Quick Reference
Therapeutic diets are individualized food and fluid plans used to support medical and nutritional needs.
| Diet | Purpose | CNA Considerations |
|---|---|---|
| DASH | Supports blood-pressure management | Encourage ordered fruits, vegetables, whole grains, and appropriate lower-sodium choices |
| Diabetes meal plan | Supports blood glucose management | Verify meal, observe intake, and promptly report missed meals |
| Low-sodium | Limits sodium intake when clinically indicated | Follow prescribed restrictions |
| Heart-healthy | Limits saturated fat and emphasizes nutrient-rich foods | Follow individualized meal plan |
| Gluten-free | Avoids gluten for conditions such as celiac disease | Check for wheat, barley, rye, and cross-contact |
| Lactose-restricted | Reduces symptoms of lactose intolerance | Follow ordered dairy substitutions and restrictions |
| Texture-modified | Supports residents with chewing or swallowing problems | Verify exact prescribed food texture |
| Thickened liquids | Alters liquid consistency for certain swallowing difficulties | Verify prescribed thickness and permitted equipment |
Gluten-Free Diet
For celiac disease, gluten-containing grains include:
- Wheat.
- Barley.
- Rye.
- Triticale.
Naturally gluten-free options include rice, corn, quinoa, potatoes, and other appropriate foods.
Check for cross-contact and hidden gluten in ingredients.
Postoperative Diets
Common diet orders include:
- NPO: Nothing by mouth, except as explicitly authorized.
- Clear liquids: Transparent liquids allowed by the prescribed plan.
- Full liquids: A wider range of liquids and foods that become liquid, as defined by the order.
- Soft diet: Foods requiring less chewing or otherwise modified as directed.
- Regular diet: Foods without a prescribed texture restriction, subject to other diet orders.
Do not independently advance a resident’s diet.
Enteral & Parenteral Nutrition
Enteral Nutrition:
- Delivers nutrition into the gastrointestinal tract using a feeding tube.
- May use nasogastric, gastrostomy, or other approved access.
- Can be continuous or intermittent.
Total Parenteral Nutrition (TPN):
- Delivers prescribed nutrients intravenously.
- Bypasses the gastrointestinal tract.
- Requires specialized clinical management.
CNA Responsibilities:
- Protect tubing and equipment during routine care.
- Follow positioning and mobility restrictions.
- Observe and report concerning symptoms or equipment problems.
- Do not independently administer or adjust enteral or parenteral nutrition.
Fluid Restrictions
Residents may have individualized restrictions related to heart, kidney, or other medical conditions.
- Follow the ordered daily fluid allowance.
- Record intake as assigned.
- Include foods counted as fluids under facility policy.
- Respect the resident’s preferences and choices.
- Report requests that conflict with the care plan or concerns about dehydration.
- Never independently change a fluid restriction.
Diabetes & Meal Safety
- Verify the prescribed meal and meal timing.
- Follow ordered glucose-check and meal-coordination procedures.
- Report poor intake or a missed meal promptly.
- Observe for symptoms concerning for hypoglycemia or hyperglycemia.
- Do not independently administer glucose-lowering treatment or change medication timing.
Digestive Problems & Nutrition
Nausea and Vomiting
- Observe frequency, amount, and associated symptoms.
- Follow prescribed diet and fluid restrictions.
- Provide approved comfort and hygiene assistance.
- Report persistent vomiting, abdominal pain, or inability to tolerate intake.
Diarrhea
- Offer timely toileting assistance.
- Follow infection-prevention precautions.
- Provide appropriate skin cleansing and protection.
- Observe for changes in stool and possible dehydration.
- Report new, severe, or persistent diarrhea.
Malnutrition
Possible concerns include:
- Persistent inadequate intake.
- Unintentional weight loss.
- Weakness or functional decline.
- Poor wound healing.
Report observations rather than independently diagnosing malnutrition.
Important Considerations
- Always verify that the resident receives the correct meal.
- Diet restrictions, food textures, and fluid consistencies are resident-specific.
- Never substitute foods or liquids when their safety or compatibility is uncertain.
- Respect food preferences, culture, and informed refusal.
- Do not independently modify diet orders or nutrition treatments.
Related
- Nutrition & Essential Nutrients
- Assisting with Feeding
- Dysphagia & Aspiration Precautions
- Measuring Intake & Output
- Dehydration
- Care of Residents With Medical Tubing
- Digestive System
Sources
- CNA Module 11C — Diet Therapy
- NHLBI — DASH Eating Plan
- NIDDK — Eating, Diet, & Nutrition for Celiac Disease
- ASHA — Adult Dysphagia
- IDDSI — Framework
- Facility therapeutic diet, nutrition, and fluid-restriction policies
Flashcards
What is the purpose of a therapeutic diet?01-foundations / reference-guidelines
Answer
Support individualized medical and nutritional needs.
Which grains contain gluten?01-foundations / reference-guidelines
Answer
Wheat, barley, rye, and triticale.
What does NPO mean?01-foundations / reference-guidelines
Answer
Nothing by mouth unless explicitly authorized.
What is the difference between enteral and parenteral nutrition?02-mechanisms / reference-guidelines
Answer
Enteral uses the GI tract; parenteral delivers nutrients intravenously.
May a CNA independently advance a postsurgical diet?03-application / reference-guidelines
Answer
No. Follow the prescribed diet and nursing direction.
What should a CNA do when a resident with diabetes misses a meal?03-application / reference-guidelines
Answer
Notify the nurse promptly and follow the care plan.