Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Symptoms and Potential Nutrition Solutions


  1. Dyspnea and fatigue
  2. Dysphagia/Dental problems
  3. Oral thrush due to improper inhaled corticosteroid use
  4. Decreased appetite related to impact of disease, depression and/or social isolation
  5. Dyspepsia/Aerophagia
  6. Early satiety during meals
  7. Constipation

Dyspnea and fatigue


  • Consider easy meal preparation.
  • Prepare meals utilizing simple recipes in bulk where single portions can be frozen.
  • Stocking up on prepared foods may also be an alternate solution.
  • Arrangements of home delivered meals may also be a possibility.
  • Encourage resting before eating and cough techniques prior to meals (if necessary).
  • Encourage the individuals to eat slowly and utilize pursed-lip breathing.
  • Consider use of oxygen (if indicated) at meal times.

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Dysphagia/Dental problems

  • Promote good dental hygiene.
  • Assess denture fit and ensure adequate oral rinsing.
  • Encourage high calorie, dense foods in a soft diet.
  • Consider liquid nutritional supplementation.

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Oral thrush due to improper inhaled corticosteroid use

  • Assess oral cavity.
  • Promote good dental hygiene.
  • Ensure appropriate medical follow up.
  • Ensure adequate rinsing of mouth post-inhaled corticosteroid. Consider liquid nutritional supplementation if individual is unable to eat.
  • Utilize holding chamber

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Decreased appetite related to impact of disease, depression and/or social isolation

  • Assess nutritional intake and eating habits.
  • Consider alternative eating environments (e.g., church-based or communitybased volunteer programs)
  • Promote easy meal preparation alternatives (e.g., meals on wheels)

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  • Encourage individuals to eat slowly and chew food well. Smaller meals (5-6 small meals/day) are ideal for encouraging adequate nutritional intake.
  • Avoid drinking while eating or carbonated beverages to prevent gas swallowing.
  • Gas producing foods such as broccoli, cabbage, cauliflower and onions should be avoided.

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Early satiety during meals

  • Avoid drinking liquids one hour prior to meal time.
  • Cold meals instead of hot meals, as hot meals create a sense of fullness.
  • Consider liquid nutritional supplementation, to compensate for inadequate nutritional intake.

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  • Recommend high fibre foods and drinking of fluids.
  • Promote mobility by encouraging exercise/activity as tolerated.

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