Fluid restriction diet - 800ml
This document is part of the ACI Diet Specifications for Adult Inpatients. It is not to be used for patient education.
Aim
To control the number of beverages provided to patients requiring strict fluid restriction, limiting fluid intake to 800mL per day.
Characteristics
The diet counts the beverages, soups and jelly as drink exchanges. It does not count the fluids from other foods including custard, yoghurt and ice cream. All canned and portion-controlled fruits are served drained.
Patient beverage selections can be edited to conform to the following suggested patterns of drink exchanges (including beverages, thickened fluids, soup and jelly as drink exchanges):
| Meal | 100mL drink exchange | 200mL drink exchange |
|---|---|---|
| Breakfast | 2 | 1 |
| Morning tea | 0 | 0 |
| Lunch | 2 | 1 |
| Afternoon tea | 1 | 1 |
| Dinner | 2 | 1 |
| Supper | 1 | 0 |
Indications
Where appropriate, clinicians may consider ordering this diet for patients:
Controlling fluid overload in:
- end-stage renal failure or dialysis
- congestive cardiac failure
- liver failure with ascites.
Nutritional adequacy
This diet is nutritionally adequate.
Precautions
- All beverages are offered on the menu but will be counted in the pattern. In order to meet protein and energy requirements, custard, yoghurt and ice cream are not counted as fluids. Solid food choices are allowed, depending on diet prescription.
- Water jug or bottled water should not be left by bedside.
- The patterns above should be modified in accordance with the diet prescription and in consultation with the patient. The treating multidisciplinary team needs to apply caution when combining this diet with thickened fluid diets (mild, 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, soups).
- Fluid intake and measurement remains the responsibility of nursing staff.
Paediatrics
Suitable for use in paediatrics when combined with an age-appropriate diet.
Specific menu planning guidelines
| Allowed | Not allowed | |
|---|---|---|
| Hot main dishes | As allowed by diet prescription | - |
| Sauces, gravies | As allowed by diet prescription | - |
| Starchy vegetables / pasta / rice | As allowed by diet prescription | - |
| Vegetables | As allowed by diet prescription | - |
| Soups | As allowed by diet prescription | - |
| Sandwiches | As allowed by diet prescription | - |
| Salads, dressings | As allowed by diet prescription | - |
| Breads, cereals | As allowed by diet prescription | - |
| Spreads | As allowed by diet prescription | - |
| Hot breakfast choices | As allowed by diet prescription | - |
| Fruit | As allowed by diet prescription Canned fruit drained of juice Portion-control fruit snack pack opened and drained of juice/syrup | - |
| Yoghurt | As allowed by diet prescription | - |
| Desserts | As allowed by diet prescription | - |
| Milk and cheese | As allowed by diet prescription | - |
| Beverages | As allowed by diet prescription | - |
| Biscuits | As allowed by diet prescription | - |
| Miscellaneous | As allowed by diet prescription | - |
References
- Dietitians Association of Australia. Nutrition manual. 9th ed. Canberra: DAA; 2014.
- Iowa Dietetic Association. 2007. Simplified dietetic manual 10th ed. Ames: Blackwell.
- Dietitians Association of Australia: Australia and New Zealand Renal Guidelines Taskforce. Evidence based practice guidelines for the nutritional management of chronic kidney disease. Nutr Diet 2006;63 Suppl 2:S35-45.
- Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG et al. ACC / AHA guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology / American Heart Association Task Force on Practice Guidelines. Circulation 2005;105:e154-234.
- Gines P, Cardenas A, Arroyo V, Rodes J. Management of cirrhosis and ascites. N Engl J Med 2004;350(16):1646-54.