Silly question about what is considered a liquid - page 2
by queenjean | 6,929 Views | 24 Comments
Okay, I had a CHFer on a pretty severe fluid restriction (severe for our floor, we are a medical floor in a smaller hospital). Anyhow, this gentleman was hungry, it was the middle of the night, and we don't have a lot in the... Read More
- 0Aug 10, '08 by Murse901Quote from locolorenzo22I think that's the key thing to consider. If the pt is hungry and you just don't have anything else stocked that would be suitable, what else can you do? Starve your patient? If you're that worried about the liquid, what I would do is educate the patient on the approximate liquid content of the pudding, inform him of the possible consequences of excess liquid based on his diagnosis and reason for being on fluid restrictions, then document his request for the food item despite being educated.if he needed the calories for nutrition, I would probably let him have it.
That way, you don't starve your patient, you make do with what's stocked, and you CYA.
- 3Aug 11, '08 by nalu0622Here's the solution to that question:
Liquid diet is divided into two category:
1. CLEAR LIQUID DIET - allows liquid that are clear and transparent. such as meat or vegetable broth, bouillion or clear fruit juices, clear carbonated drinks, and believe it or not, even POPSICLES and hard candies, teas or coffee but d/t special considerations on medical tests, some may prefer it to be CLEAR.
2. FULL LIQUID DIET - allows liquid that can be transparent or opaque but essentially smooth in consistency. Px on this diet can consume juices, milk, ice cream, PUDDING, strained cream soup, fruit nectar with pulp, soft cooked cereals like oatmeals or even wheat.
So there it is, i hope that clear things out...
- 0Aug 11, '08 by canoeheadLook at the patient needs. If he's hungry and can't sleep, and that's what you've got, then feed him. If you have an alternative that wouldn't be counted as a fluid- give him that.
I do vote that it should be counted as a liquid, but there are circumstances where I would tell him to go ahead and eat even if he was over his fluid allowance. Unfortunately, I would also plan on TPTB second guessing me in both cases, and it's too bad if we base our decisions on what our managers will say as opposed to what's best for a particular individual.
OK now we're off on a tangent- I'll go sit down.
- 1Aug 11, '08 by Virgo_RNQuote from queenjeanThe key word here is "fluid" restriction. Pudding is not a fluid. With CHFers, with fluid restrictions, we're typically talking water, juice, coffee, milk, etc.Okay, I had a CHFer on a pretty severe fluid restriction (severe for our floor, we are a medical floor in a smaller hospital).
Anyhow, this gentleman was hungry, it was the middle of the night, and we don't have a lot in the low sodium, fluid free snack department. The aide gave him pudding. I told her she needed to document it as a liquid. The other nurses disagreed with me, saying pudding is not considered a liquid. I have always reported it as a liquid.
If ice cream and jello are considered liquids, why is pudding not considered a liquid? Or is it?
- 1Aug 11, '08 by justme1972Quote from DonaldJI agree with this (to check hospital policy), this is what we were taught in school.It probably really just depends on your hospital's policy. Check with the RD in your hospital.
As for saying "If it's liquid at room temp, it's liquid", the pudding that we stock in the places I've worked is the kind that doesn't have to be refrigerated and is thick at room temp.
Eggs whites are a liquid until they are cooked, but after they are cooked I don't think anyone would consider them a liquid.
Ice, jello, ice cream, all go back to liquid at room temp. Puddings experience a chemical, not a physical change, and will not return back to a liquid state...just like the cooked egg whites.
- 0Aug 11, '08 by rita359Quote from nessajune21I agree that it is a liquid (full). Never been in a hospital where it was not considered a liquid. However, if the man is hungry in the middle of the night you have to feed him something unless he is NPO. We are talking what, maybe 120cc. If need be that can be subtracted from his allowed amount for the next shift.hmm... this appears to not be such a simple question!
I still say that if it is listed on the full liquid diet menu, then it is a full LIQUID.
- 0Aug 11, '08 by queenjeanThanks for the input.
I would like to note that my question is not whether I should have given my pt something to eat or not. The question is whether pudding is considered a liquid or a solid, particularly when a dietary restriction (such as a strict fluid restriction, full liquid diet, etc) is in place. And apparently the answer is there is no true consensus.