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Nursing Pharmacology
The seven rights of medication
administration
RIGHT DRUG
RIGHT CLIENT
RIGHT DOSE
RIGHT TIME
RIGHT ROUTE
RIGHT REASON
RIGHT DOCUMENTATION
General Principles in Drug Administration
Whoever prepares the medication, administers
and charts it
Consult a drug reference manual or pharmacist
for information on unfamiliar drugs
For elderly clients: use devices like calendars,
daily pill dispensers
For pediatric clients, use syringe
Obtain assistance of parents to hold child in
position
Assess client’s allergy
Check drug’s expiry date
Read labels three times before administration
Wash hands before and after administration
Do not let the tip of the tube/dropper touch the
client
Document administration on medication record
and client’s response to medication.
For eye medication:
Position: supine or sitting position with
forehead tilted back slightly
Medication is administered into the conjunctival
sac
For ointments, apply from inner to outer
canthus ending it with a twisting motion
Let the client close his eyes
For liquid medications, press firmly
nasolacrimal duct for at least 30 seconds
If medication temporarily affects vision, instruct
client not to move until vision is clearer
Lift side rails and place call light within reach
For ear (otic) instillation:
Wash ear if excess wax in noted
Position: Side-lying, sitting, or semi-Fowler’s
position
For adults: pull auricle of ear up and back
For children: down and back (<3 years)
Instruct client to remain in position for 3-5
minutes
For nasal instillation
Cleanse nares
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Position: Sitting with head tilted slightly
backwards, or supine with head tilted back in
hyperextended position
Hold dropper ¼ to ½ inch above nares
Instruct client to take one short deep breath
after each instillation and to remain position for
3-5 minutes.
For oral medication:
Do not crush or chew enteric coated tablets.
Many oral medications require administration
with milk or food
Schedule first doses of new medications on
different hours from other medications
For Pediatric Patients
If drugs are being mixed with food or liquid, use
only small amount
Medicine can also be given through nipples or
droppers
Toddlers: allow to choose on method of
delivery- spoon, dropper, syringe, and allow to
help
Position: Semi-Fowler’s or sitting
Instruct client to place tablets/ capsules at the
back of the throat and to follow with enough
liquid
Administer liquid medications after pills
Remain with the client until all the medications
are taken. Check the client’s mouth
Check client 30-60 minutes later for effects of
medication.
For buccal and sublingual medication
Place under the tongue (sublinggual) and
between cheek and gum (buccal)
If client’s mucous membranes are dry, offer a
sip of water
DRUGS
1.Local anesthetics:
-blocks nerve conduction
-metabolized by hepatic enzymes
-produces temporary loss of sensation
and motion in a limited area of the body.
E.g: Procaine (novocain),Benzocaine
(americaine),mepivacaine (carbocaine)
Nursing implications:
a. force fluids
b. keep side rail-up
LIDOCAINE TOXICITY
SLURRED SPEECH
ALTERED CNS
MUSCLE TWITCHING
SEIZURES
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2. Non narcotic analgesics and antipyretics Tablet can be crushed and mixed with
Aspirin food/fluids
-analgesia Teratogenic
-antipyretic 5. Anticonvulsants
-anti-inflammatory Barbiturates (phenobarbital)
-anti-platelet -for gen. and absence seizures
Acetaminophen/Tylenol Benzodiazepines (valium)
-Analgesic,antipyretic -drug of choice for status epilepticus
-Antidote: acetylcysteine (mucomyst) Hydantoins (dilantin)
-monitor liver/kidney function and CBC. -prevents dissemination of electrical
SALICYLATE POISONING discharges in motor cortex area of the brain
TINNITUS LETHARGY/EXCITABILITY, Succinimides (zarontin)/valporic acid
HYPERVENTILATION HYPERTHERMIA (delpakene)
METABOLIC ACIDOSIS -absence seizures
NONNARCOTIC ANALGESICS AND Acetazolamine (diamox)/ Tegretol
ANTIPYRETICS -diuretics,absence,tonic-clonic or myoclonic
Nursing Implications seizures.
Monitor CBC, PT, kidney and liver function Nursing Implications
studies -7-10 days therapeutic level
Additive effects if with use with anticoagulants -turn urine pink, red or red-brown.
Drink plenty of fluids -not given IM
Take with food or fluids. -gingival hyperplasia
Never given with children/adolescents with flu/ -caution use in pregnancy
chicken pox ENDOCRINE DRUGS
Don’t crush enteric-coated tablets. 1. ANTIDIABETIC AGENTS
Avoid intake of alcohol Insulin
stop therapy one week before surgery Adverse Effects:
3. Narcotic analgesics Allergy
Codeine Hypoglycemia
hydromorphone (dilaudid), meperidine Lipodystrophy
(demerol), methadone, Nursing Implications:
oxycodone HCL Do not inject cold insulin.
-induces sedation, analgesia and euphoria. Discard discolored solutions or those with
-relief of moderate to severe pain in MI. precipitates. Do not shake vial.
- relief of dyspnea in Pulmonary edema or Left Draw up clear insulin first.
ventricular failure. Rotate injection sites
Nursing Implications: Monitor blood glucose levels regularly.
-assess pain before giving Inform patients regarding signs of
-monitor RR hypoglycemia and appropriate treatment.
-change position slowly If ill continue taking insulin and drink freely
-check urinary retention nancaloric liquids.
-nalaxone (narcan) available Inform regarding avoidance of smoking.
4.Sedative and Hypnotics Oral Hypoglycemic agents
Eg. Phenobarbital-luminal a. Sulfonylureas
Diazepam-Valium promotes inc. insulin secretion from pancreatic
Hinders movement of impulses from thalamus beta cells
of the brain cortex. First-Generation Agents:
Creates depression in the CNS Tolbutamide, Acetohexamide, Tolazamide,
Nursing Implications: Chlorpropamide
Deep IM Second-Generation Agents
IV adm. monitor insertion sites for Glypizide, Glyburide
extravasation b. Biguanides

reduces hepatic production of glucose by
inhibiting glycogenolysis
decrease the intestinal absorption of glucose
and improving lipid profile
Agents
Phenformin , Metformin , Buformin
c. Alpha-glucosidase inhibitors
Inhibits alpha-glucosidase enzymes in the
small intestine and alpha amylase in the
pancreas
Decrease rate of complex carbohydrate
metabolism resulting to a reduced rate
postprandially.
Agents
Acarbose (precose), Miglitol (glyset)
Nursing implications:
Tablets should not be crushed
Monitor for signs of hypoglycemia
Use other forms of contraception aside from
OCPs
Alcohol can trigger a hypoglycemic effect.
Cover body is sunshine. Use of sunscreen.
Sulfonylureas are best taken before meals
Monitor for drug to drug interactions.
CORTICOSTEROIDS
Cortisol, hydrocortisone, prednisone,
prednisolone, methylprednisone, triamcinolone,
dexamethasone
Mineralocorticoid (fludrocortisone)
Uses:
Replacement therapy for adrenocortical
insufficiency
Anti-inflammatory agent
Adverse effects:
1. Altered protein metabolism
Muscle wasting
Osteoporosis
Easy bruisability
2. Altered fat metabolism
Moon facies
Buffalo hump
Truncal obesity
hyperlipidemia
3. Altered carbohydrate metabolism
Hyperglycemia
Altered immune response
Sodium and water retention
Hypertension
7. Hypokalemia, metabolic alkalosis
8. Emotional instability
9. Excessive androgen activity
10. Gastric irritation
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Nursing Implications:
Review patient’s medical history prior to giving
the drug
Administer in light-resistant containers
Observe for mental changes.
Monitor for BP, weight, I and O, glucose,
electrolytes.
Take with food or milk.
Take drug before 9 AM.
Never abruptly stop taking the drug
Teach patient ways to prevent infection.
Restrict sodium, alcohol and caffeine intake.
Increase intake of foods high in potassium.
Rinse mouth after using inhaled steroids
Teach patient to avoid strenuous activities and
falls
ANTITHYROID DRUGS
Propylthiouracil (PTU) and methimazole
Mechanism of action
Blocks thyroid hormone synthesis
Adverse effects:
Skin rash
Urticaria
Agranulocytosis
Hepatitis
Myalgia
Headcahe
Hypoprothrombinemia
hypothyroidism
Nursing considerations
Give the drug with meals to reduce GI effects
Watch for signs of hypothyroidism
WOF: Agranulocytosis
Instruct patient to report for skin eruptions
The drug should be stopped if severe rash
develops or cervical lymph nodes become
enlarged
Advise patient to avoid foods high in iodine or
potassium
Warn the patient against the use of the
over-the-counter medication
Store the drug in a light-resistant container
Monitor for weight and PR regularly.
SSKI/Lugol’s solution
Potassium or sodium iodide (potassium
iodide SSKI), strong iodine solution
(Lugol’s solution)
Treatment for thyrotoxic crisis
Mechanism of action:
Inhibits the release and synthesis of thyroid
hormones
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Decreases the vascularity of the thyroid gland Monitor BP, heart rate and I and O.
Decreases thyroidal uptake of radioactive Regularly monitor for uterine contractions and
iodine following radiation emergencies or FHR.
administration of radioactive isotopes of iodine Discontinue if:
Adverse Effects: With note of tetanic uterine contractions.
Unpleasant tase Signs of fetal distress
Hypersalivation Urinary flow is less than 30 ml/hour
Acne Signs of abruptio placenta and uterine rupture
Rashes For ergonovine/methergine- C/I for patients
angioedema with vascular, renal and hepatic problems
Burning sensation Ophthalmic Drugs
THYROID HORMONES A. Mydriatics and Cycloplegics
Levothyroxine -Atropine, Cyclogyl
Liothyronine -causes mydriasis (dilatation) and
Thyroglobulin (Proloid) cyloplegia, w/c paralyzes the lens and eye
Adverse Effects: muscles.
Signs of hyperthyroidism Nursing Implications:
Nursing Implications: -sunglasses
Different brands of levothyroxine may not be -artificial tears
bioequivalent -elderly caution to atropine-IOP
Warn the patient (especially the elderly) to tell B. Miotics
the doctor if with signs of hyperthyroidism Acetylcholine (miochol)
Instruct the patient to take thyroid hormones at Carbachol (isopto carbachol)
the same time each day to maintain constant Pilocarpine
hormone levels. -causes miosis (contraction) of pupils
Nursing Implications: and ciliary muscles
Medications taken in the morning -decreases IOP
Monitor apical pulse and blood pressure. If Cardiovascular Drugs
pulse is >100 bpm, withhold the drug Cardiac Glycosides
Store in air-tight and light-resistant containers Digoxin (Lanoxin)
Monitor prothrombin time; a patient taking -increases force of myocardial contraction (+
these hormones usually requires less inotropic effect
anticoagulant - improves blood supply to vital organs and
OXYTOCIN kidneys, providing a diuretic effect.
Uses: -decreases rate of contraction (-
Promotion of uterine contractions chronotropic effect)
Control of bleeding -CHF,Atrial fibrillation, atrial flutter,paroxysmal
Release of milk from breast atrial tachycardia.
Oxtocin-related drugs: Cardiovascular Drugs
Methergine Nursing Implications:
Ergonovine -avoid high Na, increase K
Adverse Effects: -Antidote: digoxin immune Fab
Tachycardia (digi-bind)
Water intoxication Hold if apical pulse:
Uterine rupture -infants: below 90 beats
Nausea and vomiting -children/adolescence: below 70
Cardiovascular collapse -adults: below 60 or above 120.
Anaphylaxis Monitor serum digoxin levels: 0-5 to
Hypertension (oxytocin-related drugs) 2.0ng/ml.
Nursing Implications: Anti anginal Drugs
Use infusion pump for administration. Never Nitrites & Nitroglycerin
give IM
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-dilates the peripheral vascular smooth -take early am & after meals
muscles of small vessels. -agranulocytosis
-decreases cardiac pre load and after load.- -take high K diet
decreased myocardial oxygen needs -change position gradually
-dilates large coronary arteries,which helps -daily weights
decrease anginal pain & hypoxia of the Loop Diuretics
myocardium Furosemide ( lasix )
Anticoagulants -Acts by inhibiting reabsorption of Na
Heparin and CL at the proximal portion of the
-blocks conversion of prothrombin to ascending loop of Henle,increasing H2O
thrombin and fibrinogen to fibrin excretion.
Warfarin (coumarin) -use in HPN, Pulmonary edema,
-blocks prothrombin synthesis cirrhosis, renal disease
-takes 2-5 days –effect Nursing Implications
Thrombolytic Drugs -take with meals
Streptokinase -monitor for hearing loss
Activase, urokinase -use with 5 % dextrose in water, NaCL &
-when use in treatment of MI, start LR
therapy within 6 hours of attack. -incorporated lasix should be use in 24
- corticosteriods -given to decrease hours
allergic reaction -take dose in am
-Reconstitute it with normal saline or 5% -diet high in K
dextrose solution -stay out of sun, use sunscreen
-Avoid IM route
-Antidote: Aminocaproic acid K-sparing diureticss
Antihypertensives spironolactone ( aldactone )
ACE INHIBITORS - CAPOTEN/CAPTOPRIL, -blocks aldosterone receptors in the
VASOTEC/ENALAPRIL, kidney tubules,thus causing excretion of water
LOTENSIN/BENZAPRIL & sodium & K retention
BETA – BLOCKERS- Nursing Implications:
INDERAL/PROPANOLOL, - may last 2-3 days after drug is stopped
TENORMIN/ATENOLOL -avoid high K diet
CALCIUM ANTAGONIST- CALAN
ISOPTIN/VERAPAMIL, Osmotic Diuretics (mannitol)
CARDIZEM/DIALTIZEM, -acts by increasing osmotic pressure of
PROCARDIA/ NIFEDIPINE the glomerular filtrate inside the renal tubules
Nursing Implications -this causes less reabsorption of F &
-avoid alcohol & hot showers E+ by tubules & increase loss of Fluid,CL &
-low Na diet Na.
-change position gradually Nursing Implications:
-monitor CBC,E+,urinalysis -warm solution to dissolve crystal
Diuretics -used IV filters
Thiazides: hydrochlorothiazide (Hydrodiuril) -I&O q 30 minutes
Chlorathiazide (Diuril) -Signs of E-
- Blocks Na reabsorption in the distal Respiratory Drugs
convoluted tubule,which prevents H20 A. Antiasthmatic Drugs
reabsorption Theophylline,Aminophylline
-increases urine output -relaxes bronchial smooth muscles cells
-decrease blood volume -increases renal blood flow, producing
-K excretion diuretic effects and acts as CNS stimulant.
-use in HPN, edema with CHF Respiratory Drugs
Nursing Implication: Nursing Implications
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-theophylline level: 10-20 mcg/ml Nursing Implications:

-with milk or meals:GI upset present -emesis should occur w/in 20-30 min
-not present give 1-2 hours before -repeat dose
meals with water -less than 10 yrs old,one dose only
-avoid excessive caffeine -not given: corrosive,petroleum based or
cyanide
B. Cromolyn sodium
-acts on lung mucosa to prevent E. Anti gout
histamine release Allopurinol (Zyloprim) - prevents production of
uric acid
C. Mucolytics Nursing Implications:
-reduces the viscosity of mucus in the -force fluid:2-3 liters
bronchial tree -take after meals
GIT Drugs -monitor Liver function test/CBC
A.Histamine (H2) antagonists
Cimetidine (Tagamet) Colchicine (Novocolchine)
-Decreases stomach acidity by -drug of choice for acute gouty attacks
impending the action of histamine -decreases the inflammatory response
-Competes with Histamine for to deposits of monosodium urate crystals
occupancy of H2 receptors site on the parietal Nursing Implications:
cells in the stomach -acute attack: given 1-2 hrs until pain
-Suppresses the release of gastric acid ceases
Antimicrobials
Nursing Implications: A. Aminoglycosides:
-antacids decreases absorption Gentamicin (Garamycin)
-4-6 weeks treatment ,ulcer disease. -bactericidal
-toxic effect: confusion Nursing Implications:
-caution with decreased renal function,
B. Antidiarrheals agents reduced hearing, dehydration,neuromuscular
Absorbent disorders
-Pepto-bismol -adequate hydration
-kaopectate B.Penicillin G Potassium (Pentids)
Opiate -Bactericidal
-Imodium Nursing Implication:
-Lomotil -check allergic reactions
-Paregoric -Skin test
Nursing Implications: -give oral tablet empty stomach,
with full glass of water
-not taken with CNS depressants -monitor CBC, BUN, Creatinine
- C. Cephalosporins:
C. Laxatives -Bactericidal
-use to promote movement of feces Nursing Implications:
Ex. Dulcolax, Lactulose, Metamucil -IM: rotate sites
Nursing Implications: -Assess for hx.of penicillin allergy: cross allergy
-not given with nausea, vomiting, abd’l between cephalosporin & penicillin
pain, s/s appendicitis or intestinal obstruction -reduce dose with renal/liver problems.
-Thrombophlebitis: long IV administration.
D. Ipecac Syrup Report diarrhea,rash,hives,dyspnea, bleeding
-irritates the GIT to induce vomiting / D. Erythromycin:
delaying the absorption time of toxic -Bacteriostatic
substances Nursing Implications:
-do not crush enteric coated tablet

-take in empty stomach ,full glass of
water
-do not give w/ antacids
-GI s/s are dose related
E. Tetracyclines
-Bactericidal
Nursing Implications:
-avoid with pregnant women
Nursing mothers, Children under 8 y/o
as drug binds to calcium in teeth & new bone
growth
-lead to tooth discoloration of permanent
teeth & retarded bone growth.
-Avoid taking w/ dairy products,
antacids, vitamins, minerals.
-take 1 hr before meals,2 hrs after
meals.
-report diarrhea episodes
F. Urinary-Anti-infectives
Nitrofurantoin (Macrodantin)
-Bacteriostatic
Nursing Implications:
-monitor pulmonary ,neurologic status
-give w/ milk or meals
-avoid crushing tablet: tooth staining
-dilute suspension
-rinse mouth
-nausea/vomiting common effect
G.Vancomycin HCL (Vancocin)
-Exhibit bactericidal & Bacteriostatic
effect.
Nursing Implications:
-monitor renal/auditory function test
-adm.IV slow 60 minutes: prevent
phlebitis, extravasation, red-neck syndrome
( fever, hives, rash & redness of the face)
H. ciprofloxacin (Cipro)
-Bactericidal
Nursing Implications:
-adm. with large glass of water
-do not give with antacids
-give 2 hours after meals
I. Antitubercular Drugs
Isoniazid (INH)
-Bacteriostatic, If high concentration
becomes Bactericidal
Nursing Implications:
-assess neuromuscular function
-give B6 pyridoxine
-empty stomach-single daily dose
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-with meals & divide daily dose into 3
equal parts: GI upset.
Ethambutol (Myambutol
-report any s/s blurring of vision
(unable to see red or green)
-Caution with renal impairment
.Rifampin (Rifadin, Rimactane)
-expect orange tinged body fluids
-report anorexia,nausea/vomiting,
jaundice, malaise,dark urine
Computations
Preparing Solutions
1. Liquid to Drug Solutions
Determine the strength of the solution, the
strength of the drug on hand and the quantity
of the solution required
Formula
Dose = Amount of Solution
Strength on hand
Example
You have a 100% solution of hydrogen
peroxide on hand. You need a liter of 50%
solution.
50 X 1000 ml = 500ml
100
Solid Dose of Oral Administration
Physician orders patient to have 1.0 g of
ampicillin. The ampicillin bottle states that
each tablet in the bottle contains 0.5 g.
2 Methods
dosage desired = 1.0 g =2
dosage on hand 0.5 g
Exercise
The physician order 1000 mg of
ampicillin. On hand: 0.25 grams per tablet.
X=
Liquid Dose of Oral Administration
30 ml = 1 oz
Physician orders 60 ml of a liquid medication.
How many ounces will be given?
Physician orders 45 ml. How many ounces will
be given?
Liquid Dose of Oral Administration
Order: 500 mg;Dose at hand: 250mg/5 ml.
How many ml will be given?
Formula: D/H x Q
500/250 x 5 ml= 10 ml
Order: 250 mg; dose at hand: 125 mg/ml
Order: 500 mg; dose at hand: 125 mg/ml
Calculation of Flow Rates
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Drops/ min Carbohydrates 4

Formula: Protein 4
vol in ml x gtts (ugtts)/ml = drops/min Lipids (Fats) 9
time in minutes Vitamin B1, (Thiamine)
Infuse 1000 ml Lactated Ringer’s (LR) solution Vitamin B2, (Riboflavin)
over 10 hour to a 40 year old male. Vitamin B3, also Vitamin P (Niacin)
1000ml x 15 gtts/min = 25 gtts/min Vitamin B5, (Pantothenic acid)
10 hrs x 60 min/hr Vitamin B6, (Pyridoxine)
Infuse 1 liter of 0.9 NACl over 8 hours using 10 Vitamin B7, also Vitamin H (Biotin)
gtt factor. Vitamin B9, (Folic acid)
Infuse 500ml of .45 NaCl over 12 hours to a Vitamin B12, (Cyanocobalamin)
3-year-old child. Thiamine (B1)
Milliliters per Hour (ml/hr) A coenzyme
Formula: Volume in ml Need increases as metabolism increases
Total # of hours= ml/hr Sources: lean pork, whole grains, legumes,
Infuse 1000 ml Lactated Ringer’s (LR) solution seeds, nuts
over 10 hour. Deficiency: Beri-beri
1000 ml ÷ 10 hour = 100 ml/hr Wernicke-Korsakoff syndrome
Riboflavin (B2)
Drugs ordered in Units per Hour or Milligrams Coenzyme
per Hour Sources: enriched grain, broccoli, asparagus,
Doctor’s order: mix 10,000 U heparin in 1000 dark leafy vegs, milk, meat, fish, poultry
ml D5W; infuse 80 units per hour Deficiency: Ariboflavinosis
1000 ml : 10,000 units :x ml : 80 U/hr Niacin (B3)
10,000 units x =80,000 ml-U/hr Active vitamin percursor
10,000 U 10,000 U Sources: meat, poultry. Fish, legumes. Milk,
x= 8 ml/hr coffee ands tea
milliliters per hour Def: Pellagra ( diarrhea, dermatitis, dementia
Mix 10,000 U heparin in 1000 ml D5 W; infuse Pyridoxine (B6)
at 15 ml/hr. How many units of heparin are deficiency causes blood, skin, and nerve
being delivered per hour? changes. This vitamin is unique in that both
1000 ml : 10,000 U : : 15 ml : x U deficiency and excess can cause peripheral
1000 ml X = 150,000 U-ml neuropathy
1000 ml 1000 ml Biotin (B7)
x= 150 U Assist in transfer of carbohydrate from one a
Calculation of Flow Rates compound to another
Milliliters per Hour (ml/hr) Deficiency: dry scaly rash, hair loss, loss of
Formula: Volume in ml appetite, depression, glossitis
Total # of hours= ml/hr Sources: liver, kidney, peanut, egg yolk
Infuse 1000 ml Lactated Ringer’s (LR) solution Folic Acid (B9)
over 10 hour. Coenzyme
1000 ml ÷ 10 hour = 100 ml/hr Sources: green leafy vegs, fruits, juice,
NUTRITION legumes
Food Pyramid deficiency: in pregnant women, can lead to
Bread, cereal, rice, pasta- 6-11 neural tube defects
Fruit- 2-4 Cyanobalamin B12
Vegetable- 3-5 servings Coenzyme
Milk- 2-3 servings Sources: meat, chicken, fish, pork,
Meat, poultry, fish, dry beans, eggs, eggs, dairy products
nuts- 2-3 servings Deficiency: Pernicious anemia
Fats- use sparingly Vitamin C
K Caloric Values Anti oxidant; collagen formation
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Enhances absorption of iron iron

RDA 90-125mg/day Responsible to distribute oxygen throughout
Deficiency: scurvy our body
Vitamin A Found in RBC, muscles
Maintains skin and mucous membranes Spleen and liver
throughout the body Deficiency: anemia
Vision, immune system, bone growth Toxicity: hemosiderosis
Sources: zinc
Whole milk, butter, liver, egg yolks, fatty fish Growth processes, taste, smell, healing
Carotenoids: deep green, yellow, orange fruits process, immune system, carbohydrate
Deficiency: Xeropthalmia metabolism by assisting insulin function
night blindness Found in: meat, fish, poultry, whole grains,
keratomalacia legumes, eggs
Toxicity: Hypervitaminosis A Deficiency: related to function
Vitamin D Dwarfism, hypogonadism, hypogeusia,
Enhance absorption of calcium hyposmia
Deficiency: poor wound healing, reduce immunity
Rickets toxicity: Vomiting, diarrhea,
Osteomalacia fever, exhaustion
Osteoporosis iodine
Toxicity: hypercalcemia Part of thyroxine
Vitamin E Increase in hypothyroidism
Anti oxidant Decrease in hyperthyroidism
aphrodisiac Water
Sources: Fluid in which the substances can be use by
vegetable oil; margarine the body
Whole grains, seeds, nuts, wheat germ, green Provides a means of transportation for
leafy vegetable nutrients to and from cells
May interfere with Coumadin 8 glasses of water/day
Primary deficiency: rare Clear liquid diet
Vitamin K Illness or surgery, acute inflammatory
Cofactor in synthesis of blood clotting conditions of the GIT, for conditions requiring
Sources: decreased fecal material
bacteria in GIT Inadequate in nutritional essentials
Liver production liquid at room temperature; Use for 1 -2 days
Sources: green, leafy vegetable only
Lesser amt in cereals, dairy products, meats Clear fat free broths , strained juices, tea and
and fruits coffee , salabat, plain gelatin , sugar plain, hard
Calcium candies
Nerve impulse Full liquid diet
Muscle contraction and relaxation Post –op , acute infection, acute inflammatory
Blood clot conditions of the G.I.T. for patients too ill to eat
Blood pressure regulation solid or semi solid foods, impaired chewing and
Sources: swallowing ability
Milk and milk products Liquid at room temp. and free from cellulose
except cream cheese and butter and irritating spices and condiments. 6-8 small
Broccoli feedings recommended
Small fish with bones Strained cream or soups, pureed strained meat
+Tea and tannins reduce absorption of and fish, strained fruit juices ,plain ice cream
calcium+ and custard, cornstarch pudding and milk and
Deficiency: osteoporosis cocoa
Toxicity: urinary stone Soft Diet
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Patients who are unable to chew, swallow or

digest foods
Modification in consistency and texture
Foods low in cellulose content, low in fiber free
from connective tissues and strong flavors,
simple and easily digested
Low residue diet
Dysentery , diarrheas , pre-op and post –op
when it is desired to reduce fecal residue, as in
colostomy, ileostomy , and bowel resection
foods which form least amount of fecal matter;
may require supplementation
Cereals strained soups, chicken
Bland diet
Gastric and duodenal ulcers, gastritis ,
ulcerative colitis
Foods are non irritating
Mildly flavored foods without fiber, connective
tissue
avoid – alcohol , coffee black pepper and
chili powder
High fiber diet
Atonic constipation, Atherosclerosis,
diverticulosis, DM
Full diet with emphasis on long fibered
vegetables , raw fruits and vegetables, whole
grain cereals and coarse breads
High caloric
Underweight, protein energy malnutrition,
fevers and infections, hyperthyroidism, burns,
growth pregnancy and lactation
3 meals with in between feeding – gradual
rather than drastic. Vitamins and minerals at or
above RDA. Contains greater amount of total
energy
Cereals, bread, butter , cream and other fats
and sugar
Low caloric
Obesity and those cases where excess weight
is a complicating factor as DM, CVD, renal,
HPN, gout, gall bladder and preceding surgery
Contains reduced amount of energy to effect a
negative energy balance
Sufficient bulk , low in calories . Avoid high fat
foods and high CHO foods