Nutrition, Hydration, and Elimination
Diets and swallowing
The care plan specifies a regular, mechanical soft, pureed, low-sodium, low-fat, renal, or carbohydrate-controlled diet, and a thin, nectar-thick, honey-thick, or spoon-thick liquid. Never change a diet on your own, even if the resident asks. For dysphagia, sit the resident upright at 90 degrees, chin tucked slightly, small bites, one texture at a time, and check the mouth for pocketing after the meal. Keep the resident upright for at least 30 minutes after eating to prevent aspiration. Signs of aspiration are coughing, choking, a wet voice, or tearing at meals - stop and report.
Hydration
Offer fluids frequently and record intake. Dehydration shows as dry mouth, dark concentrated urine, poor skin turgor, and confusion. Respect fluid restrictions exactly. NPO means nothing by mouth - no water and no ice chips - unless the plan says otherwise.
Feeding
Feed at the resident's pace, offer choices, engage them, and allow finger foods when able. Never feed a resident who is lying flat, and never force food; report refusals.
Elimination
Record output; typical adult urine output is about 1500 mL per day, and output below 30 mL per hour is reported. Give catheter care with soap and water, front to back, and keep the bag below bladder level. Record bowel movements, including color and consistency. Encourage fluids and activity for constipation as the plan allows.
Traps
NPO items that offer ice chips, aides changing diets, and thickened-liquid shortcuts.
Rule of thumb
Feeding is about safety first - upright, slow, small bites, and watching the swallow - not finishing the tray.