CHAPTER IV

Chapter 46,974 wordsPublic domain

METHODS OF FEEDING IN NORMAL AND ABNORMAL CONDITIONS

There are several methods of feeding which have been adopted to meet the needs of the individual under various conditions: Feeding by mouth, gavage or forced feeding, rectal feeding (nutrient enemata), and inunction.

~Feeding by Mouth.~--The first method is the one used in health and in the majority of abnormal conditions. In cases where there is a certain abnormal development of the mouth or throat, and in some cases of insanity or unconsciousness, where for some reason it is impossible for the individual to swallow, this method cannot be used.

~Forced Feeding.~--With very young children and babies gavage or forced feeding is found at times to be necessary. In these cases a small rubber catheter is introduced into the stomach through the nostrils and the milk or other fluid poured through the tube. In unconscious or insane patients it is often found necessary to insert a gag (a cork will serve the purpose) between the teeth to prevent the biting of the tube when it is inserted through the mouth into the stomach.

~Food Used for Forced Feeding.~--The food in these cases consists of reenforced soups, milk gruels, or nutrient beverages, not more than six or eight ounces given at one time. Finely chopped meat and vegetable purees have been given in this way when the digestion of the patient was not impaired, but when conditions rendered it necessary to resort to this method of feeding.

~Technique of Gavage.~--The apparatus used in gavage consists of a moderate sized soft rubber tube to which is attached a rubber or glass funnel and a "pinch cock." The tube should be filled with water to prevent air entering the stomach and causing pain or discomfort. In certain cases the patient refuses to swallow the tube and it will be found necessary to use some means to force the passage if the throat is shut off. By closing the nostrils the patient will be obliged to breathe through the mouth, thus opening the passage into the throat through which the tube may be quickly slipped. In certain abnormal conditions the gastric organ is so badly impaired as to render it impossible for the patient to retain food taken in by way of the mouth. It is often found that food introduced into the stomach by means of the "stomach tube" will be retained and utilized which otherwise would be rejected. It is disagreeable, however, and should only be used when it is impossible to feed otherwise.

~Rectal feeding~ is used when the other organs of digestion are impaired to such an extent as to render the need of more food obligatory. Many investigators believe that rectal feeding is absolutely useless, while others have firm faith in its efficacy.

~Technique of Rectal Feeding.~--The rectum should be cleansed by flushing with a soapsuds enema one hour before the nutrient enema is given. This should be done once a day, in the morning. The cleansing enema may be either soapsuds, a solution of bicarbonate of soda, or boric acid (1 teaspoonful to the pint), or a saline solution. When there is much mucus, or if the rectum is inflamed, the soda or boric acid solution may be more soothing than the saline or soapsuds enema. After one hour's rest the patient should be given a nutrient enema.

The method of administering nourishment through the rectum is important. A nutrient enema injected only into the lower bowel not only does no good, but may actually cause a good deal of unnecessary discomfort to the patient.

~Temperature of Enema.~--Care must be taken not to have the temperature of the nutrient enema too hot or too cold or it will be promptly rejected. The patient is placed on the side with one knee flexed; the solution is poured into a fountain syringe bag or an enamel container (heat the container before pouring the solution into it or the latter will be chilled). The bag or container has attached to it a rubber tube with a cock adjusted so that only a small stream will flow in at a time. To the end of this tube a rubber rectal tube or catheter--1 cm. (about 1/2 inch)--is attached. This should be well greased (do not use glycerin as this substance is irritating to the mucous lining of the rectum). The liquid should be allowed to fill the tube before it is inserted into the rectum, to prevent any air passing in with it. The tube should be inserted with a gentle twisting movement, using very little force or the tender mucous membranes will be injured. Insert the tube twelve or more inches, since the solution is more completely absorbed if given high up in the bowel. The bag containing the solution should be held only a few inches higher than the rectum, thus allowing only a small stream to pass in and allowing an air space above the stream for the passage of gas which may be accumulated in the upper part of the rectum. The tube should be allowed to remain in the rectum for fifteen or twenty minutes, then very gently withdrawn to prevent the liquid from being rejected. A pad of gauze may be pressed against the anus to assist the patient in retaining the enema. It is well to divert the attention of the patient also, to further assist her in retaining the liquid.

~Duration of Rectal Feeding.~--Rectal feeding cannot be substituted for a great length of time, first, because the patient cannot absorb sufficient nourishment in this way to fully cover the body requirements, and, second, because the rectum becomes more or less sensitive and will reject the liquid before it has an opportunity to be absorbed. From three to four nutrient enemas a day is about the limit for the average patient. Between the nutrient enemas it is advisable to give one of saline solution.

The following regime is practiced during the "Total Abstinence Period" in the treatment of gastric ulcer: 7 A.M., cleansing enema; 8 A.M., nutrient enema; 1 P.M., nutrient enema; 3 P.M., saline enema; 6 P.M., nutrient enema. One saline and one nutrient enema may be given during the night if the patient is very weak. She should not be wakened, however, to be given the enema.

~Feeding by Inunction.~--This method consists in the rubbing into the body of certain nutrient oils, such as olive oil, cocoanut oil, cocoa butter, etc. It is of little value, but is occasionally resorted to with very much emaciated and underfed infants, when digestional disorders make it impossible to introduce enough food by mouth to cover the needs of the body.

SPECIAL DIETS

There are a number of diets formulated to meet the various normal and abnormal conditions. In hospitals these are classified as follows, for the convenience of both nurse and doctor:

~House Diet.~--That which is served to the hospital staff, the nurses, and those patients not requiring special diets.

~Liquid or Fluid Diet.~--Consisting of milk, nutrient and other palatable beverages, broths, and thin gruels.

~Light, Semi-solid or Convalescent Diet.~--Composed of thick or cream soups, eggs, toast, cereals, custards, jellies and ice cream, and later vegetable purees, broiled birds, chicken, lamb chops, and rare beefsteak.

~Mixed Diet.~--The diet used in normal conditions and for those not affected by any special food.

~Special Diets.~--Those designed to be used for certain pathological conditions, such as scarlet fever, nephritis, etc. These diets are classified as follows:

~Milk Diet.~--A diet in which milk is the sole article of food.

~Carbohydrate-free Diet.~--One in which the sugars and starches are eliminated.

~Purin-free Diet.~--One in which the foods rich in purin bases are eliminated. This is used in gout, arteriosclerosis, etc.

~Salt-free Diet.~--Diet in which sodium chloride (salt) is as far as possible excluded. It is used in certain cases of nephritis when edema is present.

~Nephritic Diet.~--A diet used in nephritis and diseases complicated by nephritis (scarlet fever). In this diet the protein foods, meat in particular, are restricted, milk being the exception.

~Diabetic Diet.~--A diet in which the carbohydrates are restricted or eliminated.

~"Allen Treatment of Diabetes"~ consists chiefly of "starvation" for a given period and a reeducation of the organs to a toleration for carbohydrates.

~Emaciation Diets.~--Those containing a high percentage of fat-forming foods, such as milk, cream, eggs, cereals, potatoes, etc., olive oil.

~Obesity Diets.~--Those containing as few of the fat-forming foods as possible, such as cream, olive oil, potatoes, white bread, etc., pastry and desserts, candy and soda water, and containing lean meats, fish or shellfish cooked and served without butter or other fats, fresh or stewed fruit without sugar, green vegetables and salads served without oil or other fats; one egg a day two or three times a week, coffee and tea without sugar or cream, toasted gluten bread (1 slice) without butter, saccharine substituted for sugar.

There are a number of other diets, but they come more or less under the above heads.

THE TRAY

As the patient's tray assumes an important part of the daily regime, it is necessary to give close attention to the arrangement and serving of it. There are certain definite rules to observe: (1) The linen, silver, glassware, china, and food must be absolutely clean. (2) The tray must be sufficiently large not to appear crowded. (3) The arrangement of the obligatory articles, such as salt and pepper, silver, water glass, napkin, etc., must be alike at every meal; this not only facilitates the service by making it easy for the nurse to see whether any of these necessary articles are left off, but it also enables the patient to find them without trouble.

~The Linen.~--The linen cover of the tray must be clean and uncreased. The napkin likewise must be clean and unwrinkled. The china must be free from chips and cracks. Care must be taken not to put a collection of odd pieces on the tray as it gives an untidy appearance.

~The Silver.~--The silver must be bright and in cold weather made slightly warm, as must also the china. The chill of cold silver may readily obliterate a fragile appetite, and to place hot food in cold dishes will deprive it of much of its palatability. The foods intended to be hot must be really hot, not warm, and those which are intended to be cold should be thoroughly chilled before being served to a patient. The placing of flowers on a tray is a questionable addition to it; a single flower laid across the folded napkin may add daintiness and attractiveness, but it is poor judgment to over-decorate, either with flowers or by garnishing the dishes.

~Arranging the Tray.~--If the nurse will place the necessary articles upon the tray and memorize their position so that she will be able to duplicate the same at each meal, she will be able to tell at a glance if everything needed is in its proper place, thereby saving herself unnecessary steps and the patient the worry of having to wait until they can be brought. Food should not be allowed to stand in the sickroom, and glasses or plates in which food has been served should be removed from sight as soon as the patient finishes with them. Care must be taken, however, not to create the impression of hurry or the patient will be made nervous and either will lose her appetite or have indigestion.

The nurse should be careful of her topics of conversation during the meal hour. Especially must disagreeable subjects and business matters be rigidly excluded if the invalid is to obtain the full benefit of the food served her.

1. ~Setting the Tray.~--Tray should be sufficiently large not to give the appearance of being crowded, but not too large.

2. Tray cover must be spotless, and of a size to just cover the edges of tray; if too large, make a pleat down the center.

3. Place service plate directly in front of patient.

4. Knife, cutting edge in, to the right of plate; fork, tines up, to the left of plate.

5. Spoons, bowls up, next to the knife.

6. Napkin on the lower left side of tray, open edges to the lower right side.

7. Bread and butter plate on top of napkin.

8. Soup tureen in lower right corner, with cup and saucer above it.

9. Tea or coffee pot and hot water pot in upper right-hand corner of tray, with sugar bowl next to hot pot and cream pitcher next to sugar bowl.

10. Place salt and pepper next to cream pitcher (to the left).

11. Water glass in upper right corner of tray.

12. Second vegetable dish placed on the upper right side of dinner plate.

13. Place dessert to the upper left of dinner plate.

~Suggestions for Serving.~--Make tray as attractive as possible.

In the cases requiring special diets, the nurse should make out the "diet sheet" for the day. In hospitals this is passed to the dietitian, who carries out the directions laid down by the physician. The nurse, however, should carefully check the tray before serving it, since mistakes sometimes occur, and to give the wrong food to a patient suffering from certain disorders may give rise to serious trouble, causing pain and discomfort and at times death.

~Contamination of Food.~--Food should always be protected from dirt and dust and from contamination and pollution from flies and other insects. Typhoid fever and certain intestinal disturbances have been known to result from flies coming in contact with raw food--milk, for example. Poisoning due to polluted water used to freshen vegetables has already been spoken of. All of these types of poisoning may be avoided by using care in the handling of the fresh foods. ~Ptomaines~, however, are not easy to prevent. Their source cannot always be traced to one particular article of diet. They may be present in cooked, raw, frozen, or canned foods. At times the evidence of extreme decomposition will be found in the foods themselves, while at other times there will be no such evidence in the food, but the result of the ptomaine will be perfectly evident whenever certain individuals partake of that food. This is a personal idiosyncrasy which it is impossible to account for.

~Food Poisoning.~--Poison caused by decomposed eggs has manifested itself in individuals who have partaken of cake in which such eggs were used. Canned meat and fish have produced the most violent types of ptomaine poisoning. As a rule in these cases the canned article has begun to decompose and while the decomposition may not have advanced sufficiently far to be discernible from the flavor or odor, it is there, and if the resistance of the individual eating this food is not great, serious danger may result. Poisoning develops in some individuals upon the eating of shellfish, strawberries, oranges, pimentos, and various other foods,--another evidence of personal idiosyncrasy against certain articles of diet. There is no way to overcome these idiosyncrasies; the only thing to do is to warn the individuals so affected to let the offending foods alone.

ADULTERATION OF FOOD

The adulteration of food, which formerly was practised by unscrupulous dealers to cover up inferior articles, or by manufacturers to prevent or arrest decomposition in canned goods, is regulated by law. The passage of the National Pure Food and Drug Act gave the Government authority to regulate the preservatives and coloring matter used in canned and bottled goods, forcing the manufacturers to state on the label the exact contents of each bottle or can. There are likewise stringent laws governing the adulteration of milk, butter, and other articles of food.

~Tests for Adulterants.~--Boric acid, borax, and formaldehyde are the preservatives more often found in milk. These chemicals are introduced to arrest the natural souring and decomposition which takes place after milk reaches a certain age. Occasionally salicylic acid and sodium carbonate are used. Formaldehyde may be detected by placing about 20 c.c. of milk in a small glass vessel or tube. Dilute with an equal amount of pure water, add commercial sulphuric acid, allowing it to flow gently down the inside of the tube. A purple ring will appear at the zone of contact if formaldehyde is present. "Boric acid and borax may be detected by adding a drop or two of hydrochloric acid to a few drops of milk in a white dish and then several drops of a saturated alcoholic solution of _turmeric_. The dish is then heated gently for a few minutes, and, if boric acid or borax is present, a pink or dark red color will appear. A dark blue-green should appear when the dish is cooled and a drop of ammonia added."[28]

~Canned goods~ must be carefully examined before being used. The domestic canned goods are rarely adulterated, but imperfect sterilization and defective cans may bring about a condition of fermentation and gas formation due to bacterial action. Cans should have a concave appearance on the top. If there is a bulging of the can it may be due to gas formation, and a small hole should be made in the can to note any escape of this gas. Should there be any indication of fermentation, the contents should be discarded. It is advisable to look with suspicion on cans that appear old, rusty, and soiled; they are probably left-over stock and liable to be bad. Peas which have been imperfectly sterilized produce a type of gas which is soluble in the liquid. After decomposition has occurred there will be no apparent evidence by the escape of gas, but the liquid will be found to be excessively acid, and will present a muddy appearance. Certain foreign importations of canned goods are preserved in color by the introduction of certain color preservatives. Peas--petits pois, for example--and the very small string beans which are imported are intensely green from the copper sulphate used. Its presence may be detected by adding a few drops of hydrochloric acid to some of the colored material, then dropping in a bright steel nail, knitting needle, or knife blade. There will be a deposit of copper salts (like copper plating) upon the steel if the preservative is present in the can. Canned corn is often artificially sweetened with saccharine, which may be detected by shaking several tablespoonfuls of the liquid in an equal amount of chloroform. Saccharine is soluble in chloroform, while sugar is not. Allow the mixture to stand a few minutes and remove some of the chloroform which has settled at the bottom. Place in a small dish, evaporate the chloroform by gently heating the dish; taste the residue; if sweet, saccharine is present.

~Coffee~ is adulterated more often when it is put up in ground or powdered form than when sold in the bean. Real coffee contains a small percentage of oil, and will float when thrown into a glass of water. Substitutes generally sink to the bottom. Coffee substitutes are often made up of starch-containing materials, such as cereals, beans and peas. This starch may be detected by mixing one tablespoonful of the suspected coffee in a little cold water, adding one cup of boiling water; allow it to boil two minutes, filter through cotton, and pass the liquid through charcoal to remove the color. When it is cold, add a few drops of dilute iodine solution. If starch is present, a blue color will appear.

METHODS USED IN THE PREPARATION OF FOOD

Food is prepared for consumption by a number of methods and the method by which the food is prepared either increases or decreases its digestibility, palatability, and general usefulness.

Certain foods, as has already been stated, require a high degree of temperature to make them wholesome, but if this temperature is applied by means of heated fat, as in frying, the food is changed from a wholesome to a more or less indigestible article. In health the organs of digestion are capable of overcoming much of the harm wrought by wrong preparation, but even in the healthy, normal individual a steady diet of fried food will eventually undermine what is known as good digestion. In abnormal conditions (illness) frying is a method seldom, if ever, used.

~Preparation of Food.~--The various methods to which food is subjected in preparation for human consumption may be summed up as follows: boiling, simmering, steaming, baking, roasting, broiling, frying, sauteing.

~Boiling~ is cooking in water raised to the boiling point, 212 deg. F. (sterilizing). This method is commonly used in the cooking of starchy vegetables and cereals, and in the cooking of green vegetables, such as spinach, carrots, beets, corn, asparagus, etc. Stewing is a form of boiling. As a rule water is used, and the vessel is left uncovered, so that as the food is cooked the surplus moisture evaporates, leaving the food tender. Dried fruits, such as prunes and apricots, are prepared by this method.

~Simmering~ is cooking in water, the temperature of which is not raised to the boiling point, but kept between 200 deg. F. and 210 deg. F. This method is used in the preparation of eggs and dishes in which eggs predominate, since proteins are made tough if subjected to a high degree of temperature. Coddled eggs, for example, are prepared by placing the egg in a clean vessel and pouring over it the boiling water, then covering the vessel and allowing it to stand for ten or fifteen minutes. The vessel and the cold egg reduce the temperature of the water to about 185 deg. or 190 deg. F. and in this way prevent a toughening of the albumen of which eggs are chiefly composed. Soups, broths, ragouts, etc., are prepared by this method.

~Steaming~ is cooking over hot water or by steam. This method may be accomplished on the top of the stove in a "double boiler" or in the oven in a deep covered pan fitted with a "rack" to hold the article to be cooked. Either method allows the vessel in which the food is placed to be surrounded by boiling water, but does not insure sufficient heat to raise the food within to the boiling point.

~Baking~ and ~roasting~ are both brought about in the oven. Bread, biscuits, pies and other pastry, potatoes, cakes, etc., are baked, while meats, roast of beef, lamb, veal, mutton, as well as chicken, turkey, duck, and large fish are roasted. The heat in the oven may be intense. The outside or cut surface of the meat is seared, the soluble albumens are coagulated, thus sealing the juices within. If the meat is placed in a pan surrounded by cold water and then placed in the oven, the juices are "drawn out" in the water. These juices contain the flavoring matter or extractives. Meat so treated is not so palatable or highly flavored as that which has first been subjected to intense heat, the water for the gravy added later.

~Frying~ and ~sauteing~ is cooking in hot fat. Food may be fried in deep fat, as is demonstrated in the cooking of croquettes, doughnuts, etc., or it may be sauted in butter or oil in a shallow frying pan or griddle. The latter method is used in making hashed brown potatoes, for example; also in the cooking of griddle cakes, etc.

~Broiling.~--In broiling or grilling the article to be cooked is exposed to direct heat, either to the blaze or to a very hot surface. The result is the same as in roasting. The outer surface is seared, sealing the juices within. Meat to be broiled is generally cut thinner than that to be roasted. The article, whether it is meat (steak), chops, birds, or chicken, is placed about three inches away from the flames and turned frequently until the surfaces are seared, after which the article is placed in a cooler part of the stove to allow the interior to be cooked. Pan broiling is done on top of the stove. The article to be broiled is placed directly upon a very hot surface, there is no grease used and the meat must be turned frequently to prevent burning.

~Poaching.~--This term is applied chiefly to the cooking of eggs in a shallow pan of water heated just below the boiling point. To be properly poached an egg must be perfectly fresh, or the white and yolks will run together and present an unappetizing, unpalatable appearance.

The following time-table should be used in the preparation of food to insure correct cooking:

TIME-TABLE

CARE OF ICE-BOX AND CONTENTS

The ice-box plays an important role in the preservation of the health and comfort of the family, as well as that of the invalid. Therefore the first consideration is the cleanliness of it. The old-fashioned boxes were constructed without ventilation. This was clearly a mistake, since many foods absorb both the odor and flavor of the substances about them if allowed to stand for any great length of time in a closed compartment with them. The ice-boxes or refrigerators of to-day have a ventilation system which insures a circulation of air constantly throughout the interior of the box. The drain pipes require special attention, because no matter how clean the box itself is kept, the melting of the ice causes a slime to accumulate on the inside of the pipe which will clog it and become offensive unless it is flushed out often. This may be accomplished by pouring through it a solution made by dissolving one-half ounce of borax, washing soda, or ammonia in one gallon of boiling water. The adjustable part of the pipe can be removed and cleaned with a long brush made for the purpose. The pipe is then replaced and the boiling water poured through. In this way the entire drainage system of the box is completely cleaned. All loose bits of food which may drop from the containers to the floor and shelves should be carefully removed each day and the interior of the box and shelves thoroughly wiped out. Three times a week is sufficient to wash and flush the box and pipes unless milk, cream, or other food materials have been spilled, in which case it should be washed at once before it has an opportunity to sour or spoil and become offensive. Ice should always be washed off before being put in the box, and all milk and cream bottles should likewise be wiped with a clean wet cloth before being placed on the ice.

Hot food must never be put in the ice-box, as the heat from the food will raise the temperature of the air in it. In some cases the sudden chilling of the food itself is undesirable, but this is not so often the case. However, the best results are obtained by first allowing the food to cool, and then placing it on ice. This is particularly the case with jellies made from gelatin.

Milk and milk products, cream, butter, buttermilk, cheese, etc., meat, fish, and, at times, eggs should be kept in a refrigerator or in a cold place such as the cellar in the country, when it is impossible to procure ice.

Broths of all sorts, beef juice, and meat jellies will sour and decompose unless kept close to the ice. Carbonated waters, such as Vichy, Apollinaris, White Rock, etc., as well as champagne and other sparkling wines, must be kept in a dark, cool place, lying on the side. It is better to put only one or two bottles on the ice at a time, since the wine flattens (loses its sparkle) if it is ever allowed to become warm after once being placed on ice. Koumiss and other fermented milk products must be treated in a like manner to assure having them served at their best.

RULES GOVERNING SELECTION OF FOOD

There are certain fundamental rules to be observed in the selection of our food materials, whether they are intended for those in health or for those suffering from pathological conditions. These rules are definite and obligatory. All food materials must be of good quality; that is, they must be of known purity and cleanliness, and adulteration should not be tolerated. In health the small amount of preservative used in certain canned and bottled foods would probably have little if any effect on the individual, but in sickness this is not always the case. With regard to milk, this point has particular significance. To obviate danger, the nurse should use discrimination in the selection of the dealer from whom the meat, milk, eggs, fruit, and vegetables are purchased, as well as the grocer who supplies the remainder of the food materials used by the patient.

THE CARE OF FOODS AND UTENSILS

The next point of consideration is the care of the food materials. This is quite as important as the selection, for even the best of food may be ruined by careless handling, not only in the preparation, but likewise during the period before it is prepared for the invalid's consumption. The rules governing the handling of food materials before they reach the consumer are subject to inspection by law, but the housekeeper or nurse has no such rules to guard or govern her; hence she may be wantonly careless or ignorantly unsanitary unless taught the right way to care for the food in her charge. Perishable fruits and vegetables must be kept in a cool place to preserve their freshness.

~Method of Washing Dishes.~--Cleanliness must be observed in the care of all food materials and the utensils in which they are to be prepared. If the nurse will observe the scientific rules governing the solubility of the foodstuffs, she will be able to save herself much time and trouble. For example, it is a known scientific fact that starch is insoluble in cold water and more or less soluble in boiling water, hence it would be a useless waste of time to try to wash a utensil in which a starchy food has been cooked in cold water. Fats solidify under the influence of cold and melt under the influence of heat, so that hot water should be used in conjunction with soap or an alkali to remove grease from dishes and silver and utensils. Albumens are soluble in cold water and are coagulated in hot, therefore to remove milk, egg white, and like protein substances from glasses, spoons, etc., it is advisable to soak first in cold water to wash out the food material, and then to wash thoroughly in hot soapsuds to cleanse and polish. The dishcloths used in the washing and drying of dishes and kitchen utensils should be washed after using in hot soapsuds, rinsed in clear water, then dried in the sun. When this is impossible, they should at least be hung in the fresh air to make them sweet and clean before the next using. In contagious diseases the care of the utensils and dishes used by the patient is of the utmost importance. They should be thoroughly sterilized before being placed with those used by the rest of the family, otherwise the disease may be communicated to the unaffected members. A word about the handling of glasses and spoons used in administering medicine in the sickroom: It is advisable when possible to keep these separate from those used on the tray, as many medicines have a very lasting and disagreeable taste, which is more than apt to cling to the spoons or glasses in which they are measured and in turn be communicated to the food, making it distinctly unpalatable. This has been found to be the case with asafetida, valerian, ichthyol, etc.

METRIC MEASURE

The metric system is a system of weights and measures expressed in the decimal scale. The principal units with which we are concerned are:

The liter--L. Cubic centimeter--c.c. The gram--gm. Centigram--cgm. Milligram--mgm.

These units have prefixes to show how they are divided decimally, _i.e._:

deci.--0.1 centi.--0.01 milli.--0.001

UNITS OF WEIGHT

10 milligrams = 1 centigram (cgm.) 10 centigrams = 1 decigram (dgm.) 10 decigrams = 1 gram (gm.) 10 dekagrams = 1 hektogram (hgm.) 10 hektograms = 1 kilogram (kilo.) 1000 kilograms = 1 metric ton

A cubic centimeter of water weighs 1 gram; 28.35 grams = 1 ounce.

A liter of water weighs 1 kilogram; 1 kilogram of water = 2.2 lb.

HOUSEHOLD WEIGHTS AND MEASURES

4 saltspoons = 1 tsp. 3 tsp. = 1 tbs. 4 tbs. = 1/4 cup or 1/2 gill 8 tbs. = 1/2 cup or 1 gill 16 tbs. = 1 cup or 1/2 pint = 8 oz. = 227 gm. 2 cups (c.) = 1 pint = 454 gm. 2 pints (pt.) = 1 quart (qt.) = a little less than 1 liter 4 qt. = 1 gal. 2 tbs. butter = 1 ounce (oz.) 2 cups butter (solid) = 1 pound (16 oz.) 2 cups granulated sugar = 1 pound 2-1/2 cups powdered sugar = 16 oz. = 1 lb. 4 cups flour (sifted) = 16 oz. = 1 lb. 1 pt. milk or water = 16 oz. = 1 lb. 1 pt. chopped meat = 16 oz. = 1 lb. 10 medium size eggs = 1 lb. (with shells) 8 eggs, without shells = 1 lb. 2 cups rice = 1 lb. 4 tbs. butter = 2 oz. = 1/4 cup 2 tbs. sugar = 1 oz. 4 tbs. flour (sifted) = 1 oz 4 tbs. coffee (powdered) = 1 oz. 2 tbs. powdered lime = 1 oz. 2 tbs. lemon juice = 1 oz. 2 tbs. orange juice = 1 oz. 1 glass orange juice = 8 oz. or 1/2 pint 2-2/3 cup oatmeal = 1 lb. 4-3/4 cup rolled oats = 1 lb.

28.35 grams = 2 tablespoons = 1 ounce of the following substances: arrowroot, barley flour, brandy, butter, grape juice, lemon juice, orange juice, molasses, cream, dry peptonoids, liquid peptonoids, milk (whole, skimmed), buttermilk, malted milk, rice flour, oatmeal, olive oil, wine.

Materials requiring 3 tablespoons to weigh 28.35 gm. or 1 oz.:--corn meal, farina, gum gluten flour, Graham flour, white flour.

Material requiring 4 tbs. to weigh 1 oz.: cocoa.

The standard measuring cup holds 8 ounces or 16 tablespoonfuls.

1 ordinary glass (water) = 8 ounces 1 coffee cup = 8 ounces 1 tea cup = 6 ounces 1 wine glass = 2 ounces

The following list shows the approximate weights and measures of the foods comprising dietaries:

Asparagus, 8 stalks, E.P. = 2 ounces Apple (1 medium size) = 5 ounces Bread, 1 slice, home-made, 4 in. x 3-1/2 in. x 1/2 in. = 1 ounce Bread, 1 slice, baker's, 4 in. x 3-1/2 in. x 3/4 in. = 1 ounce Bread, 1 slice, whole wheat, 2-1/2 in. x 2-3/4 in. x 1/4 in. = .7 ounce Bread, 1 slice, corn, 3 in. x 3 in. x 1/2 in. = 2 ounces Bread, muffin, 1 small, or biscuit = 1/2 ounce Banana, 1 medium size = 5 ounces Chicken, 1 serving = 3 ounces Chicken (creamed) 2 tbs. = 1-1/2 ounces Cream, 2 tbs. = 1 ounce Custard (soft, 1/2 cup) = 4-1/2 ounces Custard (baked, 1/2 cup) = 4 ounces Cream (ice, 1/2 cup) = 4 ounces Custard (rice, 1/2 cup) = 3-1/2 ounces Dates (3 medium size) = 1 ounce Eggs (scrambled, 1/4 cup) = 2 ounces Eggs (poached, 1 egg) = 1-1/2 ounces Fish, medium serving, 2-1/2 in. x 3 in. = 2-1/2 to 3 ounces Honey, 4 tsp. = 1 ounce Hominy (cooked, 1/2 cup) = 4 ounces Lamb chop, E.P., 2 x 2 x 1/2 inch = 1.6 ounces Lemon or other jellies, 1/2 cup = 3.8 ounces Steak (sirloin), 3 x 1/2 x 3/4 in. = 3 ounces Vegetables: Beets, 1 medium size (4 slices) = 2 ounces Carrots, 1/3 cup diced = 2-1/2 ounces Peas (canned or drained), 1/3 cup = 3 ounces Potatoes, baked, sweet, 1 medium size = 6 ounces Potatoes, baked, white, 1 medium size = 3 ounces Spinach, cooked, 1 serving, 1/2 cup = 4 ounces Tomatoes, 1 medium size--fresh = 3 to 4 ounces Soups: Cream, 1/2 cup = 4 ounces Clear soup, 1 cup = 7-1/2 ounces

PERCENTAGE CALCULATION

A percentage of a number is the result obtained by taking the stated number of hundredths of it. The rate per cent. is a fraction whose denominator is 100 and whose numerator is the given number of hundredths; thus 6% of a number is 6/100 of that number.

The method of figuring the per cent. of foodstuffs in a food material is simple. Milk, for example, has a percentage composition of 3% protein, 4% fat, and 5% sugar. To find the definite amounts of these foodstuffs in 1 ounce of milk it is best to reduce the ounce to grams, since the gram is the unit of measurement generally used.

1 ounce = 28.35 grams In 1 oz. there will be 28.35 x .03 = 0.85 gram protein In 1 oz. there will be 28.35 x .04 = 1.13 grams fat In 1 oz. there will be 28.35 x .05 = 1.41 grams sugar

THERMOMETRY

There are two scales used in thermometry, the Fahrenheit and the Centigrade. The former is generally used. However, since many of the scientific calculations are made using the Centigrade scale it is wise for the nurse to understand how to translate one to the other.

Centigrade has 0 deg. as the freezing point and 100 deg. as the boiling point, while Fahrenheit has 32 deg. as freezing point and 212 deg. as boiling point. To change Fahrenheit to Centigrade it is necessary to subtract 32 from 212 in order to make the freezing points correspond. This would read 212-32 = 180 deg. F. = 100 deg. C; hence a degree Centigrade represents 5/9 of a degree Fahrenheit.

To change Centigrade to Fahrenheit it is necessary to remember that every Fahrenheit degree is 9/5 times as large as the Centigrade and the addition of 32 deg. must also be made. For example: Change 105 deg. F. to Centigrade: 105 deg.-32 deg. x 5/9 = 41 deg. C. Change 50 deg. C. to Fahrenheit: 50 deg. x 9/5 + 32 deg. = 90 deg. + 32 deg. = 122 deg. F.

FOOTNOTE:

[28] "Diseases of Nutrition and Infant Feeding," by Morse and Talbot.