Fluid restriction diet - 800mL

Aim

To provide a diet that limits total daily fluid intake to 800mL for patients requiring strict fluid restriction, including beverages and fluid-containing foods.

Characteristics

• The diet counts the beverages and jelly as fluid exchanges. It does not count the fluids from other foods, including custard, yoghurt, ice cream and oral nutrition supplements.
• Soup is not offered on this diet.
• All canned and portion-controlled fruits are served drained.
• Patient fluid selections are edited to conform to the following suggested pattern of 100mL fluid exchanges, including beverages and jelly as fluid exchanges.
• Clinicians can modify the pattern of exchange distribution to meet a patient’s individual needs.

Table 1: Example pattern of fluid exchange distribution over a day

Meal	100mL fluid exchange
Breakfast	2
Morning tea	0
Lunch	2
Afternoon tea	1
Dinner	2
Supper	1

The following tolerances are applied when calculating fluid exchanges.

Table 2: Fluid exchange (ex) ranges used in pattern coding

Exchanges (ex)	Fluid exchange range
1	75–150mL
2	151–250mL
3	251–350mL

Indications

Consider for patients where prevention and management of fluid overload is important, e.g. end-stage renal failure or dialysis, congestive cardiac failure or liver failure with ascites.

Nutritional adequacy

This diet is nutritionally adequate. It can provide sufficient nutrition to patients without the need for supplementation.

Precautions

• Fluid intake and measurement remains the responsibility of nursing staff.
• All beverages are offered on the menu but will be counted in the pattern, with the exception of oral nutrition supplements.
• To meet protein and energy requirements, custard, yoghurt, ice cream and oral nutrition supplements are not counted as fluids.
• Water is provided at the ward level and is not included in the diet pattern. It is to be provided in smaller decanted volumes.
• Water jug or bottled water should not be left by the patient bedside. They may be stored in an alternative location for clinical staff to access and offer to the patient, as needed, to contribute towards daily fluid target of 800mL.
• The patterns of fluid exchanges should be modified in accordance with the diet prescription and in consultation with the patient.
• ‘Fluid restriction diet - nil beverages on tray’ can be considered as an alternative diet if clinically indicated.
• The treating multidisciplinary team needs to apply caution when combining this diet with thickened fluid diets (slightly, mildly, moderately and extremely thick) to ensure adequate hydration.
• The pattern may provide up to 900mL in total volume to accommodate commercial beverage packaging and available fluid content, e.g. thickened fluids.
• Solid food choices are allowed depending on the individual diet prescription.

Paediatrics

Suitable for use in paediatrics when combined with an age-appropriate diet.

Paediatric formula intake should be prioritised, with oral fluids limited according to the child’s total prescribed fluid allowance.

‘Fluid restriction diet - nil beverages on tray’ may be a more appropriate diet code for infants and children where fluid intake is predominantly formulae, breastmilk or paediatric oral nutrition supplements, and fluid provision is managed by nursing staff.

Specific menu planning guidelines

	Allowed	Not allowed
Hot main dishes	All	Nil
Sauces, gravies	All	Nil
Starchy vegetables / pasta / rice	All	Nil
Vegetables	All	Nil
Soups	Nil	All
Sandwiches	All	Nil
Salads, dressings	All	Nil
Breads, cereals	All	Nil
Spreads	All	Nil
Hot breakfast choices	All	Nil
Fruit	Canned fruit drained of juice Portion-control fruit snack pack, opened and drained of juice or syrup All others	Undrained canned or packaged fruit
Yoghurt	All	Nil
Desserts	All	Nil
Milk and cheese	All	Nil
Beverages	All	Nil
Biscuits	All	Nil
Miscellaneous	All	Nil
Celebratory foods, special occasions	All	Nil

< id="">Change log