Question

Nutrition for Patients with Upper Gastrointestinal Disorders: Chapter 17 Learning objectives: Dudek's Nutrition essentials for nursing practice:

1   Give examples of ways to promote eating in people with anorexia.

2   Describe nutrition interventions that may help maximize intake in people who have nausea.

3   Compare the three levels of solid food textures included in the National Dysphagia Diet.

4   Compare the four liquid consistencies included in the National Dysphagia Diet.

5   Describe nutrition therapy recommendations for someone with gastroesophageal reflux disease (GERD).

6   Teach a patient about the role of nutrition therapy in the treatment of peptic ulcer disease.(Describe what you would teach the patient)

7   List possible nutrition strategies for patients with gastroparesis.

8   Give examples of nutrition therapy recommendations for people experiencing dumping syndrome.

Answer 1

Ans) 1) Encourage healthy-eating habits. Talk to your teen about how diet can affect his or her health, appearance and energy level. Encourage your teen to eat when he or she is hungry. Make a habit of eating together as a family.
Discuss media messages. Television programs, movies, websites and other media might send your teen the message that only a certain body type is acceptable. Encourage your teen to talk about and question what he or she has seen or heard — especially from websites or other sources that promote anorexia as a lifestyle choice, rather than an eating disorder.
Promote a healthy body image. Talk to your teen about his or her self-image and offer reassurance that healthy body shapes vary. Don't allow hurtful nicknames or jokes based on a person's physical characteristics. Avoid making comments about another person based on his or her weight or body shape.
Foster self-esteem. Respect your teen's accomplishments, and support his or her goals. Listen when your teen speaks. Look for positive qualities in your teen, such as curiosity, generosity and a sense of humor. Remind your teen that your love and acceptance is unconditional — not based on his or her weight or appearance.
Share the dangers of dieting and emotional eating. Explain that dieting can compromise your teen's nutrition, growth and health, as well as lead to the development of binge eating over time. Remind your teen that eating or controlling his or her diet isn't a healthy way to cope with emotions. Instead, encourage your teen to talk to loved ones, friends or a counselor about problems he or she might be facing.

2) Check medications: alter where possible to minimise adverse effects
Encourage “little and often” – three small meals with regular in-between snacks of energy rich, high protein foods (see Practical food suggestions). Encourage people to eat every two to three hours.
Maximise times of better appetite, e.g. if hungry in the morning suggest a cooked breakfast – eggs, baked beans, cheese on toast
Serve meals and snacks that are appealing in size and appearance – large meals can be off putting, use small plates and maximise the “eye appeal” of the food
Food has to be eaten to be of benefit – encourage the patient to select favourite foods that can be eaten at any time, e.g. cereal for supper, soup for breakfast
Drinks can lessen appetite – suggest that drinks are taken after meals rather than before and during a meal
Find ways to stimulate the appetite – a short walk before meals can be helpful
Consider meal settings – make meal times enjoyable and avoid interruptions or rushing during meals.

3) NDD Level 1: Dysphagia-Pureed (homogenous, very cohesive, pudding-like, requiring very little chewing ability).
NDD Level 2: Dysphagia-Mechanical Altered (cohesive, moist, semisolid foods, requiring some chewing).

NDD Level 3: Dysphagia-Advanced (soft foods that require more chewing ability).
Regular (all foods allowed).

4) Level 1 – Slightly Thick

Level 2 – Mildly Thick

Level 3 – Moderately thick/Liquidised

Level 4 – Extremely thick / Pureed