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six meal-planning principle known to promote good health
variety, adequacy, balance, moderation, energy contol, and nutrient density
seven main challenges to trying to meet the nutritional needs of all the clients in a hospital at any given time
- 1. each client has individual dietary needs and preferences
- 2. achieving patient satisfaction
- 3. specialized diets under limited budget
- 4. food safety
- 5. effective communication
- 6. quick response to nutritional needs required
- 7. prevention and reduction of waste
what are outsourced food products?
outsourced food products are those not prepared in the foodservice hospital. They are bought pre-prepared and are included in the hospital menu.
what is a regular diet?
a regular diet is a healthy diet suitable for adult hospital patients who are able to eat and who do not require any dietary modification or restrictions.
What is a selective menu?
a menu from which clients can choose what foods they want to eat from a limited assortment.
what is a cyclical menu?
a menu in which the daily food choices rotate over a set number of days.
what is a menu template?
a general pattern or model outlining what types of foods will be offered for each day of the cyclical menu, including what types of foods are offered for each meal.
Define consistency of food.
the consistency of food refers to the measure of the flow of a semi-liquid or liquid under gravity at a given temperture and time.
what is the texture of food?
the texture of food refers to the structure in which the componenets of a food are arranged.
What are dietary fibers?
portions of carbohydrates not digested by the enzymes of the digestive tract and that contribute to increase the fecal output.
what are residues?
unabsorbed dietary elements and postdigestive colonic luminal content postdigestion. Colonic residues include nondigested food particles, bacteria, and dead mucosal cells.
What is the relation between dietary fibers and residues?
dietary fibers increase residues.
what does edenulous mean?
without any teeth
what are the four physiologic phases of the normal swallow?
- 1. Oral preparatory phase
- 2. Oral phase
- 3. Pharyngeal phase
- 4. Esophageal phase
What are modified diets?
diets in which composition, consistency/texture, and/or presentation of food have been changed to prevent or treat a disease or for a diagnosis/examination/treatment procedure.
Give some examples of diets modified in consistency.
clear liquid diet, mechanically altered diet, and diets for dysphagia
When does consistency of foods served to clients need to be modified?
acute gastrointestinal disturbances, problems chewing, or problems swallowing, before or after bowel surgery, and beofre endoscopic bowel examination.
what is dysphagia?
Dysphagia referes to any problem chewing and or swallowing a person may have.
What main diets for dysphagia are available in acute care hospitals?
- NDD Level 1: Pureed
- NDD Level 2: Mechanically Altered
- NDD Level 3: Advanced
Liquid viscosity may be thin, nectar-like, honey-like or spoon thick.
What is a clear liquid diet?
Description: minimum residue liquid diet. This diet does not include foods solid at body temperature and foods containing residues and fibers
indication: in preperation for intestinal surgery, before exam of the colon, transition following parenteral nutrition, during acute malfunction of the GI
What is a blenderized liquid diet?
Description: diet including food that is blenderized to liquid consistency for clients not able to chew and/or swallow, or otherwise tolerate food that is solid.
Indicaiton: surgery of the mouth or face, abnormalities of the esophagus.
What is a mechanically altered diet?
Description: diet in which the texture of food has been modified to minimize the need for chewing. This diet includes foods easy to masticate, such as pureed, mashed, ground and soft, moist, chopped foods.
Indication: Reduced ability to chew solid foods due to head, mouth, or neck surgery, teeth/gum problems, or esophageal abnormalities
What is a dysphagia diet?
Description: consists of individualized dietary recommendations to offer each client with dysphagia a diet modified in food texture and fluid consistency, which is safe for the client and allows him or her to have a healthy nutritional and hydration status.
Indication: disease or condition resulting in chewing or swallowing impairment, neurologic illness, structural lesions, motility disorders, iatrogenic conditions, psychiatric problems.
Which foods are included in a clear liquid diet?
only low-residue fluids are included in the clear liquid diet: clear fruit juices, low-pulp or pulp-free juices, clear and low-fat bouillon or broth, clear gelatin or frozen pops, and low-fat, lactose-free, and low-residue oral nutritional supplements
What is the purpose of a clear liquid diet?
to supply the body with some fluids, electrolytes and a small quantity of energy, while requiring minimum digestion and stimulation of the digestive tract.
Which foods are included in a blenderized diet?
foods that blend/blenderize well such as milk and smooth custard, soft bread, cooked cereals, cereals soaked in milk, cooked and canned fruits, cooked and tender meat, cooked potatoes and noodles, and vegetable juice.
Foods recommended for clients in the mechanically altered diet.
foods that require minimum chewing such as soft, mosit foods. Such as ripened fruits, cooked vegetables, and pureed, mashed, ground, or chopped soft foods.
a failure of sphincter muscles to relax and open.
refers to difficulty speaking caused by a brain injury, emotional stress, noncoordination, paralysis, or spasticity of the muscles necessary to speak.
refers to a lack of capacity to coordinate muscles to accomplis voluntary movements, resulting in lack of coordination, inefficiency, and jerkiness.
referes to a repetitive oscillatory muscle movements or shaking
refers to difficulty to accomplish voluntary movements.
refers to dry mouth due to lack of salivary secretion
refers to lockjaw or persistent contraction of the jaw muscles.
refers to the passage of substance beneath the vocal cords into the pharynx and trachea.
What health complications are associated with untreated dysphagia?
Increases the risk of weight loss, dehydration, malnutrition, psychological problems, and aspiration. Malnutrition can lead to reduced immunity, infection, poor wound healing, and diminished quality of life.
Why is aspiration dangerous?
it can lead to the development of pneumonia, which is a major cause of morbidity and mortality in clients with dysphagia.
What is the difference between overt aspiration and slient aspiration?
overt aspiration causes the client to cough, whereas the silent aspiration happens without cough or choking sensation.
What are the four phases of the swallow
- 1. Oral prepatory phase
- 2. Oral phase
- 3. Pharyngeal phase
- 4. Esophageal phase
What are some neurologic disease associated with dysphagia?
- -parkinson's disease
- -head injury
- -cerebrovascular accident
- -multiple sclerosis
- -muscular dystrophy
- -alzheimer's disease
- -Cerebral palsy
The main goals for diets for dysphagia
- 1. to ensure that the client recieves an adequate amount of energy, nutrients, and fluids
- 2. to reach and maintain a healthy nutritional status
- 3. to prevent dysphagia complications and maintain the client's quality of life
- 4. to offer solid and fluid foods safe for the client
- 5. to monitor and adjust to the chaning needs of the client.