A Guide To Speech Language And Swallowing Disorders

Question 1

Dysphagia

Answer 1

Difficulty swallowing
May affect any stage (oral , pharyngeal , esophageal )
Caused by structural , functional or cognitive factors
Cam affect persons of age

Question 2

Structural etiologies of Dysphagia

Answer 2

Oral cancer -glossectormy
Poor dentition or ill fitting dentures
Throat cancer -laryngectomy
Tracheostomy
Diverticulum
Other esophageal patho

Question 3

Cognitive functional etiologies of Dysphagia

Answer 3

CVA , head injury
PD,Tumors,MS
General weakness ,
REFLUX, motility disorders

Question 4

Cognitive Dysphagia

Answer 4

Dementia
Head injury
Lethargic or obtunded pt
May affect feeding efficiency , adequacy of PO intake

Question 5

Nurses role in Dysphagia

Answer 5

Good history (RN assessment form)
Good oral mechanism exam
Observation with meals and medications
Assistance with oral care **
Assistance with feedings **
Hasten referrals to other professionals

Question 6

S/s of Dysphagia

Answer 6

Cannot manage oral secretions
Difficulty chewing, prolonged chewing
Pocketing of food in Buccal cavities
Holding food in mouth for long periods
Excessive drooling during meals
Absent swallow ( know how to palpate )
Coughing / choking or throat clearing after swallowing
Wet,gurgly voice after swallowing
Pain with swallowing
Swelling many times for bolus

Question 7

What can indicate Dysphasia

Answer 7

Aspiration pneumonia
Recurrent pneumonia
Weight loss
Chronic dehydration or malnutrition

Question 8

Feeding/swallowing precautions

Answer 8

Tucking chin before swallowing
Thickened liquids
Straws v no straws
Follow-up swallows (swallow 2x to make sure it all went down)
Throat clearing
One med at a time
Purée last resort for meds
General precautions

Question 9

Top 3 risk for aspiration pneumonia

Answer 9

Dependence on others for feeding
Dependence on others for oral care
Missing or decaying teeth

Question 10

Other indicators for Dysphagia

Answer 10

Tube feeding
Multiple medical diagnosis
Chronic reflux
DYSPHAGIA IN COMBINATION OF OTHER RISK FACTORS

Question 11

Fiber optic endoscopic evaluation of swallowing

Answer 11

Tube camera used down pt nose

Question 12

Referral to other professionals if normal and seems like esophagus is still bugging them

Answer 12

Ex. GI

Question 13

Silent aspiration

Answer 13

No reflexive cough is triggered to protect air way
Results in false negative bedside swallow eval
If suspected an MBS or FEES study would be better able to identify the aspiration

Question 14

Special diets

Answer 14

Clear liquid (easiest2move)
Full liquid (pudding,yogurt)
International Dysphagia diets
Regular
Restrictions as prescribed by RD or MD (heart healthy)

Question 15

Using simply thick

Answer 15

One entire pack to 4 oz liquid
Shake for 5 seconds in mixing cup with lid or stir with a for for 20 seconds

Question 16

The Frazier water protocol

Answer 16

A tool that allows and encourages pt at high risk of aspiration to have ice and water throughout the day
Research and years of clinical application have proven that oral bacteria is the source of aspiration pneumonia not water

Question 17

Benefits of the Frazier water protocol

Answer 17

NPO pt increased opportunities to swallow hastens a return to safe PO intake

Increases hydration especially orally to reduce bacterial growth
Has the potential to improve a pt psychological starte of mind

Question 18

Requirements of oral Frazier

Answer 18

Pt are able to swallow water without demonstrating excessive coughing and discomfort
Maintain alertness and arousal

Question 19

Oral hygene

Answer 19

Make sure it gets done daily
So important

Question 20

Communication disorders

Answer 20

Motor speech disorder
Language
Cognitive communicative disorder

Question 21

Motor speech disorders

Answer 21

Dysarthria
Voice
Disorders
Apraxia
Often seen with CVA PD ALS MS MG , other

Question 22

Dysarthria

Answer 22

Drunk speech something wrong with tongue muscles

Question 23

Voicedisorders

Answer 23

A persons focal folds causing whispers

Question 24

Apraxia

Answer 24

Unable to perform task of movement
Typical with stroke pt CVA Parkinson’s ALS MS MG or other

Question 25

Expressive aphasia

Answer 25

Can read the word house but can’t tell the picture

Know what you want to say, but can’t find the word for it

Question 26

Receptive aphasia

Answer 26

Difficulty processing what pt is telling you

Question 27

Mixed aphasia

Answer 27

Combo of both

Question 28

Language disorders are usually caused by

Answer 28

Left brain injury

Question 29

Cognitive communities disorders

Answer 29

Head injury
Right brain CVA
Dementia
Anoxic brain injury
Toxi metabolic encephalopathy
May affect pregmatic social skills, problem loving and memory

Question 30

Strategies for communicating with aphasia patients

Answer 30

Using hearing aides and or glasses
Speak slowly directly and keep sentences short
Allow plenty of time for responses
Give two choices rather than asking open ended questions if possible
Use word boards only if directed
Do not talk to to pt plz

Question 31

Communicating with hearing impaired pt

Answer 31

Using hearing aids and glasses
Stand /sit close to pt
Speak slowly and low pitch
Keep sentences short
Rephrase rather than just yelling louder

Question 32

Patsy Muir speaking valves

Answer 32

Teach cuff must be deflated