Nutrition for nursing
Dr. Fahad Aldhafiri
Feeding Patients:
Oral Diets
and Enteral
and Parenteral Nutrition
ORAL DIETS
Normal, Regular, and House Diets:
• No foods are excluded, and portion sizes are not limited on a
normal diet.
• Sometimes, physicians order a diet as tolerated (DAT) on
admission or after surgery. This order is interpreted according
to the patient’s appetite and ability to eat and tolerate food.
The nurse has the authority to advance the diet as tolerated
Modified Consistency Diets:
• Modified consistency diets include clear liquid and
mechanically altered diets.
1. Clear liquid:
• Clear liquid diets may be used to maintain hydration during
gastrointestinal illness, such as nausea, vomiting, and
diarrhea; in preparation for bowel surgery or procedures; or
when oral intake resumes after a prolonged period.
2. Mechanically altered diets:
• contain foods that are pureed,
chopped/ground, or soft for patients
who have difficulty chewing or
swallowing
Therapeutic Diets
• Therapeutic diets differ from a regular diet in the amount of
one or more nutrients or food components for the purpose of
preventing or treating disease or illness.
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Examples:
Diabetic diet
Weight management diet
Low fat diet
Low salt diet
Nutritional Supplements
• Some patients are unable or unwilling to eat enough
food to meet their requirements, either because
intake is poor or because their nutritional needs are
so high that it is difficult to meet requirements in a
normal volume of food.
• For these patients, nutritional supplements with or
between meals can significantly boost protein and
calorie intakes.
ENTERAL NUTRITION
• Enteral Nutrition (EN): the delivery of nutrients by tube,
catheter, or stoma into the gastrointestinal tract beyond the
oral cavity; commonly known as tube feeding.
• Enteral nutrition (EN) is a way of providing nutrition
for patients who are unable to consume an adequate
oral intake but have at least a partially functional
gastrointestinal (GI) tract that is accessible and safe
to use.
Feeding Route:
Transnasal routes:
• include nasogastric (NG), nasoduodenal (ND), and
nasojejunal (NJ), of which NG is the most common.
• long-term feedings, a surgical incision or needle
puncture is used to create an ostomy route, either
into the stomach (gastrostomy) or jejunum
(jejunostomy).
Delivery Methods:
• Intermittent feedings are administered
throughout the day in equal portions of 250 to
400 mL of formula over 30 to 60 minutes
every 4 to 6 hours, usually by gravity flow or
an electronic pump.
• Bolus feedings are a variation of intermittent
feedings. The formula is poured into the barrel of a
large syringe attached to the feeding tube. A large
volume of formula (500 mL maximum; usual volume
is 250–400 mL) is delivered relatively quickly, usually
in 15 to 30 minutes.
• These rapid feedings are given four to six times per
day
• Continuous Drip Method are given at a
constant rate over a 12- to 24-hour
period to maximize tolerance and
nutrient absorption.
PARENTERAL NUTRITION
• Parenteral Nutrition (PN): the delivery of nutrients by vein;
parenteral literally means “outside the intestinal tract.”
• PN is a life-saving therapy in patients who have a
nonfunctional GI tract, such as in the case of obstruction,
intractable vomiting or diarrhea, short bowel syndrome, or
paralytic ileus. In practice, PN is used for other clinical
conditions, such as critical illness, acute pancreatitis, liver
transplantation, and AIDS, and in cancer patients receiving
bone marrow transplants