For those patients who are temporarily chair bound, consideration should be given to cushions that furnish maximum pressure reduction over the ischial tuberosities, adequate support, and comfort Proper body alignment is essential for chair bound patients. Patients who are able must be instructed to reposition themselves at 15-20 minute intervals. Patients who have sufficient upper body strength should be taught to do wheelchair push-ups. Nutrition Nutrition is important for maintaining tissue integrity. Sufficient nutrients for individual needs must be available.
Dietary consultation is indicated for nutritional evaluation.
The diet prescription should consider patient preferences and special needs, such as a dental soft diet for and endentuous patient. Assistance with meals may include opening food containers, elevating the head of the bed to allow the patient to eat or be fed, providing an environment conducive to eating and allowing sufficient time and assistance for optimal oral intake. When, despite these measures, patients are unable to consume adequate amounts of nutrients, tube feeding or parenteral alimentation should be considered. Patient and family preferences and the overall goals of treatment should guide these decisions. Reversible causes include urinary tract infection medications confusion fecal impaction polyuria due to glycosuria or hypercalcemia restricted mobility due to restraints A bowel training program must be instituted for spinal cord injury patients.