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Clinical Nutrition 2 > APNED vs. IDDSI > Flashcards

APNED vs. IDDSI Flashcards

1
Q

What does APNED stand for

A

Association professionnelle des nutritionnistes exprets en dysphagie

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2
Q

What is the mandate of APNED?

A
  • To share expertise

- Encourage the exchange of ideas and experiences of clinical practices in the area of dysphagia.

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3
Q

APNED modified textures from most permissive to most restrictive?

A

-Tender, Soft, Minced, Pureed

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4
Q

APNED liquids from most permissive to most restrictive?

A

-Clear, Nectar, Honey, Pudding

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5
Q

What does “more restrictive” include?

A

The lower restrictions plus additional restrictions
–> If an item is not allowed on a less restrictive diet, then automatically it would not be allowed on a more restrictive diet

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6
Q

Tender?

A
  • A regular menu
  • Everything allowed except hard or raw foods
  • Most vegetables are cooked
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7
Q

Permitted foods tender?

A
  • Firm food
  • Crunchy fod
  • Sticky food (Soft PB ok, but not crunchy PB)
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8
Q

Not permitted foods tender?

A
  • Hard, raw vegetables
  • Nuts
  • Hard, dried fruits
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9
Q

When is soft ideal?

A

-Chewing is posible, but more difficults

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10
Q

Permitted foods soft?

A
  • Partially firm food, that can be separated by a fork

- Tourtiere, meat pie, hashbrowns, quiche

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11
Q

Not permitted foods soft?

A
  • Grilled or tough meat or in lage pieced

- Sticky food (peanut butte)

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12
Q

When is minced diet ideal?

A
  • Minimal chewing required

- Food can be re-shaped or re-formed

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13
Q

Permitted foods on minced diet?

A
  • Finely sliced food (<5 mm) with obligatory sauce

- Meat loaf, small pasta and ground meats

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14
Q

Not permitted foods on the minced diet?

A
  • Crust (meat pie, quiche)

- Grilled sausage

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15
Q

When is the pureed diet ideal?

A
  • When there is no chewing necessary

- Can be reshaped or reformed

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16
Q

Permitted foods on puree?

A
  • Smooth puree

- Fish puree, meat puree

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17
Q

What is not permitted on puree?

A

Any puree with texture

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18
Q

Clear fluids?

A
  • Regular liquids
  • No change require
    i. e. water, coffee, tea, fruit juice, milk
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19
Q

Clear fluids on bostwich?

A

24 cm/30 sec

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20
Q

Nectar fluids?

A
  • Can be taken with a glass or straw
  • Slowly flows from spoon
    i. e. Cold tomato jice, eggnog, yoplait drink
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21
Q

Nectar fluids on boswitch?

A

14 cm/30 seconds

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22
Q

Honey fluid?

A
  • Can be taken with a spoon, but doesnt hold shape
  • Too thick with a straw
    i. e. tomato sauce, yogurt, honey
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23
Q

Honey fluid on boswitch?

A

8 cm/30 seconds

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24
Q

Pudding liquids?

A

Very thick liquid, must be taken with spoon

i.e. pudding, firm yogurt

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25
Q

Pudding liquid on boswitch?

A

4 cm/30 seconds

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26
Q

What does IDDSI stand for?

A

International Dysphagia Diet Standardisation Initiative

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27
Q

Objectives of IDDSI?

A
  • Standardize naming and descriptions of texture modified foods an thickened liquids
  • Develop person focused global terminology for people of all cultures
  • Seek common language that can be used for technical, cultural, professional and non-professional uses
28
Q

Why do we need to learn IDDS?

A
  • Due to a possible transition into the IDDSI system in Quebec in the future
  • DC supports IDDSI
29
Q

IDDSI Foods from more permissive to more restrictive?

A

-Regular, soft & bite-sized, minced & moist, pureed, liquidized

30
Q

IDDSI liquids from more permissive to more restrictive?

A

Thin, slightly thick, mildly thick, moderately thick, extremely thick

31
Q

Which foods are transitional foods in IDDSI ? (3)

A

-Regular, Soft & Bite Size, Minced & Moist

32
Q

Regular foods?

A
  • Normal, everyday foods of various textures an sizes

- Any method can be used to eat these foods

33
Q

Normals sizes of regular foods for pediatric and adults?

A
  • Pediatric: Larger or smaller than 8 mm

- Adult: Larger or smaller than 15 mm

34
Q

Normal textures of regular foods?

A
  • hard, crunchy, soft, chewy, fibrous, stringy, dry, crispy

- Food with seeds, husks bone

35
Q

What is soft and bite sized foods?

A
  • Can be eaten with a fork, spoon or chopsticks
  • Can be mashed/broken down with a fork
  • No knife or chewing required
  • Soft, tender, moist foods with no separate thin liquids
36
Q

Bite sized pieces of foods in “soft and bite-sized” in Pediatric and Adults?

A

Pediatric: <8 mm
Adults: <15 mm

37
Q

Permitted foods on “soft and bite sized”?

A
  • Soft, tender meats <15 mm
  • Steamed, boiled vegetables
  • Mashed or cut fruit
  • Crumbly textures
38
Q

No permitted foods on “Soft and bite sized”?

A
  • Firm meat, fish and bones
  • Hard, raw, stir-fried vegetables
  • Mixed thin/thick textures
  • Regular dry break
39
Q

What is 15 mm equal to?

A

Adult thumbnail or standard fork

40
Q

What is the fork pressure test in “soft & bite sized”?

A
  • Pressure from fork held on its side can “cut” foods

- When a sample is pressed with the base of a fork, the sample is squashed and does not return to it’s original shape

41
Q

What is minced and moist?

A
  • Food can be eaten with a fork or a spoon
  • Can be scooped & shaped on a plate
  • Lumps are easy to squash with tongue
  • Minimal chewing required
  • Soft, moist foods with no separate thin liquid
42
Q

Permitted foods on minced and moist?

A
  • Finely minced, chopped and mashed foods <4 mm

- Extremely thick, smooth or non-pouring sauce or gravy

43
Q

Not permitted foods on minced and moist?

A
  • Particles larger than 2mm

- Similar restrictions to level 6 soft and bite size

44
Q

Fork pressure test in minced and moist?

A
  • When pressed with fork, particles should be easily separated and come through the prongs
  • Easily mashed with little pressure
45
Q

What is roughly 4mm?

A

Similar width of the pongs between a standard fork

46
Q

What are transitional foods?

A
  • Foods that start as one texture, and then finish as another texture
  • Specifically, when moisture is applied o changes in texture occur
47
Q

Rationale for transitional food?

A
  • Minimal chewing required
  • Tongue pressure sufficient to break food down after change in state
  • Developmental teaching or rehab of chewing skills
48
Q

Examples of transitional foods?

A
  • ice chips
  • cie crea
  • Wafers
  • waffle cones
  • Potato crisps
  • Shortbread
49
Q

Fork pressure test with transitional foods?

A

After moisture or temperature is applies, sample can be easily deformed and doesn’t recover it’s shape

50
Q

Pureed/Extremely thick?

A
  • Usually eaten with a spoon
  • Cannot be drink from a cup or straw
  • Does not require chewing
  • Can be piped, layered or molder
  • No lump, not sticks
  • Liquids must not separate from solid
51
Q

Fork drip test in pureed?

A

-Small amount may flow through and form tail below fork, but does not flow or drip continuously

52
Q

Spoon tilt test in pureed?

A

Cohesive enough to hold it’s shape on spoon. Not firm or sticky, with little food left on spoon when tilted

53
Q

What is the liquidized/moderately thick?

A
  • Can be drunk from a cup
  • Some effort is required to suck through standard bore straw
  • Cannot be piped, layered or molded
  • Cannot be eater with a fork
  • Can be eaten with a spoon
  • No oral processing or chewing required
  • Smooth texture
54
Q

Example of liquidized/moderately thick?

A
  • Sauces, gravies
  • Fruit syrup
  • Runny pureed fruit
55
Q

Fork drip test in liquidize?

A
  • Drips slowly in dollops through prongs of fork
  • Prongs of fork do not leave clear patten on surface of test liquid
  • Spreads out if spilled onto flat surface-
56
Q

IDDSI flow test for liquidized?

A

-When the test liquid flow through 10 ml slip tip syringe it leaves >8 ml in the syringe after 10 seconds

57
Q

Mildly thick liquids?

A
  • Flows off a spoon
  • Sippable, pours quickly from spoon but slower than thin drinks
  • Effort required to drink through standard bore straw
58
Q

IDDSI flow test in mildly thick?

A

-When test liquid flows through 10 ml slip tup syringe and leaves 4-8 ml after 10 seconds

59
Q

Slightly thick ?

A
  • Thicker tha wate
  • Requires a little more effort to drink than thin liquids
  • Flows through straw or syringe
  • Similar to thickness of anti-regurgitations infant formula
60
Q

IDDSI flow test for slightly thick?

A

-When test liquid flows through 10 ml slip tip syringe and leaves 1-4 ml after 20 seconds

61
Q

Thin?

A
  • Flows like water

- Fast flow

62
Q

IDDSI flow test for thin?

A

-When test liquid flows through 10 ml slip tip syringe is leaves no residue after 10 seconds

63
Q

APNED tender/Soft, IDDSI?

A

Regular

64
Q

APNED Tender, Soft, Minced, IDDSI?

A

Soft & Bite Sized

65
Q

Ice cream?

A

Regularon IDDSI

Clinical Nutrition 2 (21 decks)

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