b. You should relate the diet to body function and the condition being treated. For
example, a low fat diet is usually the first step in treating patients with elevated blood lipids
(hyperlipidemia). Hyperlipidemia may be caused by improper diet or it may have a
secondary cause, such as hypothyroidism or renal failure. Untreated hyperlipidemia can
lead to coronary heart disease.
c. Be able to explain the general principles of the diet to the patient, and obtain the
(1) For example, teach a diabetic patient the relationship between his insulin
and the amount of food consumed.
(2) Observe the patient's reaction to the diet. If the patient understands the
relationship between his condition and his diet, and is shown that he can continue to enjoy
most of his favorite foods, he is more likely to remain on the diet.
d. Help plan for the patient's continued care.
(1) Most patients are hospitalized only during the acute and early
convalescent phases of their illness so it may be necessary to continue a special diet at
(2) Chronic conditions, such as diabetes or hypertension, require permanent
(3) Be aware of the patient's home situation and the problems that the diet
may cause. The patient and his family will have to adjust their meal plans.
(4) Request a consultation for the patient with the dietitian early in the
hospitalization to allow for instructions and follow-up care.
5-10. REASONS FOR THERAPEUTIC DIETS
Nutritional support is fundamental, whether the patient has an acute illness or faces
chronic disease and its treatment. Frequently, it is the primary therapy in itself. The
registered dietitian, along with the physician, carries the major responsibility for the
patient's nutritional care. The nurse, and other primary care practitioners provide essential
support. Valid nutritional care must be planned on identified personal needs and goals of
the individual patient. We should not lose sight of the reasons for therapeutic diets.
a. To Maintain or Improve Nutritional Status. The stereotypical all-American
family with two parents and two children eating three balanced meals each day with a ban
on snacks is no longer a common reality. Widespread societal changes include an
increase in the number of women in the work force and families who rely on food items
and cooking methods that save time, space, and labor. The "snack" is clearly a significant
component of foods consumed. A therapeutic diet may be planned to promote foods that
contribute to nutritional adequacy.