1. The client/caregiver can list diseases or conditions that may impair nutritional status requiring a high-calorie diet.
   1. To promote physical health and decrease risks for diabetes and cardiovascular disease
   2. Trauma resulting in severe wounds or burns can also increase the need for calories and proteins
2. The client/caregiver can list foods to increase calories in the diet.
   1. Add wheat germ to meatloaf, pancakes, and so forth.
   2. Add eggs to soups, ground meats, casseroles, and so forth.
   3. Add powdered milk to scrambled eggs, soups, gravies, ground meats, casseroles, puddings, and so forth.
   4. Add baby food to casseroles.
   5. Use milk or half-and-half instead of water when making soups or sauces.
   6. Add cheese or diced meat to foods whenever possible.
   7. Add sour cream or yogurt to vegetables.
   8. Add raisins, nuts, dates, and brown sugar to hot or cold cereals.
   9. Add sauces to vegetables.
   10. Drink high-calorie beverages with fruit, milk, buttermilk, or yogurt.
   11. Add melted butter to foods.
   12. Add ice cream and whipped cream to desserts.
   13. Eat high-calorie snacks such as nuts, dried fruit, popcorn with butter, crackers and cheese, and ice cream.
   14. Eat mayonnaise, oil, and salad dressing.
   15. Serve gravy over meat.
   16. Eat creamed or thick soups.
   17. Enrich milk by adding 1 cup of nonfat milk with whole milk and add flavorings (i.e., fresh or frozen fruit, ice cream, or syrups).
   18. Spread butter on toast while it is hot.
3. The client/caregiver can list nutritional supplements available.
   1. Carnation Instant Breakfast
   2. Milkshakes with powdered egg substitute, ice cream, or protein powder
   3. Supplements such as Ensure, Sustacal, Pulmocare, Meritene, Isocal, and Boost
4. The client/caregiver can list calorie-dense foods (foods that are high in calories per square inch and low in bulk).
   1. Peanut butter has 90 calories per tablespoon (add to toast, celery, crackers, etc.).
   2. Cream cheese has 52 calories per tablespoon (add to celery, crackers, etc.).
   3. Honey has 64 calories per tablespoon (add to bread, cereal, etc.).
   4. Butter has 100 calories per tablespoon (add to soups, vegetables, mashed potatoes, cooked cereals, rice, etc.).
   5. Whipping cream has 60 calories per tablespoon (add to pies, fruit, puddings, hot chocolate, Jell-O, etc.).
   6. Roasted chopped peanuts have 52 calories per tablespoon (add to ice cream, desserts, salads, etc.).
5. The client/caregiver can list general measures to increase calories and promote weight gain.
   1. Eat small, frequent meals.
   2. Keep high-calorie snacks within sight.
   3. Eat foods high in unsaturated fat. Fats have nine calories per gram while carbohydrates and proteins have four calories per gram.
   4. Avoid empty calories such as chips, candy, and carbonated beverages.
   5. Avoid low-calorie soups, salads, and beverages at the beginning of the meal, which tend to diminish the appetite.
   6. Set realistic goals for weight gain daily. A weight gain of 1 pound per week may be suggested.
   7. Do not skip breakfast.

Resources

My Pyramid—United States Department of Agriculture
www.mypyramid.gov

Registered dietitian

References

Lutz, C., & Przytulski, K. (2001). Nutrition and diet therapy. Philadelphia: F. A. Davis Company.
Lutz, C., & Przytulski, K. (2004). Nutri notes: Nutrition &diet therapy pocket guide. Philadelphia: F. A. Davis Company.
Nutrition made incredibly easy. (2003). Philadelphia: Lippincott Williams & Wilkins.
Perry, A., & Potter, P. (2006). Clinical nursing skills & technique. St. Louis: Mosby Inc.
Taylor, C., Lillis, C., & LeMone, P. (2005). Fundamentals of nursing . Philadelphia: Lippincott, Williams & Wilkins.
Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott Williams & Wilkins.