Fluid Restricted Diet Alaine Mills Dietetic Intern 1212013

Fluid Restricted Diet Alaine Mills, Dietetic Intern 1/21/2013 -1/22/2013

What is a Fluid? �A fluid is anything that is liquid or anything that melts at room temperature. �Some foods do not necessarily seem liquid, but must be counted as part of a patient’s fluid intake since they are liquid at room temperature or have liquid as a major ingredient.

Why Does a Patient Need a Fluid Restricted Diet? � For a patient who is on fluid restriction, excessive fluid can lead to fluid overload � Fluid overload causes complications, such as � swelling � shortness of breath � congestive heart failure � fluid in the lungs � fluid in the abdominal area

Diet Orders � Common diet orders you may see a fluid restriction with: � Renal Diet � Cardiac Mediterranean Diet

Traditional Examples of Fluids � Water � Milk � Coffee � Tea: Hot and Iced � Juice � Soda � Lemonade � Nutritional supplements, such as Boost®

Other Examples of Fluids � Ice cubes � Soup � Gelatin and Jell-O® � Ice cream � Sherbet � Sorbet � Freezer pops/Popsicles

Exceptions � These foods contain water, but not a significant amount and should not be counted as a part of a patient’s fluid restriction � Pudding � Oatmeal � Grits � Fruits � Vegetables � Custards

Planning the diet �A patient’s fluid restriction should be broken down into milliliters (m. L’s) per tray � If a fluid restriction is in place, but the amount per tray is not specified, clarify with the nurse before providing the patient’s tray � Ask � if it is total fluid or free water Foods that are liquid at room temperature should be counted by milliliters (m. L’s) � Fluid is usually ordered in the form of cubic centimeters or “CC’s” � 1 m. L is equal to 1 cc

Conversions �Milliliters can be converted from ounces or cups as follows: 30 ml = � 120 ml = � 180 ml = � 240 ml = � 960 ml = � 1 fl oz 4 fl oz or ½ cup 6 fl oz or ¾ cup 8 fl oz or 1 cup 32 fl oz or 1 qt

Fluids in the Regular Diet

Amount of Fluid in Commonly Served Items � Small bottled water: 8 oz or 240 ml � Tea (in small clear cup): 8 oz or 240 ml � Pre-thickened water cup: 4 oz or 120 ml � Apple, Orange, Prune Juice in cup: 4 oz or 120 ml � Milk Carton (skim, 1%, 2%, chocolate and whole): 8 oz or 240 ml � Coffee in black mug: 8 oz or 240 ml

Nutritional Supplements

Nutritional Supplements � Some items have less free water than other fluids, because of other ingredients. � Boost Plus, Boost Glucose Control, Resource Breeze, Resource Diabetishield � ~200 ml � Novasource � 170 ml Renal

Fluid Content of Foods

Fluid Content of Foods � These foods should be counted as a part of the allowed fluid for the day � Soup (6 oz) in black bowl: 150 ml � Jello (2 ½ Oz) in dessert dish: 100 ml � Ice cream/Sherbet (4 oz): 95 ml � Popsicles (whole) : 80 ml � Pre-thickened water cups (4 oz): 120 ml

What is a Free Water Restriction? �A free water restrictions means patients can have all fluids EXCEPT WATER. � All other fluids can be served as usual