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_hospital diet final by LT Antra Tiwari.pptx

It's about healthy diet

Health & Medicine◦
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1 HOSPITAL DIET Presented By- LT ANTRA TIWARI
 Hospital diet is an essential part of modern therapy in all medical depts. It comprises both the normal diets and the various forms of modified nutrition.  The type of diet prescribed depends on the patients need and restriction.  It is a part of a clinical treatment and in some cases can be the principal treatment of the condition. 3 HOSPITAL DIET
 Armed forces Hospitals are responsible for ration supplies both to their entitled personnel and their dependents.  Correct prescription of diet, delivery of diet to patients and accounting requires detailed attention both in the interest of the patient and economy.
 All patients admitted in the hospital are authorized hospital diets and extras according to the scales given in AI 94/76  The daily scales of diet for patients have been made as comprehensive as possible to suit the requirement of majority of patients to be treated in service hospitals. Authorization of Hospital Diets in Armed Forces
 Fluid diet - ‘F’  Subsistence diet - ‘S’  Convalescent diet - ‘C’  Ordinary diet - ‘O’  No Diet - ‘N’ Classification of Diet
FLUID DIET (F DIET):-  It is given to those patients who are unable to take solid food.  It can include any liquid foods like soup, juices, and milk ,egg flip, pureed dal and vegetables etc. These may be given orally or through nasogastric tube.
Fluid diet Clear fluid diet  No residue fluids  Nutritionally inadequate Indications  First step to restarting oral feeds after oral/abdominal surgeries  Fluid and electrolyte replacement in patients with diarrhoea and dehydration  Before specific investigations 400kcal/day
SUBSISTENCE DIET (S DIET):-  It is given to those patients who are admitted after 1200hrs till 1800hrs.  It is like ordinary diet but the scales of items are less  It is demanded from MI Room.
CONVALESCENT DIET(C DIET):-  This is a high-energy, high protein diet given to the patients who require growth and building up of tissues.  The patients who are given this diet include postoperative patients, burns patients, patients who are critically ill and recovering after major illness.
ORDINARY DIET (O DIET):-  It is given to all routine patients.  It contains all nutrients in required quantity to meet the needs of an adult.  This is most common diet given in the hospital.  It is given to those patients who are admitted after 0000hrs to 1200hrs
NO DIET (N DIET):-  It is normally called as N diet with extras.  The scale of this diet includes items like eggs, biscuits, horlicks , protinex , cheese etc.
 0-6 months – 100gm of lactogen /day  6-12 months – weaning + 50gm lactogen /day  1-5 yrs :- ½ N DIET  6-10 yrs :- ½ O DIET  10 yrs onward :- O DIET DIET FOR PAEDIATRIC WARD
RATION QTY TEA 05gms SUGAR 30gms MILK FRESH 60gms Diet Of Night Duty
ITEMS F DIET S DIET C DIET O DIET ATTA/RICE 230GM 335GM 600GM BREAD 120GM CEREAL FOR B’FAST 25GM CEREAL FOR PUDDING 25GM MILK FOR NONVEG 1000ML 440ML MILK FOR VEG 1540ML 440ML 1830ML 1080ML MILK FOR OVA 1280ML 640ML EGG 2 3 2 PATIENT RATION SCALE
ITEMS F DIET SDIET C DIET O DIET BUTTER 30GM MEAT 200GM 230 CHIKAN DRESSED 55GM FISH/TINNED 50/20GM FRUIT FRESH CITRUS 230GM FRUIT FRESH VARIETY 230GM 230GM VEGETABLE FRESH 170GM 170GM ONION 100GM 60GM POTATOES 110GM 110GM DAL 30GM 60GM 60GM SUGAR 90GM 40GM 90GM 90GM Continued Scale
ITEMS F DIET S DIET C DIET O DIET TEA 07 GM 07GM 09 GM 09 GM FRESH LIME OARB OARB OARB OARB CONDIMENTS 04 GM 14 GM 14 GM PICKLE OARB OARB OARB SAUCE/VINIGAR OARB OARB OARB SALT 15 GM 05 GM 20 GM 20 GM OIL HYDRATED 30 GM 60 GM 60 GM LPG GAS 150 GM 95 GM 150 GM 150GM BISCUIT 30 GM JAM/HONEY 20 GM Continued scale
ARTICLES OD NONVEG GMS OD VEG GMS OD OVA GMS CD NONVEG GMS CD VEG GMS CD OVA GMS ATTA/RICE 600 600 600 325 325 325 SUGAR 90 90 90 90 90 90 DAL 60 60 60 60 60 60 R/OIL 60 ML 60 ML 60 ML 60 ML 60 ML 60 ML TEA 9 9 9 9 9 9 SALT 20 20 20 20 20 20 SCALES
ITEMS OD NONVEG OD VEG OD OVA CD NONVEG CD VEG CD OVA PUDDING _ _ _ 25 25 25 TEA 9 9 9 9 9 9 PICKLE 15 15 15 15 15 15 POTATO 110 110 110 110 110 110 ONION 60 60 60 100 100 100 VEG 170 170 170 170 170 170 CONTD…. SCALE
ARTICLES OD NONVEG OD VEG OD OVA CD NONVEG CD VEG CD OVA FRUIT 230 230 230 230 230 230 MILK 440ml 1080ml 640ml 1000ml 1830ml 1280ml MEAT 230 230 EGGS 2 4 3 5 FISH 50 50 CHICKEN 55 55 LPG 145 145 145 145 145 145 BREAD 110 110 110 JAM 20 20 20 BUTTER 30 30 30 BISCUITS 30 30 30 CONTD… SCALE
‘N’ Diet (Auth : AI 10/84 & SAI 94/S/76) Items Authorization Atta/Rice 170 Biscuits 57 Bread 170 Butter 28 Condiments 7 Cream fresh 57 Cheese Tinned 28 Dal 60 Items Authorizatio n Liver 454 Onions 30 Potatoes 110 Sago 57 Fresh Vegetables 170 Fresh fruit 230 Gelatine 57 Eggs, Coffee, Corn flour, Rice water, Sugar, Vinegar- OARB **Children <10yrs-Half Adult Scale
Nursing responsibilities  Daily dispatch of diet requisition slip  Diet supervision  Monitor food intake of patients  Hygiene of the food handlers  Maintenance of food trolleys
Contd…  Prevention of pilferage of food items  Maintenance of diet registers  Monthly submission of diet sheet (IAFM-1282)  Suggestion book & Patient satisfaction survey
 IAFM-1266 – Daily Diet Requisition  IAFM-1282– Monthly Diet Requisition ◦ Ward submits the daily requisition for the following day normally after the morning ward round. ◦ The diet requisition should tally with the entries in the ward diet sheet (IAFM-1282). ◦ MO i/c verifies that the diet prescribed are issued and consumed by the patient for whom it is prescribed. How to demand the Diet
 Particulars of patients and A &D No are correctly entered  The patients are physically present in the ward.  Diet prescribed and requisition are correctly shown.  Extras prescribed are correctly entered.  Diet requisition IAFM-1266 tallies with entries in IAFM-1282.  Cutting and over writing are avoided  IAFM-1266 signed by MO I/c daily IAFM-1282 monthly and thereafter by Commandant Maintenance of IAFM-1282
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 Ration in the hospital can be divided into- (a) Ration issued to kitchen (b) Ration issued directly to Ward Distribution of ration
The following items are directly issued to wards  Eggs  Fruit  Butter  Bread  Jam/honey/cheese  Extras as ordered (e.g horlicks, proteinx, etc) The Nursing Officer ensures that these items are duly received and distributed to the patient as per diet ordered. Issue to wards
Therapeutic Diet
WHAT IS THERAPEUTIC DIET 37 Planned diet Modification of normal diet Supplements the nutrients from all food groups Prescribed by doctor and planned by dietician
38 Removing or adding foods or nutrients CONT…. Change nutrients, caloric content and/or texture Increase or decrease bulk in the diet e.g. high or low fiber diets Increase or decrease the energy values
. Purposes of therapeutic diets Regulate amount of food Assist body organs to maintain normal function Aid in digestion 39
40 To improve specific health conditions CONT…. Increase or decrease body weight Modify the intervals of feedings.
Therapeutic diet  Fluid diet  Soft diet  Bland diet  Low sodium diet  Cardiac diet  Renal diet  Diabetic diet
Fluid diet  It includes liquid foods with smooth consistency.  It is a bridge between clear fluid diet and soft diet.  It is easy to digest and leaves a little food in stomach and intestines.
MEAL MENU AMOUNT KCAL BREAK FAST MILK 300ML 20 SUGAR 2tsp 120 EGG FLIP 200ML 210 MID MORNING JUICE 200ML 120 LUNCH MILK SOUP(VEG/NON VEG) 100ML 200 ML 67 165 EVENING GLUCOSE WATER 200ML(40GM) 160 DINNER CHICKEN SOUP 200ML 109 DAL SOUP 100ML 115 BUTTER 2tsp 270 CUSTARD 100ML 200 SAMPLE MENU FOR FLUID DIET Total calories-1800kcal
Soft diet
Soft diet  Used as the second step to restarting oral feeding once clear liquids are tolerated.  Made up of simple easily digestible foods Indications  Ac Infections  Gastrointestinal disorders  Post operative Patients  Patients with dental problems  Lab Procedures 1500kcal,35-40gm protein/day
Low Sodium diet Cardiovascular diseases such as Hypertension or Congestive heart disease, kidney disease .
 Dietary approaches to stop hypertension which is promoted by national institute of health(USA).  The DASH diet is rich in fruits, vegetables, whole grains, and low fat dairy foods; includes meat, fish poultry, nuts and beans and is limited in sugar sweetened foods and beverages, red meat, and added fats. DASH Diet
Meal Menu Amount Breakfast Milk 1 cup Idli/dosa/porridge/ragi roti/ upma/ dry chapatti Egg white /sambhar/dal chutney/curd/cornflakes Fresh fruit juice/Nuts 1 bowl 1 bowl 1 cup Mid morning fruit/buttermilk/veg soup 1/ 1 cup Lunch Leafy vegetables/rice/dry chapatti / Sambhar/dal/rasam/chicken curry Curd/salad 1 bowl/2 1 bowl Evening snacks tea/ coffee/milk/puffed rice/ sprouted salad 1 cup Dinner Dry chapatti/ ragi roti/ Sambhar / dal/ fish curry Skimmed milk 2 1 bowl 1 cup Sample menu for DASH Total calorie-2000kcal
Cardiac Diet
Cardiac diet  This diet includes : - Low fat, low salt - fruits and vegetables - Fibre rich foods - Foods rich in omega 3 fatty acids
Renal diet This diet includes:  Limited fluids  Low protein diet  Limited sodium, potassium, phosphorus, and other electrolytes  Enough calories if there is loss of weight
Renal diet menu [ 2000 kcal] MEAL MENU QUANTITY CALORIES(Kcal) EARLY MORNING 7 AM Warm water Tea Mariegold biscuits 1 glass 1 cup 2 - 35 56 Breakfast 8 AM Milk or Egg /paneer bhurji Chapatti / bread Salt free butter/jam porridge 1 cup 1 bowl 2 no. 2 tsp 1 bowl 35 30 160 200 142 Mid meal 11 AM Apple/watermelon/ orange 1 40 Lunch 1.30 PM Veg Dal Chapatti Rice 1 medium bowl 1 bowl 2 small 1 bowl 85 130 150 200 Evening 4.30PM Green tea/lemon water/milk Roasted chana 1 cup 1 cup 35 85 Dinner 7.30 PM Same as lunch
Diabetic diet Dietary recommendation: ◦ Cut down on sugar ◦ Eat starchy foods ◦ Fresh fruits and vegetables ◦ Reduce intake of animal or saturated fats
Foods to be eaten in moderate quantity Fruits  Banana, Mango, Lichi, Grapes, Chiku Starchy Vegetables Potato, Colacasia, Yam, Sweet Potato Refined Cereals Refined Wheat, Rice
Foods to avoid  Sugar and sweetened beverages  Trans fats  Dried fruits  Packed fruit juices  White bread, pasta, rice  Flavoured coffee, drinks  Honey  Packed snacks, French fries
Diabetic diet menu [ 1200 kcal] Meal Menu Quantity Calories(Kcal) Early morning 7 am Warm water Tea without sugar Mariegold biscuits 1 glass 1 cup 2 - 35 56 Breakfast 8 AM Stuffed methi/palak/lauki paratha Curd or Egg white/paneer bhurji Plain chapatti or Veg poha/daliya upma 2 small 1 bowl( 50gm) 1 medium bowl 2 small 1 bowl 200 30 130 150 230 Mid meal 11 AM Apple/guava/orange 1 40 Lunch 1.30 PM Salad Veg ( capsicum/gobhi/lauki) Dal Chapatti 1 medium bowl 1 medium bowl 1 bowl 2 small 30 85 130 150 Evening 4.30PM Green tea/lemon water/milk Roasted chana 1 cup 1 cup 35 85 Dinner 7.30 PM Same as lunch
Meal Menu Amount Breakfast Warm water with lemon juice/ tea without sugar / coffee without sugar 200ml Mid morning Porridge /oats/idli/dosa/cornflakes Bread with boiled egg whites Dry chapatti Curd/ fruit 1 bowl 2 2 1 cup Lunch Fruit salad Medium size chapatti /ragi roti Rajma curry / vegetable curry Fish curry 2 2 1 bowl 1 bowl Evening Green tea without sugar/ baked snacks 1 cup Dinner Medium chapatti Any vegetable curry Chicken stew Milk with pinch of turmeric 2 1 bowl 1 cup 1 cup Sample menu for Diabetic diet Total calories- 1800kcal
Meal menu Amount Breakfast Scrambled egg Toast with butter Banana/milk 2 2 1 medium size/200ml Mid morning Milk with protein x 200ml Lunch Thick cream soup Lean meat /vegetable Rice / butter chapatti Salad 1 bowl 1 bowl 1 bowl 1 bowl Evening Egg flip 2 Dinner Mixed green vegetable Dal Chicken curry Milk with protein X 1 bowl 1 bowl 1 bowl 1 cup Sample menu for High calorie high protein diet Total calories-30-35kcal/kg/IBW Total protein-1.2-1.5g/kg/IBW
Conclusion  Important supportive service  Ensure good quality nourishing food, of right type, in right quantity and at right time  Close monitoring by Hospital authorities
Let food be thy medicine, Thy medicine shall be thy food
THANK YOU  “Your diet is a bank account. Good food choices are good investments”- B Frankel  “Take care of your body. It’s the only place you have to live” -Jim Rohn  “The doctor of the future will no longer treat the human frame with drugs, but rather will cure and prevent disease with nutrition” - Thomas Edison
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