10 CHAPTER 5 QUESTION
1. An employee on the trayline notices that a client has a minced and moist diet, but the tray contains a lettuce salad with crackers. What should be replaced for the lettuce salad with crackers and why?
ANSWER
Replace the lettuce salad with any cooked vegetable, finely mashed with excess liquid drained. Replace the crackers with mashed potatoes or rice WITH GRAVY to hold the grains together (not break allowed). Minced & Moist food may be used if the client is not able to bite off pieces of food safely but have some basic chewing ability. Minced & Moist foods only need a small amount of chewing and for the tongue to ‘collect’ the food into a ball and bring it to the back of the mouth for swallowing. It’s important that Minced & Moist foods are not too sticky because this can cause the food to stick to the cheeks, teeth, roof of the mouth or in the throat. These foods are eaten using a spoon or fork.
2. A client with colon cancer is placed on a clear liquid diet because they keep getting small bowel obstructions. The oncologist feels the clear liquid diet is the best way to prevent any more obstructions. However, the client has lost weight and is weak. The client has been on a clear liquid diet for the 7 days, and they are complaining of weakness and hunger. What should the dietary manager do?
3. The CDM, CFPP sees a family member bring in a fruit smoothie from the cafeteria to give her father. He is on a full liquid diet. What should the family member be told?
4. What foods high in phosphorus should be limited on a renal diet?
5. client’s family member suggests the client restrict what he is eating so he can lose some weight. However, the client was recently discovered to have a pressure injury. How should the situation be addressed?
Notify the RDN. The Clear Liquid Diet is not recommended for more than three days, and especially in a client with a high-energy-demand condition such as cancer.
SUPPLEMENTAL MATERIAL
A full liquid diet consists of foods that are either liquid or become liquid at room temperature. Although a smoothie seems like a liquid, the fibrous content of the fruit used would not be allowed on a full liquid diet.
Milk, dairy products, meat, poultry, fish, eggs, legumes, nuts, cereals.
First, verify with nursing that the family is aware that the client has a pressure injury. If the family is aware, then discuss with the client and family the importance of proper nutrition in order to heal a pressure ulcer, and how energy restriction could delay healing. The client may benefit from a referral to the registered dietitian nutritionist to help optimize healing the pressure ulcer.
Nutrition Fundamentals and Medical Nutrition Therapy
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