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Skills 1 & 2

Beginning Tasks
9 WAKI APE LU

* Wash hands
*Assemble equipment
* Knock and pause before entering
*Introduce self and verify resident as appropriate
*Ask visitors to leave
* Provide privacy for the resident
*Explain the procedure and answer questions
* Let the resident assist as much as possible and honor preferences
*Use standard precautions when in contact with blood, body fluids, mucous membranes or non-intact skin is likely

Completion Tasks
12 PRWR PCOC WLRD

*Position resident comfortably
*Remove or discard gloves/protective equipment
* Wash hands
*Return the bed to lowest position
* Place signal cords, phone & water within reach of resident
* Conduct general safety check/resident and environment
* Open curtains
* Care for equipment as necessary
* Wash your hands
* Let visitors reenter, as appropriate
* Report completion of task, as appropriate
* Document action and observations

Basic Facility Diets

* Prepare the patient for the meal
* Check the tray card for the patient's name
* Check the tray card against the patient's arm band
* Check the items on the tray to make sure they are allowed on the patient's diet
* Serve the tray to the patient
* Assist with feeding as necessary

Four Common Diets

* Regular or house-sometimes called a general diet
* Full Liquid
* Clear Liquid
* Soft

Progression of Diets Following Surgery

1. Ice chips/sip of water
2 Clear Liquids
3 Full Liquids
4 Soft Diet
5 Regular Diet

Regular Diet

* Anything-Great variety of foods. Excludes: pastries, heavy cakes, fried foods and highly seasoned foods (which might be difficult for inactive people to digest)
* Lower Caloric Count (lesser active needs less calories)

Liquid Diets (2)

*Clear Liquid Diet
*Full Liquid Diet

Clear Liquid Diet

*Is considered a temporary diet because it is an inadequate diet. It is made up primarily of water and carbs for energy.
*Feedings given every 2, 3 to 4 hours as prescribed by the Doctor
*Only liquids you can see through

Clear Liquid Diet Items

*Tea
*Coffee with sugar without cream
*Strained fruit or vegetable juice with gellatin (occasionally)
*Fat-free meat broths
*Ginger ale (usually), 7UP, Coke, strained grape juice or apple juice
*Gelatin
*Popsicles

Full Liquid Diet

*Does supply nourishment and may be used for longer periods of time than the clear liquid diet, but is also considered a temporary diet
*6 to 8 ounces are given every two to three hours
*Given to some patients with acute infections
*Given to patients with conditions involving the digestive tract

Full Liquid Diet Items

*Includes all items allowed on the clear liquid diet in addition to the following
*Strained cereal, such as cream of wheat or rice, blenderized soup, or potatoes pureed in soup
*Strained soups, milk-based soups
*Sherbet
*Gelatin
*Eggnog
*Malted milk
*Milk and cream
*Plain ice cream
*Strained vegetables and fruit juices
*Junket
*Solids that liquefy at room temperature
*Yogurt

Soft Diet

*Usually follows the full liquid diet
*Although the diet nourishes the body, between-meal feedings are sometimes given to increase the calorie count

Foods allowed on the soft diet are

*Low-residue, which are almost completely used by the body
*Mildly flavored, slightly seasoned or unseasoned
*Prepared in a form that is easy to digest
*Liquids and semisolid foods that have a soft texture

Soft Diet is given to patients who...

*Soups
*Cream cheese and cottage cheese
*Crackers, toast
*Fish
*White meat of chicken or turkey (boiled or stewed)
*Fruit juices
*Cooked fruit (sieved)
*Tea, coffee
*Milk, cream, butter
*Cooked cereals
*Eggs (not fried)
Beef & lamb (scraped or finely ground)
*Cooked vegetables (mashed or sieved)
Angel food or sponge cake
*Small amounts of sugar
*Gelatin, custard
*Pudding
*Plain ice cream

Foods to avoid on a soft diet...

*Coarse cereals
*Spices
*Gas-forming foods (onions, cabbage, beans)
*Rich pastries and desserts
*Foods high in roughage/fiber
*Fried foods
*Raw fruit & vegetables
*Corn
*Pork (except bacon)

Orthodox Jewish faith foll

*There are strict prohibitions against shellfish and non-kosher meats such as pork
*Certain fishes, such as tuna and salmon, are permitted
*Foods may not be prepared with utensils that have been used for non kosher food preparation
*There are strict rules regarding the sequence in which milk products and meat may be consumed

Therapeutic Diets

*Standard diets can be changed to conform to special dietary requirements.
*For example, an order might be written for a low-sodium, mechanical soft diet when a patient has ill-fitting dentures and heart disease
*Planned and prepared according to a patient's individual health problems
*Commonly prescribed therapeutic diets include the diabetic diet, sodium-restricted diet and low-fat diet

Diabetic Diet

*Nutritionally adequate
*Provides enough energy in the form of calories for a 24-hour period
*Important to evaluate and report the patient's intake.
*Foods and liquids have a major impact on diabetes management
*The diet is balanced by insulin or hypoglycemic drugs

The Exchange List

*Is based on standard household measurements to make it easier to measure
*Excludes sugar and high-sugar content foods, to prevent rapid swings in blood sugar
*Divides foods into six groups
*Allows equivalent exchanges to be made within a group but not from group to group

Exchange list groups (six)

* Milk exchanges
* Vegetable exchange: Group A, Group B
* Fruit exchange
* Bread exchange
* Meat exchange
* Fat exchange

Sodium Restricted Diet

* May be ordered for patients with chronic renal failure and cardiovascular disease
*Sodium-restricted diets are some of the most difficult diets to follow

Foods that you MAY have to avoid on a sodium-restricted diets

* Meat
* Fish
* Poultry
* Milk and milk products
* Eggs

Foods to avoid on a sodium restricted diets

*Pork, ham, bacon
*Breads
* Potato chips, pretzels and similar snacks
* Saltine crackers
* Pop containing sodium
* Pickles
* Processed meats
* Canned foods, such as vegetables and soups

Foods that are naturally low in sodium

* Some cereals, such as shredded wheat
* Vegetables
* Fruits

As long as activity remains constant, a person must take in approximately

500 calories a day less than usual (3,500 calories deficit) to lose one pound

Calorie-restricted diets are prescribed for...

patients who are overweight

When prescribing a calorie-restricted diet they take in consideration, the patient's:

*energy output
*general nutritional state
*weight goal

In planning a low-calorie diet, the dietitian tries to...

*Create a realistic balance between fats, proteins and carbs.

A low-calorie diet encourages the patient to

develop better, more consistent eating habits.

On a low-calorie diet may be balanced as follows:

20% Proteins
25-35% Fats
45-65^ Carbs

Low-Fat/Low-Cholesterol Diet are prescribed for...

patients who suffer from vascular, heart, liver or gallbladder disease and for those who have difficulty with fat metabolism

In a Low-Fat/Low-Cholesterol Diet are limited in...

fats and calories are balanced by increasing proteins and carbws

Low-Fat/Low-Cholesterol Diet Foods are...

baked, roasted or boiled and the skin is removed from chicken

Low-fat foods include:

*Low-fat cottage cheese (no other allowed)
*Skim milk, buttermilk, yogurt
*Lean meats, fish, chicken
*Vegetables and fruits
*Jams, jellies and ices
*Cereals, pasta, bread, potatoes, rice
*Carbonated beverages, tea, coffee

Mechanically Altered Diets

This means that the consistency and texture are modified, making the food easier to chew and swallow

Mechanical Soft Diet is commonly served to...

patients who have no teeth, or those with serious dental problems

Mechanical Soft Diet Meats and hard foods....

*Are ground to the consistency of hamburger.
*Soft items, such as bread, are not ground

Pureed diet is blended...

with gravy or liquid until it is the consistency of pudding

The pureed diet is for patients who...

have difficulty swallowing

Pureed foods should not be

watery

Pureed Diet-Properly prepared food items will support

a plastic spoon in the upright position

Supplements and Nourishments

...

Patients who have wounds may receive supplements high in

protein to facilitate healing

Nutritional supplements are usually given to patients who

have experienced weight loss and those who need additional calories to meet a medical need

Other special supplements are used to treat patients with specific medical needs, such as:

those with renal failure, diabetes, chronic obstructive pulmonary disease, HIV and pediatric patients

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