Special Diets
What is a clear liquid diet?
has limited nutrition and is only used for a short time. Clear juices with no pulp,
gelatin, popsicles and clear broth are examples. Clear liquid diet is are most commonly ordered
post operatively or any time bowel function is diminished, or in advance of bowel preparation
for diagnostic tests.
____ is an antihistamine used as an anti-emetic and sedative. Oral, IM or IV. IV should be given in the largest vein possible, preferably central. Extravasation is painful and can easily cause necrosis. Any IVP administration should be over 10-15 minutes, diluted with infusing IV fluids and in the smallest concentration available.
Phenergan (promethazine)
How to help with constipation?
(1) High fiber
(2) Hydration
(3) Exercise
(4) Meds:
(a) Psyllium and Senna-fiber
(b) Glycerin suppositories, soap and water enema-lubricant
(c) Colace (docusate)-stool softener
(d) Magnesium citrate, milk of magnesia-osmotic laxative
(e) Dulcolax (bisacodyl)-stimulant
What is a Diabetic diet/calorie or carbohydrate restricted diets?
these diets avoid simple
carbohydrates/high glycemic index foods. Lean protein, healthy fat and complex carbohydrates
are included. Avoid fruit juice, regular soda or excess fruit.
If there are changes in “blood counts” (neutropenia (WBC), anemia (RBC), thrombocytopenia (platelets) what do you do?
(1) Stop treatment
(2) Transfusions
(3) Epogen (erythropoietin) for anemia
What is a full liquid diet?
consists of foods that are or would become liquid at room temperature (this is how
to determine if a food item is included as intake as well). Any clear liquid can also be consumed
on a full liquid diet. Items such as milk and milk based items like yogurts (no pieces of fruit),
puddings and ice-cream, strained creamy soups and liquid supplements (nutritional shakes).
___ is a serotonin blocker administered 30 minutes prior to a dose and 4-8 hours following a dose of many chemo meds.. Oral, IV or IM. SE include lightheadedness, dizziness, drowsiness. It is commonly combined with a glucocorticoid/steroid like dexamethasone.
Zofran (ondansetron)
What is alopecia and how to help?
Hair loss from radiation/chemo
(1) Cut hair short, maybe shave head
(2) Wigs (cranial prosthesis)-try to choose before hair loss. Get a prescription.
(3) Caps and scarves *ACS has programs for styles
(4) Avoid hair dryers, irons and avoid heavy brushing.
What is a cardiac diet?
avoid foods that contribute to cardiovascular disease (cholesterol and salt) and
promote foods known for cardiovascular health. Avoid saturated fats (meat based) and
promote unsaturated fats (monounsaturated [ olive oil, avocados, almonds] and
polyunsaturated [corn oil, fish])
Cardiac diet may include DASH-dietary approaches to stop hypertension which will include the
above plus sodium control.
What are the warning signs of cancer?
Change in bowel or bladder habits
A sore that does not heal
Unusual bleeding or discharge from any body orifice
Thickening or a lump in the breast or elsewhere
Indigestion or difficulty in swallowing
Obvious change in a wart or mole
Nagging cough or hoarseness
What is a pureed diet?
made up of foods that require no chewing, such as mashed potatoes and pudding.
Other foods may be blended or strained to make them the right consistency. Liquids, such as
broth, milk, juice, or water may be added to foods to make them the right consistency. This
diet is for persons who cannot safely chew or swallow solid food.
___ is a dopamine antagonist. Oral, IV, IM, rectal. It
is commonly given intermittently with Zofran. SE are anticholinergic (urinary retention, dry mouth, constipation), drowsiness, hypotension.
Compazine (prochlorperazine)
What is parageusia and what do you do to help?
Metallic taste change:
(1) Good oral hygiene
(2) Avoid eating just before or after chemo
(3) Use plastic utensils
(4) Red meats are often the worst-substitute poultry, eggs, nuts
(5) Flavor food more. Tart or sour if tolerated.
What is a renal diet?
because of fluid volume excess, renal diets often include a fluid restriction. Make
sure to clarify if this is an oral limit or a total limit that also includes any IV fluids. Foods high in
potassium, sodium and phosphorous (especially colas) are limited. Protein rich foods contain
phosphorus too, and also break down into amino acids that may contribute to metabolic
acidosis, hyperphosphatemia and hypocalcemia and should be limited to those considered high
quality and total proteins. Proteins need to be adequate, but not excessive. Limit foods that
are partial proteins like some whole grains, nuts and legumes as they will contribute to acid
base imbalance while not providing all the essential amino acids.
Name examples of high protein foods
Cheese, eggs, Meat, Poultry, Fish, and milk/yogurt
What is a mechanical soft diet?
is made up of foods that require less chewing than in a regular diet.
People on this diet can tolerate a variety of consistencies. Chopped, ground, and puréed foods
are included, as well as foods that break apart easily without a knife, like soft-cooked foods.
Examples are foods like scrambled eggs, soft cooked carrots, or baked potatoes without skin.
These are used for persons who have difficulty chewing effectively.
____ is a “prokinetic” meaning it treats N/V by increasing gastroparesis. IV or IM. SE include drowsiness, dizziness and such.
Reglan (metoclopramide)
What is xerostomia and how to help?
What can also occur with this?
Dry Mouth and sore mouth (oral mucositis is inflammation and ulcers) can also occur
(1) Rinse with water every 2 hours (add salt or baking soda-1/2 tsp per 8 oz)
(2) Humidifier at night
(3) Saliva substitute and lip moisturizer (many OTC choices)
(4) Mouthwash and oral swabs-avoid those with alcohol or lemon if sore
(5) Gentle but thorough oral hygiene
(6) Xylocaine viscous with antacid for sores
(7) May need antifungal/antibacterial or antiviral-monitor for s/s infection
What is a liver diet?
Protein is important to consider for persons with liver disease. As protein is
metabolized, ammonia is a by-product. See suggestions for adequate but not excessive,
complete high quality proteins above.
The nurse is caring for a 59-year-old woman who had surgery 1 day ago to remove an ovarian cancer mass. The patient is awaiting the pathology report. She is tearful and says that she is scared to die. The most effective nursing intervention at this point is to use this opportunity to
a. motivate change in an unhealthy lifestyle.
b. teach her about the 7 warning signs of cancer.
c. discuss healthy stress relief and coping practices.
d. let her communicate about the meaning of this experience.
D. let her communicate about the meaning of this experience.
What is a thickened liquid diet?
are for persons who have trouble swallowing and are at risk for aspiration.
Common consistencies include nectar thick, honey thick and pudding thick. Thickening is done
with a commercial thickener. Follow the directions to crate the correct thickness. As a general
rule, you can thicken hot/warm beverages, but do not add ice to thickened liquids as it will
change the consistency when it melts. Remember things like milk in cereals, soups, fruit
cocktails etc. Be cautious with things like ice cream or jello as they become liquid when they
melt in the persons mouth. Although they are “thick”, they are not allowed for most persons
who require thickened liquid. Do not leave thickened liquids longer than 4 hours as they can
settle or become less thick with time.
What are the 6 eating tips to combat N/V?
(1) -avoid “strong” foods: hot/spicy, very sweet, strong smells (room temp or
refrigerated foods may be best)
(2) -avoid greasy/fried foods
(3) -eat and drink slowly
(4) -don’t drink beverages while eating
(5) -stay upright after eating
(6) -eat small meals throughout the day
What is radiation dermatitis and how to help?
Skin changes-(radiation dermatitis) common with radiation treatment: redness, irritation,
swollen, blistered
(1) Avoid tight or irritating clothes
(2) Sun protection
(3) Avoid tapes
(4) Avoid heat or cold-lukewarm water
(5) Medication: Ethyol (amifostine)-is a radioprotective medication that may
protect normal tissue from toxicity of radiation. SE include severe N/V, lushing
(feeling warm & tingly) etc.
What is the difference between a high fiber and low residual diet?
High fiber diet is often a part of a cardiac and diabetic diet as fiber helps regulate
blood sugar levels by slowing digestion. Fiber draws fluid into the GI tract making it helpful
with bowel regulation. Persons with diverticulosis should follow a high fiber diet to avoid feces
entering diverticula and causing infection.
Low residual diet is a low fiber diet to decrease stimulation of the intestines in disease processes where bowel rest is indicated. Low residual diets may be indicated in diverticulosis and inflammatory bowel disease, especially during flares. Foods like fruit without the skin like bananas and canned fruits, white rice and refined grains like simple pasta and low fiber cereals (cream of wheat), soft cooked vegetables with little or no peel like carrots, beets, egg plant etc.)
A patient on chemotherapy for 10 weeks started at a weight of 121 lb. She now weighs 118 lb and has no sense of taste. Which nursing intervention would be a priority?
a. Discuss with the provider the need for parenteral nutrition.
b. Teach the patient to eat foods that are fatty, fried, or high in calories.
c. Tell the patient to drink a nutritional supplement beverage three times a day.
d. Have the patient try various spices and seasonings to enhance the flavor of food.
D. Have the patient try various spices and seasonings to enhance the flavor of food.