Diet is as important in the treatment of diseases. A modification in the diet with more nutrients can cure certain diseases. eg; A patient suffering from peptic ulcer needs a bland diet for his recovery; a salt free diet can reduce the blood pressure in a patient with hypertension.
For every one, eating is an enjoyment. When the person is ill, the food intakes become a problem. The nurse's responsibility in the care of a sick in regard to nutrition, can be analysed into four major areas:
- Assisting patients to obtain needed nourishment either through feeding or assisting with eating. eg., tube feeding, feeding a helpless patient to eat his food etc.
- Motivating patient to eat.
- Assisting patients to obtain needed nourishment by proper planning of the diet.
- Assisting patients with special problems about therapeutic diets eg., helping a patient to accept a salt free diet.
Principles involved in the diet therapy
- The diet must be planned in relation to changes in metabolic occurring as a result of disease.
- The diet must be planned according to the food habits of the patient based on culture, religion, socio-economic status, personal references (likes and dislikes), physiological and psychological conditions, huger, appetite and satiety.
- As far as possible, changes in the diet should be brought gradually and adequate explanations are given with the changes made, if any.
- In short and acute illness, the food should not be forced, because his appetite is very poor but he may soon recover the normal appetite. But in prolonged illness it is essential to provide adequate amount of food to prevent wasting of tissues.
- Whatever the diet prescribed, there should be variety of foods for selection.
- Small and frequent feeds are preferred to the usual three meals.
- Hot foods should be served hot and cold foods should be served cold.
Modification of nutrients in therapeutic diet
Carbohydrate are well tolerated and are necessary to maintain the stores of liver glycogen. It is particularly important in patients with high fevers, liver diseases, hyperthyroidism etc. In the absence of carbohydrate, the body fat may be used for energy which may result in the formation of ketone bodies and they accumulate in the blood - a condition known as ketosis. Adequate amount of carbohydrate intake can prevent ketosis. Carbohydrates are given in easily digested forms such as glucose, sugars, gruels etc.
The fat is often not tolerated in illness especially if nausea and vomiting are present. Adequate amount of carbohydrate can replace the requirement of the body for fat.
In illness, especially when there is infection, the protein metabolism is usually greatly increased because of the increased destruction of protein. If an adequate amount of protein is not given, the body will use up the tissue proteins and the patient will loose weight. In illness there is kidney and liver damages the protein intake should be high.
The requirements of minerals should be maintained in illness especially that of calcium and iron. Sodium and potassium may sometimes need to be restricted especially when there is hypertension, oedema, ascites etc.