~Salt-free, or Salt-poor Diets~ are necessary in some cases. While restriction in the amount of salt used in the preparation of food for the nephritic patient is always advisable, if there is a tendency to edema, the salt shaker should be left off the tray, and when there is a definite amount of salt prescribed, it should be weighed or measured for the day rather than for the meal, and the amount consumed recorded after each feeding. ~Special Points~ for the nurse to remember are the necessity for an early recognition of unfavorable symptoms--of instructing the patient upon leaving her care in the need for keeping the size of the meals small;--of the danger of indulging in alcoholic or other stimulating beverages;--of eating highly spiced foods, or of eating anything which may cause gastro-intestinal disorders. She should emphasize the need for regular examination of the urine and the value of rest and freedom from nervous excitement, and the need of living in the sunshine as much as possible. The nurse should study the diet list and become familiar with the foods allowed and those to be avoided. The tables show the foods which are rich in salts and proteins. She should likewise understand and be able to make the simple test for albumen in the urine and the method of collecting the urine for the test made in the laboratory. PROBLEMS (a) Outline a salt-poor diet for patient in which the fluids are limited to 1500 c.c. per day. (b) Formulate a diet for child of ten years with nephritis following scarlet fever. (c) Write a diet order, using a salt-free diet. FOOTNOTES: [114] Fisher's Solution. Sodium carbonate (pure crystals) 14 Sodium chloride 10 Water 1000 [115] The above diets used in the Olmstead Hospital, Rochester, Minn. Courtesy of M. Foley and D. Ellithorpe, Mayo Clinic. [116] See Section of Recipes, p. 145. [117] For more extensive lists see Table of "Ash Constituents of Common Food," pp. 472 to 477. [118] "Journal of Internal Medicine," Vol. XIV, 1914. [119] _Ibid._ [120] "Food for the Sick," p. 108, by Strouse and Perry. [121] Beans and peas belong to the class of foods known as legumes, which are high in protein and must be treated as any other protein food. [122] Author's list and diet sheets. [123] Meats of all sorts should be boiled, or only the inside portions allowed. [124] Some physicians exclude ice cream from the diet, while others permit a small portion, provided it is not so rich as to cause digestional disturbances. [125] Boiled sweetbreads are sometimes allowed, but should never be given without the advice of a physician. [126] The preparation of the menus requires care and attention; meal must be small and all fried foods avoided. [127] "Food for the Sick," p. 112, by Strouse and Perry. [128] "Medical Clinics of Chicago," Vol. II, No. 5, 1917. [129] Copied from "Medical Clinic of Chicago," Vol. II, No. 5, 1917.