DIET ORDER DEFINITIONS

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DIET ORDER DEFINITIONS

• 5/06
• Presented by Sheila Croy, RD

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Clear Liquids

• Order as Clear Liquid.
• Patient will receive gelatin, broth, hot tea, and
  juice (apple, cranberry, grape, or blends of
  these types).
• Sugar packet (sugar substitute packet to
  diabetics).
• Coffee allowed if patient requests.

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Blenderized Liquid

• Order as Blenderized Liquid. A full liquid
  order will be interpreted as a Blenderized
  Liquid diet.
• Patient will receive blended soup, 2 milk,
  custard/pudding/ice cream/sherbet, juice
  (includes clear liquid juices and thicker juices
  nectars, pineapple juice, tomato juice) coffee,
  sugar, salt, pepper, and creamer.

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Blenderized Liquid (cont.)

• Omits foods that cannot be blenderized easily
  such as nuts, whole grain cereals, dried fruit,
  coconut, fruits and vegetables with seeds,
  membranes, or tough skins most hard cheeses,
  fried noodles, fried rice, crunchy peanut butter,
  popcorn, marmalade, and relishes.
• All other foods allowed that blend smooth.

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Light Labor

• Order as Light Labor.
• Patient will receive clear liquid tray plus toast
  (with margarine and jelly).

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General

• Order as General. If an order for a Regular
  diet is made, a General diet will be provided.
• Appropriate for anyone who doesnt have special
  dietary needs.

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Diets for Dysphagia (swallowing problems)

• Order as Dysphagia Diet 1, or Dysphagia Diet 2,
  etc.
• Stage 1 Puree
• Thick, smooth textures that are spoon-thick or
  pudding-like consistency.

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Diets for Dysphagia (cont.)

• Stage 2 Ground/Minced
• No course textures are allowed
• Stage 3 Mechanical Soft
• Soft textures no tough, dry, crisp, or stringy
  foods. Meats should be cut in small pieces
  (diced pieces should be ¼ of an inch or less).

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Diets for Dysphagia (cont.)

• Stage 4 Modified General If a Soft diet is
  ordered, this will be interpreted as a Modified
  General diet.
• For patients who chew soft textures but do not
  require grinding or chopping of foods.

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Diets for Heart Disease Low Fat/Low
CholesterolDiets for Gastrointestinal Disease
Low Fat

• To be ordered Low Fat/Low Cholesterol or Low
  Fat.
• Patient will receive skim milk
• Patient will be allowed 4 egg yolks per week
  (Tues., Thurs., Sat. Sun.)
• 6 oz. Meat/meat alternatives per day

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Low Fat/Low CholesterolLow Fat (Cont.)

• No more than 2 fat equivalents (1 equivalent 1
  tsp. margarine) per meal (including fat used in
  cooking)
• Allowed 1 non-dairy creamer per meal.

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Diets for Heart Disease (cont.)

• 3 gm Sodium (130 mmol) Cont.
• To be ordered 3 gm Sodium (3 gm Na, or 3000 mg
  Sodium). An order for a No Added Salt diet
  will be interpreted as a 3 gm Sodium diet.
• Patients will be allowed to order off a
  Regular/General menu (items that are high in
  sodium will be crossed off before the patient
  receives the menu).

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Diets for Heart Disease (cont.)

• 3 gm Sodium (130 mmol)
• High sodium foods are eliminated or used very
  sparingly Regular Canned or packaged gravy or
  gravy mixes, regular salad dressings, smoked,
  salted and kosher meats, regular canned foods,
  pickled vegetables, regular canned soup, salted
  snack foods, luncheon meats and soy sauce.
• ¼ teaspoon table salt is allowed in cooking or at
  the table (salt-free seasoning packets will be
  provided on patient trays).

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Diets for Heart Disease (cont.)

• 2 gm Sodium (87 mmol) To be ordered 2 gm
  Sodium (2 gm Na, or 2000 mg Sodium). An order
  for a Low Salt diet will be interpreted as a 2
  gm Sodium diet.
• - Includes use of low sodium condiments,
  gravies made from meats cooked without added
  salt.
• - Eliminates foods listed above (3 gm Sodium).
  - Limits milk to 16 oz. (2 servings) per day.

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Diets for Heart Disease (cont.)

• Cardiac (Low Fat/Low Cholesterol, 3 gm Sodium)
  To be ordered as Cardiac
• - Caffeine will be restricted in all forms as
  well as decaf. Beverages.

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Therapeutic Diets

• High-Fiber To be ordered High-Fiber
• - Same as a General diet, but with more
  emphasis on providing high fiber foods.
• - Fiber is found in plant products only

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Therapeutic Diets (cont.)

• High-Calorie, High-Protein To be ordered
  High-Calorie, High-Protein.
• - Nutritional supplements may be ordered.
• - Nutrient-dense and calorie-dense foods will be
  provided.

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Adverse Reactions to Foods

• Gluten-Free Diet To be ordered Gluten-Free
• - All food labels should be read carefully.
  - Food products that contain wheat, rye, barley,
  oats, gluten stabilizers, and hydrolyzed or
  texturized vegetable or plant protein (HVP or
  TVP) from ingredients not allowed are to be
  avoided.

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Adverse Reactions to Foods (cont.)

• Lactose-Controlled Diet To be ordered
  Lactose-Controlled. An order for a Low
  Lactose or Lactose-Free diet will be
  interpreted as a Lactose-Controlled diet.
• - People have different levels of tolerance to
  lactose.
• - The dietitian can visit patients who are
  lactose-intolerant to educate them on different
  ways to get calcium through the foods that are
  offered.

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Adverse Reactions to Foods (cont.)

• Food Hypersensitivities/Allergies To be ordered
  Allergy to ________
• - Consult dietitian for severe allergies
• - Education can be provided
• - Foods will be evaluated for known allergen
  ingredients by the dietitian.

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Adverse Reactions to Foods (cont.)

• Neutropenic Diet
• To be ordered Neutropenic Diet.
• - Menus will be adjusted according to guidelines
  on page 840 in the Manual of Clinical Dietetics.

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DIET FOR LIVER DISEASE

• To be ordered Diet for Liver Disease
• An order for a Hepatic Diet will be interpreted
  as Diet for Liver Disease.
• - A 2 gram sodium diet will be provided,
  (protein restriction is not advised).

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POTASSIUM-MODIFIED DIET

• To be ordered Low- or High- Potassium Diet.
• - A low potassium diet will be interpreted as a
  2 gm Potassium diet.
• - A high potassium diet will be interpreted as a
  4-5 gm Potassium diet.

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POTASSIUM-MODIFIED DIET (CONT.)

• The dietitian will assess usual intake of the
  patient, and either add to or decrease the amount
  of fruits/vegetables normally consumed and
  provide a meal pattern to follow.

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DIET FOR KIDNEY DISEASE

• To be ordered Renal Diet. A low protein diet
  will be interpreted as a renal diet.
• A 50 gm protein meal pattern with a 2 gm
  potassium, 2 gm sodium, and phosphorus
  restriction (inherent with low protein diet) will
  be followed until the dietitian is able to assess
  the patients needs.

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DIET FOR DIABETES

• To be ordered ______ calorie ADA diet. A diet
  order for a Diet for Diabetes will be treated
  as a No Concentrated Sweets diet order, until
  the dietitian is able to assess the patient and
  determine an appropriate calorie level.
• - Skim milk will be provided for all diabetic
  diets, unless approved by the dietitian.
• - High sugar items will only be allowed if the
  dietitian approves.
• - Sugar substitutes and diet foods (low sugar
  low fat) will be provided.

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OTHER DIETS

• No Concentrated Sweets To be ordered No
  Concentrated Sweets. A diet order for Low
  Concentrated Sweets will be interpreted as a No
  Concentrated Sweets diet.
• - Sugar-free foods will be provided.
• - High sugar items will only be provided if
  approved by the dietitian.
• - Provides a moderate fat intake
• - A calorie-controlled diet should be ordered if
  concerned about fat intake.

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OTHER DIETS (Cont.)

• Surgical Soft
• Order as Surgical Soft. If a Low Residue/Low
  Fiber diet is ordered, this will be interpreted
  as a Surgical Soft diet.
• Moderate fat restriction (avoids high fat meats
  and fried foods only) low in fiber, gas-forming
  foods, and highly seasoned foods.

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OTHER DIETS (CONT.)

• Surgical Soft (cont.)
• The following need to be ordered as restrictions
  if necessary Consumption of coffee/caffeinated
  beverages, decaffeinated coffee, chocolate,
  citrus and/or acidic foods, or carbonated/cold
  beverages.

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OTHER DIETS (cont.)

• Fluid Restrictions To be ordered _____ ml fluid
  per day, indicating total amount of fluid in 24
  hours to be taken by mouth.
• - It is the responsibility of the floor to let
  Food Nutrition know the amount of fluid that
  should be provided on meal trays.

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OTHER DIETS (cont.)

• Fluid Restrictions (Cont.)
• Common Fluid Measurements (ml cc 240 ml 8
  oz. 30 ml 1 Tbsp.)
• Soup/Cereal bowl 170 ml Coffee Cups 200 ml
• Small Styro. Cup 200 ml Large Styro. Cup 430
  ml
• Can Pop 360 ml Juice Boxes 120 ml
• Sherbet cup 100 ml Milk Carton 240 ml
• Twin Popsicle 80 ml Tomato Juice 160 ml
• Fruited Jello 80 ml Water Pitchers (on
  floors) 540 ml

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OTHER DIETS (cont.)

• Thickened Liquids To be ordered
  ______-consistency liquid.
• - Nursing staff are to thicken liquids before
  providing food tray to the patient.
• - Thickener is available from Food Nutrition