Silly question about what is considered a liquid

[queenjean]

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?

[nightmare, RN]

What kind of pudding was it?

[flightnurse2b, LPN]

correct me if im wrong...i think pudding and jello are colloids when they're cold. so they would be considered liquid suspended in a solid, right?

i think you're right... i think they are liquids.

[nightmare, RN]

Our usual rule of thumb is that if it started out as a liquid in the cooking process then it can be counted as a liquid.

[hypocaffeinemia, BSN, RN]

What's silly is that we put all this weight on "is it a liquid or a solid"?

The fact is that a significant portion of most presumably solid foods are water. Look at fruits and veggies, and even meat. You can survive on just the water from solid food.

If it gets hot in the microwave it's safe to assume that there's a decent amount of water in it (that's how microwaves work, after all).

Now, unless we're going to require nurses to perform mass analysis to determine the specific amounts of water per food item, fluid restrictions are merely reasonable guidelines for treatment and should be respected when something is clearly a liquid.

Regarding pudding-- yes, there's a decent amount of water in it that will be absorbed upon digestion. Whether or not you choose to restrict that should be a judgment call based on your assessment of the patient, their hydration and nutritional status, and even their psychological status.

Hope this helps.

[nessajune21]

Pudding is listed on the "full liquid diet" menu, correct?

[psalm51]

the principle is that if it will beccome liquid when left at room temperature, then it is liquid.

pudding qualifies.

[hypocaffeinemia, BSN, RN]

the principle is that if it will beccome liquid when left at room temperature, then it is liquid.

pudding qualifies.

No, I'm afraid that's not the principle at all. The patient's body doesn't care if its H2O comes from a bottle of water or room temperature pudding or green beans or a juicy chicken breast. It all gets absorbed during digestion and affects the body identically.

Whether or not something is a liquid at room temperature is merely an easy way to visualize its water content-- not a principle. If we could determine the exact water content of other foods as easily, we might find that a salad contains more water than a jello cup, for instance.

[Murse901, MSN, RN]

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.

[locolorenzo22, BSN, RN]

true, but if it "breaks down" to mostly liquid content...i.e pudding started as milk, then thickened with solution and cooked...in reverse, it goes back to liquid....so I would count it. But, I wouldn't consider it diet restriction unless he was gorging on it...if he needed the calories for nutrition, I would probably let him have it.

[Murse901, MSN, RN]

if he needed the calories for nutrition, I would probably let him have it.

I 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.

That way, you don't starve your patient, you make do with what's stocked, and you CYA.

[Dolce, RN]

I've never counted pudding as a liquid. Ice cream and jello, yes. Pudding, no.