Calorie restricted diet in the hospital? Thoughts?

[RNingBSNing]

For no other reason than that the patient is overweight, the physician placed a 1200 calorie restriction on the diet order (side note, I wonder if she informed the pt of this). I just think that if someone is sick in the hospital trying to heal they need the calories, do we really need to start their diet now? I think it probably just causes more harm then good for the short time that they're in the hospital.

What are your thoughts on this?

[Lunah, MSN, RN]

Has Nutrition been consulted? And did the physician actually say that the only reason was the patient being overweight?

[RNingBSNing]

No nutrition consult, physician did not make pt or nursing aware, I guess the physician didn't explicity state that her weight was the reason why, but the pt is very overweight and her history is benign other than HF, HTN. Why, exactly, would a 1200 cal diet be indicated?

[RNNPICU, BSN, RN]

With Heart failure, Hypertension, and obesity, all of those are good reasons for a calorie restricted diet. Nutrition Consult would probably help. Is the patient on a specific pathway? Sometimes some pathways may have specific treatment modalities which would include a calorie restricted diet. A 1200 calorie/day diet for a patient in a hospital that may not be moving or active is not bad.

[blondy2061h, MSN, RN]

What is the patient in the hospital for?

[KatieMI, BSN, MSN, RN]

1200 kcal/day may not be enough for basic metabolic needs of an obese patient. Plus, such super-restrictive diet is not likely to induce compliance in the future.

Be an advocate and ask for dietary consult.

[RNingBSNing]

HF exacerbation.

[Here.I.Stand, BSN, RN]

With Heart failure, Hypertension, and obesity, all of those are good reasons for a calorie restricted diet[/Quote]

But would restricting the diet for the hospitaization alone really accomplish anything? Weight loss would definitely help manage those conditions, but weight loss involves long-term lifestyle changes which need to be a priority for the PATIENT. A crash diet in the hospital won't suffice, because 1) it's short term, and 2) it's not the pt's decision.

Plus, if the pt is "starving," wouldn't they be more likely to ask their family to bring food? Possibly junk food? At least if getting a standard cal diet in the hospital, they would be getting more fruits, veggies, and protein.

That's assuming the pt didn't know about it...I can see if the PCP was aware pt was following a 1200 cal diet at home as part of a wt loss plan.

[Lunah, MSN, RN]

Definitely begs a nutrition consult. I was recently hospitalized for congestive heart failure and peripartum cardiomyopathy (probably the pinnacle of my body's pregnancy-related shenanigans thus far) and I realized that I was not fluid restricted and my I/O were not measured. Not great, so I monitored my own fluid intake, and I also lost 12 lb of fluid overnight courtesy of our friend furosemide. I mentioned all this to the director when she rounded on me. In a nutshell, it's up to us to advocate for our patients (and sometimes that patient is us!). Ask for a Nutrition consult. You are smart to question stuff. :)