ACTIVITY 7.

1
INTRODUCTION TO DIET THERAPY (THE ROUTINE HOSPITAL DIETS) PART
1:
REGULAR OR FULL DIET, FULL LIQUID DIET, CLEAR LIQUID DIET AND
COLD LIQUID DIET
Introduction
Food is an important part of nutrition care. Attempts should be made to honor patient
preferences. Imagination and ingenuity in menu planning are essential when planning meals
acceptable to a varied patient population. Attention to color, texture, composition, and
temperature of the foods, coupled with a sound knowledge of therapeutic diets, is required for
menu planning. However to the patient, good taste and attractive presentation are the most
important elements. When possible, patient selection of menus results in the delivery of food
that will most likely be consumed. The ability to make food selections gives the patient an
option in an otherwise limiting environment.
All hospitals or health care institutions have basic, routine diets designed for
uniformity and convenience of service. These standard diets are based on the foundation of
an adequate diet pattern with nutrient levels as derived from the Recommended Nutrient
Intake. The diets should be as realistic as possible yet ensure that nutrition needs of patients
are met. The most important consideration of the type of diet offered is providing foods that
the patient is willing and able to eat and that fit in with any required dietary restrictions.
Shortened lengths of stay in many health care settings result in the need to optimize intake of
calories and protein and this often translates into a relatively liberal approach to therapeutic
diets. This is especially true when the therapeutic restrictions might compromise intake and
subsequent recovery from surgery stress, or illness.
Objectives
At the end of this activity, you can:
1. Familiarize different routine diet therapy.
2. Understand clear liquid, full liquid and cold liquid diet.
3. Identify foods allowed and foods to avoid for clear liquid, full liquid and cold
liquid diet.
4. Plan a diet for clear liquid, full liquid and cold liquid diet.
5. Discuss the indication for use.
6. Modify regular diet into clear liquid, full liquid and cold liquid diet.
Concepts/Explanation
REGULAR OR FULL DIET, FULL LIQUID DIET, CLEAR LIQUID DIET AND
COLD LIQUID DIET
The routine hospital diets, sometimes referred to as the “house” diet, constitute the
majority of the diet orders in a general hospital. These are: the regular diet, the soft diet and
liquid diets. Being the most frequently served, the routine hospital diets are the basis for
special or therapeutic diets. To ensure dietary adequacy of all hospital diets, the use of a food
plan and meal pattern is recommended.
REGULAR DIET OR FULL DIET
This is the most frequently ordered among the house diets. It is also called general,
house, full hospital diet. It is a normal diet planned to provide the recommended daily
allowances for the essential nutrients and to meet the caloric needs of a bedridden or an
ambulatory patient whose general condition does not require general modification or dietary
restrictions. The diet is designed to maintain and attain optimal nutritional status. All foods
are allowed but it is sound practice to serve simply prepared foods.
Characteristics of the Diet:
 To bring and maintain a person in a state of nutritive sufficiency.
 Used as a · basis for planning therapeutic diets and it should be practiced to serve·
simply prepared foods.
 Designed to maintain optimal nutritional status and follows the principles of good
meal planning and permits the use of all foods.
 May be used in educating the patient in the principles of nutrition by example and
basis in providing food the patient is willing and able to eat.
 The quantity of food selected from each food group should vary depending on the
energy needs and preferences of the patient.
 Serves as a basis for the modification of therapeutic diets in the hospital.

Indication for Use:

 For ambulatory or bed patients whose conditions do not necessitate a modified
for therapeutic purposes.
Feeding Administration/ Interval of Feeding:
 About 5 to 6 feeding a day which · includes Breakfast, Lunch, and Supper with 2
snacks (a.m/p.m.) or 1 evening snacks.
Food Allowed:
 All food are allowed but is sound practice to serve simply - prepared foods.
Foods Avoided:
 Those foods that are highly spicy, rich-fatty, and gas-forming foods.
Food Plan for 1800 Calories

FOOD GROUP AMOUNT

Vegetables At least 3 servings; 1 ½ cup cooked per serving; one should be
leafy green or yellow.

Fruits 3 servings; one should be vitamin C rich.

Milk (evaporated) ½ cup

(non-fat milk) 4 tablespoons

Rice or substitute 8 exchanges or 4 cups cooked rice

Meat, fish or substitute 4-5 exchanges; liver or glandular organs once a week; ½ cup
cooked dried beans maybe used in place of one meat and fish
exchange
Egg
2 times a week
Fat
5-6 teaspoon
Sugar or sweets
5-8 teaspoon
Suggested Meal Pattern and Sample Menu

BREAKFAST SAMPLE MENU

Fruit or Juice Fresh fruit in season
Egg or substitute Scrambled egg
Rice or Bread Rice or bread with butter/margarine or jam
Hot beverage Coffee, tea or chocolate
LUNCH
Soup Chicken sotanghon soup
Meat, fish, poultry, or Fried Bangus
substitute Sayote Guisado
Vegetable Rice
Rice or substitute Ripe Mango
Fruit or dessert
SUPPER
Same as lunch Beef nilaga
Rice
Leche flan
SNACKS
As desired, if necessary As desired
LIQUID DIETS
A liquid diet consists of foods that will pour or are liquid at body temperature. The
nutritive value of liquid diets is low and, consequently, such diets are used only for very
limited periods of time. Liquid diets may be clear-liquid or full-liquid. They are standard
hospital diets. The liquid diet is used for various reasons. One objective is to keep fecal
matter in the colon at a minimum. The clear-liquid diet may be used after surgery. The diet
can replace fluids lost from vomiting or diarrhea. The clear-liquid diet is composed mainly of
water and carbohydrates. It is only a temporary diet, since it is nutritionally inadequate. Its
use is typically limited to 24 to 36 hours.
 Full Liquid Diet
Aims:
To provide oral nourishment to the patient who cannot tolerate solid foods, prevent
dehydration and alteration in nutrition. It is often used after surgery or fasting, which require
least effort for digestion and absorption.
Characteristic:
Intermediate between clear liquid and soft diet. Consist of liquid or strained semi
liquid foods and foods that liquefy at room and body temperature, free from cellulose and
irritating spics and condiments. When carefully planned, the diet may be made adequate in
energy value and protein and can be used for several days. A termination diet from clear
liquid to soft and regular diet and nutritionally adequate diet by proper planning.
Indication for Use:
Post-operative cases with normal gastro-intestinal function, fevers and
infection, difficulty in swallowing as fractured jaw and after oral surgery, patients too
ill to eat solid or semi-solid foods, face lifting and lesions in the mouth and G.I.
disturbances.
Feeding Administration/Intervals of feeding:
The diet is given is 6 or more feeding and can be used for several days.
Given every 2 to 3 hours feeding interval but not more than 300 ml. per feeding.
Foods Allowed:
Those foods that are included in the clear liquid diet plus strained cream
soups, pureed strained meat and fish, vegetable pureed and juices, strained lugao and
oatmeal, strained fruit juices, plain ice cream, plain gelatin, custard or cornstarch
pudding, milk and milk drinks, cocoa, cream, melted butter or margarine.
 Foods Avoided:
All solid foods, breads and other cereals, cheese, all raw and cooked
vegetables, all frozen/fresh or canned foods or fruits.
FOOD EXAMPLE
Meats Pureed meat in soup, liver spread, potted meat, soft cooked egg

Milk Whole milk, evaporated milk, low-fat milk, milk drinks, milk shake,
malted milk, plain yogurt

Rice or substitute Pureed strained lugao, cooked cereal

Vegetables All juices, pureed vegetables such as chayote, carrots, green papaya

Fruits Citrus and other fruits juices

Soup Broth or strained cream soup, bouillon

Sugar or sweets Sugar, honey, syrup, plain and unflavored gelatin, pudding, soft
custards, plain ice cream, popsicles, sherbet

Fluids Coffee, tea, carbonated beverages, cereal beverage, fruit drink

Suggested Meal Pattern and Sample Menu

BREAKFAST SAMPLE MENU

Fruit juice Mango juice
Gelatin Jello
Milk or milk beverage Sherbet
LUNCH
Soup Cream of onion soup
Meat Liver spread
Rice Pureed strained lugao
Pureed fruit or juice Orange juice
Dessert Jello
Milk or milk beverage Milk shake
SUPPER
Soup Cream soup or Strained cereal with milk
Dessert Soft Custard
Milk or milk beverage Milk
SNACKS
Milk or milk beverage Shake
Fruit juice Fruits in season
Yogurt Plain yogurt
Nutritional supplement As recommended

 Clear Liquid Diet

Aims:
To provide an oral source of fluids and small amounts of calories and
electrolytes, relieve thirst, maintain water balance, and reduce caloric residue to a
minimum.
Characteristics:
It is used as a transition from NPO to a full or soft diet. Inadequate in nutritional
essentials. Foods included are liquid or become liquid at body temperature, leaves no
residue, non-distending, non-irritating and non-stimulating to peristaltic action. This diet is
also called non-residue diet which made of clear liquid foods which leaves no residue in
the G.I. tract.
Indication for Use:
Illness or surgery accompanied by marked intolerance to foods, acute inflammatory
conditions of the G.I. tract, in conditions when it is necessary to minimize fecal material,
pre-operative and post- operative cases, acute diarrhea, vomiting and intestinal
obstruction.
Feeding Administration/Intervals of feeding:
It should be used for 1to 2 days or 24 to 48 hours only. Given every 2 to 3 hours,
when it is necessary, not more than 300ml. per feeding.
Food Allowed:
Clear, fat -free broths, strained juices, tea, black coffee, salabat, plain gelatin,
plain sugar, hard candies, ginger ale, non-carbonated soft drinks, honey, corn syrup, egg
white.
Foods Avoided:
All solid foods, milk & milk products, fruit shakes, soup cooked with fat and
creams, fruit juices with residue.
FOOD EXAMPLES
Fruits Strained fruits juices

Soup Fat-free clear broth and bouillon

Sugar or sweets Flavored and unflavored gelatin, popsicles, fruit ices (made without
milk), sugar, honey, syrup, hard candy

Fluids Coffee, tea, carbonated beverages, fruit beverage drinks

Suggested Meal Pattern and Sample Menu

SAMPLE MENU
BREAKFAST Fruit juice and/or broth
Gelatin
Tea or coffee
LUNCH Fruit juice
Broth
Gelatin
Tea or coffee
SUPPER Same as lunch
BETWEEN-MEAL- Fruit juice
NOURICHMENTS Popsicle
Gelatin
 Clear liquid nutritional support

 Cold Liquid Diet

Aims:
To rest the organ included and avoid irritation at the side of the resection. Also, to
minimize pain in oral cavity and avoid bleeding of operated area. To promote rapid
wound healing and replaces nutrient losses. It also provides on oral source of fluids for
individual who are capable of chewing, swallowing, or digesting solid foods.
Characteristics:
Cold liquid diet is sometimes referred to as T and A diet after tonsillectomy and
adenectomy. Cold fluids given to prevent bleeding of the operated area which consist of
food or iced smooth liquids. All liquids are served cold or iced or foods that have been
allowed to cool may also be given.
Indication for Use:
Tonsillectomy, dental extraction, other minor operation on the mouth or throat
and adenoid surgery.
Feeding Administration/Intervals of Feeding:
 Cold liquid diet is given on the first day after surgery.

 Day 1 – i c e chips or sips of cold water are given progressing with cold milk and
non-irritating fruit juices.
 Day 2 - Cold liquids, gels, and ice are added for example like ginger ale, gelatin,
bland strained fruit juice, plain ice cream and weak iced tea or coffee. For some other
patients who can tolerate plain pudding, custard and 3-minute egg is given before the
3rd day.
 Day 3 & 4 - strained warm cream soups, fruit and vegetable puree, soft - cooked
eggs, strained warm cereals, milk, cheese, butter, lugao or gruel and mashed
potatoes are added to the cold liquid diet.
 Day 5 - soft to liquid diet is prescribed.

Foods Allowed:
Plain ice cream, add milk, iced tea, iced coffee, soft drinks, cooked soft and bland
foods which have been cooled are allowed.
Foods Avoided:
Acidic or sour fruit juices and hot soups or foods are avoided.
 WORKSHEET VII_A
Introduction to Diet Therapy (The Routine Hospital Diets) Part 1:
Regular or Full Diet, Full Liquid Diet, Clear Liquid Diet and Cold Liquid Diet

Name: ________________________________________
Course, Year and Section: _______________________
Class Schedule: ________________________________
Date of Submission: ____________________________

Work Exercise No. 1. Consider the images on the next page. These images are examples of
routine hospital diets. Can you identify which tray should be served as regular diet, clear
liquid diet and full liquid diet? Enumerate some of the characteristics of each picture

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Work Exercise No. 2. Plan a regular diet and modify it to full liquid diet, clear liquid diet
and cold liquid diet.
REGULAR DIET FULL LIQUID CLEAR LIQUID COLD LIQUID
DIET DIET DIET
Breakfast:

AM Snack:

Lunch:

PM Snack:

Supper:

Work Exercise No. 3. How did you modify the regular diet into full liquid diet, clear liquid
diet and cold liquid diet?
REGULAR DIET TO FULL LIQUID DIET
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REGULAR DIET TO CLEAR LIQUID DIET
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REGULAR DIET TO COLD LIQUID DIET
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Work Exercise No. 4. What are the limitations of full liquid diet, clear liquid diet and cold
liquid diet?
FULL LIQUID DIET
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CLEAR LIQUID DIET

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COLD LIQUID DIET
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Work Exercise No. 5. What foods can you add to make full liquid diet, clear liquid diet and
cold liquid diet high in protein content?
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Work Exercise No. 6. What foods can you add to make full liquid diet, clear liquid diet and
cold liquid diet high in calories?
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CONCLUSION:
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RECCOMENDATIONS:
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LABORATORY CHECKLIST:
Checklist of task to be accomplished during laboratory activity. (√)
1. Enumerate characteristics of different therapeutic diets.
2. Plan a regular diet and modify it to full liquid diet, clear liquid
diet and cold liquid diet.
3. List limitations of different therapeutic diets
4. Enumerate foods that are appropriate for the different therapeutic
diets
 ACTIVITY 7.2
INTRODUCTION TO DIET THERAPY (THE ROUTINE HOSPITAL DIETS) PART
2:
SOFT DIET AND TUBE FEEDING
Introduction
During illness, many patients can meet energy and nutrient needs by following a
standard diet. Other patients may require a modified diet, which is altered by changing food
consistency or nutrient content or by including or eliminating specific foods. Diets with
altered texture and consistency are often prescribed for individuals with chewing and
swallowing difficulties. Diets with modified nutrient or food content are frequently used to
relieve disease symptoms or reduce the risk of developing complications. Some patients may
have several medical problems and need a number of dietary changes. Keep in mind that
modified diets should be adjusted to satisfy individual preferences and tolerances and may
also need to be altered as a patient’s condition changes.
Objectives
At the end of this activity, you can:
1. Familiarize different routine diet therapy.
2. Understand soft diet and tube feeding.
3. Identify foods allowed and foods to avoid for soft diet and tube feeding.
4. Plan a diet for soft diet and tube feeding.
5. Discuss the indication for use.
6. Modify regular diet into soft diet and tube.

Concepts/Explanation
SOFT DIET AND TUBE FEEDING
Mechanically altered diets are helpful for individuals who have difficulty chewing or
swallowing. Chewing difficulties usually result from dental problems. Impaired swallowing,
or dysphagia, may result from neurological disorders, surgical procedures involving the head
and neck, and various physiological or anatomical abnormalities that restrict the movement of
food within the throat or esophagus. Dysphagia diets are highly individualized because
swallowing problems can vary greatly. Furthermore, patients must be monitored regularly
because swallowing ability can fluctuate over time.
 Soft Diet

Aims:
To provide dietary and nutritional needs to the patient who is psychologically and
physically unable to tolerate regular diet.
To supplement foods that is modified in consistency and easily digestible to
facilitate mechanical case in eating. And therefore reduce the work load of the digestive
system.
Characteristics:
This diet follows the regular pattern but · is designed for patients who are
psychologically or physically unable to tolerate the regular diet. This diet serves as a
transition from full liquid to the regular or full diet. It is a nutritionally adequate diet,
modified in consistency and texture. These foods that are easily digestible with low
cellulose content and with little or no tough connective tissues like elastin and are generally
bland in flavor. The foods were prepared through cooking, washing, cutting, and
removal of skin and seeds from fruits and vegetables, gristle and elastin from meat can
improved the digestibility of these foods.
Indication for Use:
Post - operative cases - when patientcan tolerate solid food but not a full diet,
fevers and infections, G.I. · disturbances, convalescence and patient who are unable to
chew, swallow or digest foods included in the full diet.
Feeding Administration/ Intervals of feeding:
5 · feeding a day which i n c l u d e s breakfast, lunch, and supper, 2 snacks
(a.m./p.m.) and 1 evening snacks.
Food Allowed:
The food selection guide includes low in cellulose content, low in fiber, .free
from tough connective tissue and strong flavors, simple and easily digested foods.
·Foods Avoided:
Those foods that were not included on the foods allowed lists were avoided.
FOOD EXAMPLES
Vegetable Cooked mild-flavored vegetables, asparagus tips, young tender beans, carrots,
mushroom, squash, tomato juice, chayote, green papaya, peas, spinach

Fruit Citrus fruits without membranes and all fruit juices; cooked or canned low fiber
fruits such as banana

Milk Whole milk, evaporated milk, low-fat milk, milk drinks, milk shake, malted milk,
plain yogurt

Rice/Substitutes Rice gruel, bakery products made from white, refined wheat, refined cereals

Meat/Substitutes Any tender meat, fish or fowl, all without tough connective tissues, eggs; cottage
cheese, mildly flavored cheese; yogurt, cheesy-style peanut butter

Soup/Fluids Broth, cream soup, strained vegetable soup; coffee, tea, carbonated beverages, cereal
beverages

Sugar or sweets Sugar, honey, syrup, plain and unflavored gelatin, soft custards, pudding, plain ice
cream, popsicles, sherbet, chocolate, cakes and cookies without nuts

Oils/Fat Fortified margarine or butter, mayonnaise, gravy, cream vegetable oil

Miscellaneous Salt, pepper, vinegar, soy sauce, catsup, mild spices, chopped or ground leaf herbs
Food Plan for 1800 Calories

FOOD GROUP AMOUNT

Vegetable At last 3 servings; 1 ½ cup cooked per serving; one should be leafy
green or yellow

Fruits 3 servings; one should be vitamin C rich

Milk (evaporated) ½ cup

(non-fat milk) 4 tablespoons

Rice/Substitutes 8 exchanges or 4 cups cooked rice

Meat, fish or Substitutes 4-5 exchanges; liver/glandular organs once/week, ½ cup cooked
Egg dried beans maybe used in place of one meat and fish exchange
2 times a week

Oils/Fat 5-6 teaspoons

Sugar or sweets 6-8 teaspoons

Suggested Meal Pattern and Sample Menu

BREAKFAST SAMPLE MENU

Fruit or Juice Fresh fruit in season
Egg or substitute Scrambled egg
Rice or Bread with Rice or bread with butter/margarine or jam
butter/margarine or jam
Hot beverage Coffee, tea or chocolate
LUNCH
Soup Chicken sotanghon soup
Meat, fish, poultry, or substitute Baked fish
Vegetable Sayote Guisado
Rice or substitute Rice
Fruit or dessert Ripe Mango
SUPPER
Same as lunch Beef nilaga
Rice
Leche flan
SNACKS
As desired, if necessary As desired

 Tube Feeding
A form of enteral nutrition support designed to provide adequate nutrition in a form that
can be administered through a tube, used for persons that are unable to tolerate an oral
diet or who have inadequate oral intake and have functioning gastrointestinal tract.
Aims:
To provide a source of complete nutrition in a form that will easily pass through a
tube in patients in whom oral feeding methods are contraindicated or not tolerated or
whose condition warrant supplementation in the form of natural foods.
Characteristics:
Composed of foods included in the soft and liquid diet, blended, and liquefied to
enable the mixture to pass thru a polyvinyl tube.
May be administered through a gastrostomy or jejunostomy. A satisfactory tube feeding
formula must be nutritionally adequate except for prescribe modifications for specifies
nutrients. It must be inexpensive, easier, prepared, and stored
Types of Tube Feeding:
Homogenized or blenderized mixture of foods selected from a normal diet.
Indication for Use:
When patient is unable to chew or swallow due to deformity or inflammation of
mouth or throat, corrosive poisoning, coma, unconsciousness, paralysis of throat, muscles,
surgery of the head and neck, esophageal obstruction, surgery of the GIT, in severe burns,
mental disturbances, anorexia nervosa, mandibular fractures, strokes, or trauma to the oral
pharyngeal cavity.
Feeding Administration/I ntervals of Feeding:
Tube feeding may be given as continuous drip or at intervals throughout the day.
The regimen should be adjusted to the patient's condition, nutriture, and dietary
prescription by the doctor. To initiate tube feeding used dilute mixture at first, about half the
required concentration. Try 50 ml of the mixture at hourly interval then gradually
increase the concentration and volume until patient can tolerate 300 ml at 2-3 hourly
intervals. Do not exceed 300 ml per feeding.
For continuous drip method, the flow of the tube feeding should be very slow at
first then increases gradually but kept at constant, steady rate. Total volume should not
exceed 100 ml/hr. with a dilution of 1kcal/ml.
Additional water should be given as needed to make fluids requirement as patient's
condition improve, whenever possible food should be given orally.
Again, small amount of liquid food is introduced, gradually, increasing the volume
and consistency until part of the days feeding is by normal route.

Food Allowed:
Well-cooked meat, ripe fruit, cooked vegetable whole or non-fat dry milk, cooked
eggs, sugar, oil, homogenized milk, and low fibrous fruit.
Foods Avoided:
Plain pasteurized milk, course fibrous food that tend to clog the blender.
 TUBE FEEDING STANDARD FORMULA
Diet prescription: 1,800 kcal CHO g: 270 CHON g: 67.5 Fat g: 50

Food group No. of exchange Household measure

Vegetable 2 ex. 1c cooked
Fruit 3ex.
Milk 1 ex. 4 tbsp.
Sugar
Rice and Rice Equivalent 9 ½ ex. 7 ½ C lugao + 8 slice bread
MEAT
Low fat 4 ex. 120 g. cooked
Medium fat 1 ex. 1 pc. Egg
Fat 6 ½ tsp. 6 ½ tsp.
TUBE FEEDING STANDARD FORMULA (60-15-25%)

Rice and
Energy
CHOg CHONg Fats g Veg Fruit Milk Rice Meat Fat
kcal
Equivalent
500 75 18 13 2 ex 3 ex ½ ex. 2 1 ex L.F. 1 ex
600 90 23 17 2 ex 3 ex 1 ex 2 ex 1 ex L.F. 1 ex
1 ½ ex
700 105 26 19 2 ex 3 ex 1 ex 2 ½ ex 2 ex
L.F.
800 120 30 22 2 ex 3 ex 1 ex 3 ex 2 ex L.F. 2 ½ ex
900 135 34 25 2 ex 3 ex 1 ex 4 ex 2 ex L.F. 2 ½ ex
2 ½ ex
1000 150 38 28 2 ex 3 ex 1 ex 4 ½ ex 3 ex
L.F.
1,1000 165 41 31 2 ex 3 ex 1 ex 5 ex 3 ex L.F. 3 ½ ex
1,200 180 45 33 2 ex 3 ex 1 ex 6 ex 3 ex L.F. 4 ex
1,300 195 49 36 2 ex 3 ex 1 ex 6 ½ ex 3 ex L.F. 5 ex
1,400 210 52.5 39 2 ex 3 ex 1 ex 7 ex 4 ex L.F. 5 ex
1,500 225 56 42 2 ex 3 ex 1 ex 7 ½ ex 4 ex L.F. 6 ex
1,600 240 60 44 2 ex 3 ex 1 ex 8 ½ ex 4 ex L.F. 6 ex
4 ½ ex
1,700 255 64 47 2 ex 3 ex 1 ex 9 ex 6 ½ ex
L.F.
1 ex M.F.
1,800 270 67.5 50 2 ex 3 ex 1 ex 9 ½ ex 6 ½ ex
4 ex L.F.
2 ex M.F.
1,900 285 71 53 2 ex 3 ex 1 ex 10 ex 6 ½ ex
3 ex L.F.
1 M.F.
2000 300 75 56 2 ex 3 ex 1 ex 11ex 4 1/2 ex 7 ex
L.F.
1½ 1 M.F.
2,100 315 79 58 4 ex 3 ex 11 ex 7 ½ ex
ex 4L.F.
1½ 2 M.F.
2,200 330 82.5 61 4 ex 4 ex 11 ex 7 ½ ex
ex 4 L.F.
2 M.F.
2,300 345 86 64 4 ex 4 ex 2 ex 11 ex 7 ex
4 L.F.
2 M.F.
2,400 360 90 66 4 ex 4 ex 2ex 12 ex 7 ex
4 L.F.
2 M.F.
2,500 375 94 68 4 ex 4 ex 2ex 12 ½ ex 7 ½ ex
5 L.F.
 TUBE FEEDING INSERTION METHOD AND FEEDING SITES

INSERTION
METHOD & ADVANTAGES DISADSVANTAGES
FEEDING SITE
Easy to remove by disoriented clients; long-
Does not require surgery or
Trans–nasal term use may irritate the nasal passages,
incisions for placement.
throat, and esophagus.
Easiest to insert and confirm
placement; feedings can often be Highest risk of aspiration in compromised
Nasogastric
given intermittently and without clients.
an infusion pump.
Allow lower esophageal
May require general anesthesia for insertion;
sphincter to remain closed,
require incisions; greater risk of complications
reducing the risk of aspiration;
Tube Enterostomies from the insertion procedure; greater risk of
more comfortable than transnasal
infection; may cause skin irritation around the
insertion for long-term use; site
insertion site.
is not visible under clothing.
Feedings can often be given
intermittently and without a Moderate risk of aspiration in high-risk
Gastrostomy
pump; easier to insert than a clients.
jejunostomy.
Lowest risk of aspiration; allows
for enteral nutrition earlier
following severe stress; may Most difficult to insert; feedings require an
Jejunostomy allow for enteral feeding when infusion pump for administration; may take
partial obstructions, fistulas, or longer to reach nutrition goals.
medical conditions prevent
gastric feeding.
TUBE FEEDING ROUTES
 BLENDERIZED TUBE FEEDING COMPUTATION
Steps in the formulation of a food plan for a blenderized formula are as follows:
1. Convert the dietary prescription into grams CHO, PRO, Fat.
Ex. 1,800 Kcal C-60% P-15% F25%
or C-270g P-70g F- 50g
2.Distribute into food item:
Food items # Ex C P F Kcal
Veg. B 2 6 2 - 32
Friuts 3 30 - - 120
Milk WM 1 12 8 10 170
Rice 9 209 18 - 900
Meat: MF 1 - 8 6 86
LF 4 - 32 4 164
Fat 6 - - 30 270
Sugar 3 15 - - 60

Total 270 68 50 1802

3. Compute for the total fluid volume using the formula

Cal Dx = Volume
Cal Density
Volume= 1800 cal_= 1800ml
1cal/ml
4. Convert the ml into cups
Ex. Dx 1800 kcal with calorie density = 1kcal/ml

Volume= 1800 cal = 1800 ml or 7.5 cups

1 cal/ml
5. Translate into household measure. Compute fluid content.

Food Group Food Exchanges Household Meas. Fluid (ml)

Veg. B Boiled squash 2 1 cup -
Sugar Sugar 3 3 tsp. -
Egg Soft-cooked 1 1 pc. 50
Meat Boiled chicken 4 8 tbsp. -
Breast
Oil Corn oil 6 6 tsp. 30
Fruit Banana 3 3 pcs. -
Milk Evap milk 1 ½ cup 120

Total Fluid 200

Total Fluid Rx- Sub total = 1800ml—200ml= 1600 ml

Cups of thick lugao = 1600 ml/240ml/cup = 6.7 cups
Rice lugao = 6 cupsx240 ml = 1440; 6 cups thick lugao = 4 exchanges rice
Slice bread = 5 exchanges = 10 slices
Sub-total fluid = 200ml + 1440ml = 1640ml
Water to be added = Rx Fluid – sub-total fluid
= 1800 – 1640 = 160 ml.
 WORKSHEET VII_B
Introduction to Diet Therapy (The Routine Hospital Diets) Part 2:
Soft Diet and Tube Feeding

Name: ________________________________________
Course, Year and Section: _______________________
Class Schedule: ________________________________
Date of Submission: ____________________________

Work Exercise No. 1. Consider the images. These images are examples of routine hospital
diets. Can you identify which diet should be given to a patient with sore and lesions in the
mouth; and a patient with neurological disease? What do you think is the difference between
the two diet why one diet is preferable than the other?

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Work Exercise No. 2. Plan a regular diet and modify it to soft diet.

REGULAR DIET SOFT DIET

Breakfast:

AM Snack:

Lunch:

PM Snack:

Supper:

Work Exercise No. 3. How did you modify the regular diet into soft diet?
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Work Exercise No. 4. What are the limitations of soft diet?
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Work Exercise No. 5. Plan a 2000 kcal blenderized tube feeding.

 Convert the dietary prescription into grams CHO, PRO, Fat.

CHO =
PRO =
Fat =
 Distribute into food item:

Food items # Ex C P F Kcal

Veg. B
Friuts
Milk WM
Rice
Meat: MF
LF
Fat
Sugar

Total
 Compute for the total fluid volume using the formula

Volume (ml) =

 Convert the ml into cups

 Volume (cups) =
 Translate into household measure. Compute fluid content.

Food Group Food Exchanges Household Meas. Fluid (ml)

Veg. B
Sugar
Egg
Meat

Oil
Fruit
Milk

Total Fluid

 Compute for the following:

 Fluid volume and No. of Exchanges for lugao

 No. of Exchanges for Slice bread (if needed)
 Sub-total fluid
 Water to be added

Checklist of task to be accomplished during laboratory activity. (√)

1. Differentiate soft diet and tube feeding diet.
2. Modify regular diet to soft diet.
3. Compute and plan tube feeding diet.
CONCLUSION:
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RECCOMENDATIONS:
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LABORATORY CHECKLIST: