glucose
- Polyphagia
- Polydipsia
- Polyuria
- Hypotension
- Fatigue/Drowsiness
Anorexia Nervosa Assessment
- Adolescent Girls
- Fear of Gaining Weight
- Excessive Dieting
- Distorted Body Image
- Decreased Bone Density
- Stress Fractures
- Lanugo
- Amenorrhea
- Anemia
- BMI < 18.5
Bulimia Nervosa Assessment
- Normal Body Weight
- Binge and Purge
- Electrolyte Disturbances
- Alkalosis
- Hypokalemia
- Parotitis
- Enamel Erosion
- Russell's Sign
- Once Weekly For 3 Months
Anorexia Nervosa and Bulimia Nervosa Interventions
- Build Trust
- Plan Caloric Intake
- Supervise Meals
- Supervise Elimination
- Encourage Liquids
- Daily Weights
- Use Matter-of-Fact Statements
- Give Feelings of Control
- Tube Feedings If Further Weight Loss
Metabolic Syndrome
- Dyslipidemia
- Central Obesity
- Insulin Resistance
- Hypertension
- Increased C-Reactive Protein (CRP)
- Increased Fibrinogen
- Increased Risk Cardiovascular Disease