Nutrition, Feeding and Elimination Support
The basics
A balanced diet supplies energy, protein, vitamins, minerals and fibre. Therapeutic diets include diabetic (complex carbohydrate, no free sugar), low-salt (under 5 g daily), low-fat, high-protein for healing, high-fibre for constipation, fluid-restricted and renal diets. The dietitian prescribes; the GDA serves, assists and observes.
Feeding safely
Position the patient upright, ideally 90 degrees, and keep them up for at least 30 minutes after the meal. Give small bites, allow chewing, and watch for coughing, pocketing, a wet voice or drooling, which suggest dysphagia. Thickened fluids and a chin-tuck position help. Never feed an unconscious or drowsy patient orally and never force food. Record the amount eaten and any difficulty. Tube feeds are given by the nurse; the GDA may position the patient and report vomiting, distension or poor tolerance.
Elimination support
Know the patient's normal bowel pattern. Offer the bedpan, urinal or commode at regular intervals with privacy and hygiene; clean front to back after perineal soiling. Report constipation, diarrhoea, blood in stool or urine, and inability to pass urine.
Catheter and urine care
Keep the drainage bag below bladder level and off the floor, empty it when two-thirds full, use a separate container for each patient, measure output and maintain perineal hygiene. Never raise the bag during transfer.
Worked example
A stroke patient coughs and dribbles during feeding. Stop feeding, sit him upright, check the mouth for retained food, and report to the nurse for a swallowing assessment. The reasoning is aspiration risk, not fussiness.
Traps
Feeding a drowsy patient, raising the catheter bag above the bladder, recording output without measuring, and giving oral fluids to a patient who is fluid-restricted or awaiting surgery.