Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                

Ass

Download as pdf or txt
Download as pdf or txt
You are on page 1of 27

1

Academy:fitness with gomzi international institute of


teaching.[fgiit]

Name: solanki vicky mahesh bhai

Class: diploma in nutrition

Internship duration:23/01/2023-22/02/2023 1 month

Directed by: Dt.swati madam


Dt.vinita madam
Dt.reshma madam

I had done my internship in SHALBY HOSPITAL in dietetics under


dt. Reshma madam,dt.vinita madam and Dt .swati madam . It was an
amazing experience by learning from them . I learned a bundle of
knowledge from them . I am very thankful to them for helping me to
complete my internship successfully .
2

Abbreviation

Sr .no Short form Full form

1 Fd Full diet

2 Sd Soft diet

3 Add Anti diabetic diet

4 Ld Liquid diet

5 Nbm Nil by mouth

6 Rt Ryle tube feeding

7 Bd Blend diet

8 Ffd Fat free diet

9 Srd Salt restricted diet

10 Sfd Salt free diet

11 H/o History of

12 I/o Instead of

13 Hpd High protein diet

14 Prd Protein restricted diet

15 Njf Nausea jejunal feeding

16 A/h/o Acute history of

17 S/o Symptoms of

18 Ui Under investigation

19 Dd Diabetic diet

20 Md Milk diet

21 Pw Present with

22 Cpr Cardiopulmonary resuscitation


3

23 K/o Known case of

24 Htn Hypertension

25 Dm Diabetic mellitus

26 Tkr Total knee replacement

27 Cfa Common femoral artery

28 Ilh Interstitial laser hyperthermia

29 Lmca Left main coronary artery

30 Lad Left anterior descending artery

31 Lcx Left circumflex artery

32 Rca Right coronary artery

33 Lvef Left ventricular ejection fraction

34 Cag Coronary angiogram report


About shalby hospital [surat]

Shalby Multi-specialty Hospitals


Shalby Surat, located in Surat, is a multi-specialty hospital set up in March 2017.
Shalby Hospital Surat currently provides outpatient services to our patients.

With a bed capacity of 243 beds as on March 31, 2017, through Shalby Surat, we
provide tertiary care facilities including Medical and Surgical intensive care, Modular
Operation Theatres with Laminar flow, Labour Room, Nursery, Neonatal Intensive Care
Unit, Carl Zeiss Neurosurgery Microscope, C ARMs, Cardiac Cath Lab, MRI, CT,
Sonography, Digital X-Ray, in-house Pathology, Dialysis, Endoscope, Colonoscope,
Laparoscope, Ventilators, TMT, ECHO, EEG, EMG, PFT, NCV, Uroflowmetery,
Audiometer, OPG, 24 Hour Emergency services, pharmacy, and a fleet of advanced
Ambulances which can operate like a mini ICU. The hospital has a dedicated area for
Preventive Health checkups and Corporate wellness.
4

The hospital has a dedicated team of Super Specialists and Consultants providing
medical care par metro cities. This team is stationed at the hospital and provide
multidisciplinary care to complex cases.

Shalby Hospital, Surat is the First Hospital in South Gujarat to have most advanced
Thulium Laser for minimally invasive Prostate and Stone Surgery.

The hospital is specialized in the following fields:

Anesthesiology
Arthoscopy
Cardiology
Cardio-Thoracic and Vascular Surgery
Critical Care (ICU)
Dermatology
Endocrinology
ENT (Ear , Nose , Throat)
General and Laparoscopic Surgery
Heamatology And Heamato-Oncology
Hepatobiliary and Pancreatic Surgery
Internal Medicine
Interventional Radiology
Joint Replacement Surgery
Medical and Surgical Gastroenterology
Medical and Surgical Oncology
Nephrology and Dialysis
Neurology and Neurosurgery
Obstetrics and Gynecology
Ophthalmology and Glaucoma
Orthopedics and Trauma
Pathology and Microbiology
Pediatrics and Pediatrics Surgery
Plastic and Cosmetic Surgery
Preventive Health Checkup
Psyschology and Psychiatry
Pulmonology
Radiology and Imaging
Rehabilitation and Physiotherapy
5

Rheumatology
Spine Surgery
Urology

There are total 9 floor in the hospital .


On each floor there are 4 wings . Basement area- Physiotherapist , IP ( Indoor
pharmacy ) . MRD ( Medical Record Department ) , General Store Ground floor
Emergency department , Billing , X - ray room , OP ( Outdoor Pharmacy )

1 - Floor : OPD ( Outpatient Department )


2 - Floor : ICU , CATH Lab ( Catheterization Lab ) , OT ( Operation Theater )
3 - Floor : Covid ICU , General word , CSSD ( Central sterile supply department )
4 - Floor : Twin sharing room ( 2 patient ) , General room ( 3 patient )
5 - Floor : Covid twin sharing room .
6 - Floor : Floor closed for some reason .
7 - Floor : Premium ward ( 1 patient ) + Twin sharing :
8 - Floor : Administration , Pathology , IT ( Information Technology ) Department
9 - Floor : Canteen , Dialysis , Neonatal Department , Clinical Research , Cafeteria

FOOD SERVICES PROVIDED TO PATIENT

Premium Room : 6 Services ( 7 Floor ) Breakfast- 8 am


Appetizer- 10 am
Lunch- 12-1 pm .
Snacks - 4 pm
Dinner - 7-8 pm
Night milk 10 pm .
Twin sharing : 4 Services ( 4 Floor ) Breakfast- 8 pm
Lunch - 12-1 pm
Snacks - 4 pm
Dinner - 7-8 pm
Maa - Yojna , Aayushman Bharat Yojna , ESCI ( Employees State Insurance Coproration
) -3 .
services : Breakfast 8 pm
Lunch - 12-1 pm
Dinner - 7-8 pm
RT Feeding , NJ Feeding , Liquid diet : 9 service every 2 hours
6

WAYS TO PROVIDE FOOD SERVICES

Types of diet- Full diet


Salt restricted diet
Diabetic diet
Soft diet
Blend diet
Fat free diet
High protein diet
Salt free diet
Renal diet
Milk diet

Method of administration-
Orally
NBM ( Nil by mouth )
RT Feeding ( Ryle's Tube ) .
Liquid only
NJ Feeding ( Naso Jejunal )
7

23/01/2023

It was my first day at Shelby Hospital for an internship.First, Urvi madam from the HR
department made us visit the hospital.
Then we met reshma madam who is a dietician.Then madam asked us to see all the files.

25/01/2023

We visited the kitchen.Which is on the ninth floor of the hospital.Wearing a cap is a


must in the kitchen.No one can enter the kitchen without wearing a cap.There we met
the manager of the kitchen.He informed us about the various types of machines used in
the kitchen.All the chefs were doing their job well.All types of meals are arranged for
the patients in this kitchen like breakfast,mid morning breakfast, soup, lunch,
snacks,dinner etc.Here some picture i clicked at kitchen.
8
9

We met the dietician Swati madam after observing the kitchen.who was sitting in the

dietician's room. She was filling a diet sheet.We went and talked to
her and we had to learn almost everything under her.
11

26/01/2023

CPR TRAINING
CPR is Cardio- Pulmonary- Resuscitation . It is a lifesaving technique that's
useful in many emergencies like Heart attack or near drowning , in which someone's
breathing or heartbeat has stopped . I learnt very consciously and decided to give
information about this technique to other peoples for being helpful to others and by
applying this process to unknown or known people who recently face cardiac attack we
can save their life .

What i learn in this seminar


[1] Find a safe area for cardiac patients.
[2] Check the response by tapping on the shoulder of that person.
[3]Check pulses with 3 middle fingers.
[4] Say to call someone on 0999.
[5] with locked hands compressing the lower sternum 30 times.
[6] till head, lift chin give 2 breaths.
[7] Repeat this 5 times.

27/02/2023
12

Cafeteria
13

On this day we visited the cafeteria which was very good and all kinds of dishes were
kept in very good condition . For the patient's family there was a hand washing facility,
a garbage disposal facility and food was well kept.There were many types of packet
food like cheeps Biscuits.There were also present for breakfast, lunch, dinner, snacks,
etc
14

IMPORTANT TIPS FOR DIET PLANNING

-RDA must be met


-Total calories can be RDA + 50
-Energy derived from cereals should not be more than 75 %
-It is better to include two cereal in one meal
-Whole grain , brown rice , hand pounded rice , parboil rice , malted grains give
higher nutritive value and higher phytochemicals value .
-Flour should not be sieved for chapathi because it reduces bran content .
-Refine flour ( maida ) should be taken in minimum quantity .
-Cereal protein to pulse protein should be 4 : 1 .
-Two to three servings of pulses should be taken every day .
-Germinated pulses are more nutritious
-Eggs should be served with cereal or pulses to increase protein quality .
-One serving of poultry should be included if the person is non vegetarian .
-Red meat should be avoided or taken in minimum quantity
-500 ml of dairy products like milk , curd , buttermilk , paneer etc. should be
included . Food rich in fiber should be included .
-Take 2-3 servings of fruits a day .
-Include oily fish in your diet once or twice a week .
-5 servings of fruits and vegetables are included in the diet to increase
antioxidant requirements .
-Energy derived from fats or oils should be 15-20 % and 5 % from sugar and
jaggery
-Use a combination of oil for balance of omega - 3 and omega - 6 .
-Diet should be low in Saturated fat , Trans fat , and Cholesterol .
-Use salt and sugar in moderation
-Each meal should contain all five food groups .
-Water should be taken in adequate quantities .
-Supplementary foods can be given to people with a high need for recovery .

RT FEEDING MEAL PLAN

Time Menu

6 am Milk

8 am Coconut water
15

10 am Soups like tomato/beet/carrot coriender/manchau

12 pm Nutrimix(dal/rice/roti/sabji)

2 pm Moong water/dal water

4 pm Milk

6 pm Fruit juice

8 pm Nutrimix

10 pm Milk

DIETETICS DEPARTMENT POSTING

SENIOR DIETICIAN
⬇️
JUNIOR DIETITIAN
⬇️
KITCHEN DIETICIAN
⬇️
SUPERVISOR
⬇️
⬇️ ⬇️
CHEF JUNIOR SUPERVISOR
⬇️ ⬇️
JUNIOR CHEF STEWARDS-7
⬇️ ⬇️
ASSISTANT COOK UTILITY WORKERS-3

27/01/2023
I read a case study of a patient who is suffering from the breast cancer.her name is
kalyani biswas.she visited here 2/3/21 and her age is 65 years.she has also difficulty in
walking and knee joint pain.so here nandini v chavda suggest her 1900 calories diet.

28/01/2023

This day I read the file of a patient named Sonu Parmar and tried to read all his
reports and I found out that there was a problem in his urine examination, urine
transparency should be clear but it also seemed to be turbid ,calcium crystals.
16

30/01/2023

On this day I read a book called Cardiovascular care in which the book gave diet chart
related to cardiovascular heart problems.
Then I went to discharge the patient with the dietician Swati Madam.It is madam's job
to explain the diet to the patient when he is discharged and different types of people
like those with hernia problem, diabetes problem, fever, TKR to explain the diet to
them.

31/01/2023

I went to the kitchen and saw that new types of food are being prepared every day like
masala rice ,mixed vegetables, dal,samosa rajgira ladoo etc.

Then I visited many patients who were suffering from RTP ,diabetes, thyroid , TKR etc.
Swati madam guides them very well. While guiding, she asked me to discharge the
patient.But due to low confidence I could not discharge the patient.

01/02/2023

On this day we did a case study which was given to us by reshma madam.
17

Case study 1
CAG: CORONARY ANGIOGRAM REPORT

LMCA Left main coronary artery

LAD Left anterior descending artery

LCX Left circumflex artery

RCA Right coronary artery

LVEF Left ventricular ejection fraction

CAD Coronary artery disease


Name : hajra bibi pathan
Age : 56
Sex : Female
Height : - cm
Weight : -kg
IBW : -
BMI W / (H in m ) ² =
Allergies : None .
Treating Doctors : dr.shilpesh champaneria
complains : chest pain
Shortness of breathing (dyspnea)
Provisional diagnosis : acs (acute coronary syndrome)
Past H/O : -
Family H / o : -
Diet : Non-Veg
Appetite : good
Bowel Regular : regular
Medical administration sheet
Date :27/01/2023
Diagnosis :CAG,LMCD,ef 35%
Diet : veg
18

Medicines(drugs) :

T.deplatt a(150)
T.ator(40)
T.teltop(40)h
T.metrex(50)
T.nexlife dsr
T.monotrate(10)

Date of sx :01/02/2023

Diet plan (02/02/2023)

Breakfast - tea / milk / coffee veg rava chilla + tomato chuttny

Midlunch - lemon coriander soup

Lunch - masala rice + boondi raita + mixed veg kofta + masoor dal + suji halwa + roti +
butter milk

Snacks - tea / milk / coffee + corn ring

Dinner - jeera rice + dal tadka + sev turiya + watermelon + roti + tomato salad

Bed time - milk


19

03/02/2023
On this day we go as usual with swati ma'm for discharge ,opd and listening to
complaints from patients.

04/02/2023

Case study 2
Osteoarthritis

DNVD Dynamic Non-linear Vibration Dissipaters

HTN Hypertension

Name : Vallabhbhai
Age : 74
Sex : male
Height : 167 cm
Weight : 85.5kg
IBW : 2069 kcal
BMI W / (H in m ) ² = 31.66
Allergies : None .
Treating Doctors : dr.manu sharma.
complains : Rt knee joint pain
Difficulty in walking,standing
No h/o fever,cough,cold.
Provisional diagnosis :OA R KNEE JOINT
Past H/O : hernio plasty done
Family H / o : -
Diet : Veg
Appetite 4
Bowel Regular : regular
Medical administration sheet
Date : 02/02/2023
Diagnosis : pre op TKR RT
Diet : VEG

Medicines(drugs) :

T.telmisartan(40)
20

Inj.ducati(1.5gm) + ms 100ml
Inj.pan 40
Inj.samika 2ml
Inj.omiscan (500mg)
Inj.slama (75mg)

Date of sx : 03/02/2023 (rt) TKR

Approach used : anterior midline incision.

Operative steps :
Medial parapatellar arthrotomy
Routine medical release.
acl pcl both meniscus excise
Tibia anteriorly dislocated

Xray:
Osteo arthritic changes
Joint space reduction

Physical assessment :
Tenderness 5
Varus valgus 7-10
Flexion 110
DNVD NO

Diet plan (02/02/2023)

Breakfast - tea/coffee/milk + poha

Midlunch - moong water soup

Lunch - chawal + roti(2) + mix dal + kofta sabji + sabudana kheer

Snacks - tea/coffee/milk + biscuits

Dinner - daliya khichdi + kadhi + tinda sabzi + toasted salad + roti + moong dal

Bed time - milk (1 glass)


22

06/02/2023

Case study 3
Hypothyroidism
Name : charudutt
Age : 75
Sex : male
Height : - 162cm
Weight : - 55kg
IBW : - 62kg
BMR : 1331 kcal
BMI W / (H in m ) ² = 20.95
Allergies : no allergies
Treating Doctors : dr.arool shukla
complains : abdominal discomfort
Nausea
Hypothyroidism
Fever

Provisional diagnosis : atrial fibrillation with fvr


Past H/O : - hypothyroidism
Family H / o : - no
Personal H/O :
Diet : veg
Appetite : good
Bowel Regular : regular
Sleep : disturbed

Medicines(drugs) :
T.oflox (200mg)
T.panto (40mg)
T.trika(0.5mg)
T.eltroxin(50mcg)
T.cordarone (100mg )
T.cordarone (75mg)
23

T.ecosprin(75/75/20)

Diet plan

Bed tea - tea / milk / coffee + marie gold

Breakfast - tea / milk / coffee + idli + sambhar + coconut chutny

Midlunch - palak soup

Lunch -jeera rice + dal tadka + flower tomato + dry tuvar + rajgira ladoo + rice + butter
milk

Snacks - tea / milk / coffee + khakhra

Dinner - khichdi + punjabi kadhi + guvar + cucumber salad + roti + butter milk

Bed time - milk


24

07/02/2023
On this day we go as usual with swati mam for discharge ,opd and listening to complaints
from patients.

08/02/2023

Case study 4
Diabetes and hypertension.
Name : sumitra nair
Age : 66
Sex : female
Height : - -cm
Weight : -kg
IBW : -
BMI W / (H in m ) ² =
Allergies :
Treating Doctors : dr.saurabh mukherjee
complains : pain in left leg from 2 days
Feverish feeling from 2 days
Giddiness
Loose Motion from 2 days

Provisional diagnosis :
Past H/O : - diabetes
Hypertension
Family H / o : - -
Personal history :
Diet : veg
Appetite : good
Bowel Regular : regular
Sleep : disturbed

Provisional history : pyrexia in s/p/c lumbar decompression and fusion

Medicines(drugs) :
zostum 3gm + ns 100ml
Dalacin 600 mg
Ns.60ml/hr
T.sporlac-DS
25

dynapar
Pantocid 40mg
Emeset 4mg
Human Actrapid 40IU/ml
T.amlong 5mg
T.blisto-mf (4/500)
T.voglibose 0.3mg

Diet plan

Breakfast - tea/coffee/milk + poha

Midlunch - moong water soup

Lunch - chawal + roti(2) + mix dal + kofta sabji + sabudana kheer

Snacks - tea/coffee/milk + biscuits

Dinner - daliya khichdi + kadhi + tinda sabzi + toasted salad + roti + moong dal + butter
milk

Bed time - milk (1 glass)


26

09/02/2023

On this day we go as usual with swati mam for discharge ,opd and listening to complaints
from patients.

10/02/2023

On this day we go as usual with swati mam for discharge ,opd and listening to complaints
from patients.

11/02/2023

Case study 5
CABG : coronary artery bypass graft
Name : ismail adam patel
Age : 75
Sex : male
Height : - cm
Weight : -kg
IBW : -
BMI W / (H in m ) ² =
Allergies :
Treating Doctors :
complains :H/O chest pain on and off
Perspiration
Dyspnea
Not any H/O fever,cough,cold
Primary rx taken at divine heart hospital
CAG was done show SVD so come far
Laboratory report : 2d echo 5/12/2022 EF55% GIDD
Provisional diagnosis :
Past H/O : - fpstatin gold
Zyloric 300
Nicorandil (5mg)
Cag 30/01/2023
Family H / o : -
Diet : veg
Appetite : no
Bowel Regular : regular
27

Medicines(drugs) :
Inj.Heparin 4000 unit
T.imdur 30
T.zyloric 300
T.nikoran 5

Diet plan

Breakfast - tea/coffee/milk + poha

Midlunch - moong water soup

Lunch - chawal + roti(2) + mix dal + kofta sabji + sabudana kheer

Snacks - tea/coffee/milk + biscuits

Dinner - daliya khichdi + kadhi + tinda sabzi + toasted salad + roti + moong dal

Bed time - milk (1 glass)

13/02/2023

This project was given to us by Reshma Madam.The project was aimed at preventing

people who waste food. This photo was clicked by dt. Swati
Madam.I got a lot of good comments through this project.On this day we stood in the
cafeteria in a span of 12 to 2.I stopped some people from wasting food and advised
them not to waste food.Those people respected my word and said that henceforth they
28

will not waste food.In that chart, I tried to explain to people through the dialogue of
Border Movie "Khana Foj Ko Banati Hai Foj Khane Ko Nahi" that without food even our
Indian army is not progressing so what to talk to the common man.
According to the year 2021 food waste is about 50 kg which is about 92 crore rupees
and equal so so much rupees should not be wasted or so much food should not be wasted
is my appeal to all Indians.
29

14/02/2023 to 18/02/2023
These days we go as usual with swati mam for discharge ,opd and listening to complaints
from patients.

20/02/2023 to 22/02/2023
These days we have to study about medicines,their use,side effects,benefits etc.

You might also like