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Dysphagia > Background > Flashcards

Background Flashcards

0
Q

When is swallowing least frequent?

A

During sleep

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1
Q

When is swallowing frequency greatest?

A

During eating

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2
Q

A normal swallow is…

A

Quick and clean

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3
Q

Dysphagia is…

A

A. A disorder involving any stage of swallowing
B. A delay in, or misdirection of, a fluid or solid bolus me as it moves from the mouth to the stomach
C. An abnormality in the transfer of a bolus from the mouth to the stomach

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4
Q

A feeding disorder is…internal or external?

A

External - an impairment In the process of food transport Outside of the alimentary system
- impaired food delivery

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5
Q

A cause of dysphagia is…

A

Acute or degenerative neurological injury

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6
Q

A cause of dysphagia is…

A

Mechanical/structural alterations

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7
Q

Dysphagia can be a sign/symptom of…

A

Pulmonary disorder/disease

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8
Q

Dysphagia can be caused by…

A

Iatrogenic cause - surgery, medication, treatment

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9
Q

Dysphagia can be due to…

A

Age

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10
Q

Dysphagia can be caused by

A

General health problems

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11
Q

Dysphagia can be the result of…

A

Stroke (CVA)

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12
Q

Dysphagia can be caused when there is a breakdown in…

A

Cognitive processes - they might not understand the process

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13
Q

How hospital patients are dysphagic?

A

1/4 - 1/3

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14
Q

How many patients in nursing homes have dysphagia?

A

30-70%

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15
Q

Dysphagia is a problem affecting both paediatrics and adults - True or. false

A

True

16
Q

Name some impacts of dysphagia…

A 
weight loss
Impaired nutrition
Depression
Isolation
Anxiety
Distress
17
Q

What is the difference between aspiration and penetration?

A

Aspiration goes below vocal folds, penetration above vocal folds

18
Q

What is silent aspiration?

A

Penetration below level of vocal folds without cough or other outward sign of difficulty

19
Q

What are some signs of silent aspiration?

A

Patient presents with absence of subjective complaints

Often have associated weak cough, dysphonia, and bilateral neurological signs

20
Q

What are ways of detecting aspiration?

A

Instrumental - VFSS, FEES
Chest X-ray
Respiratory signs and symptoms?
Spike in temperature?

21
Q

Where in the lung is indicative of aspiration

A

Lower right lobe

22
Q

What factors influence aspiration pneumonia

A

Premorbidly healthy

Ambulant cope better

23
Q

According to Langmore 1998 what are the best predictors of aspiration pneumonia

A 
Dependence for feeding
Dependence for oral care
Number of decayed teeth
Tube feeding
More than one medical diagnosis
Number of medications
Smoking
24
Q

What is our role in dysphagia?

A

Assessment of oral and pharyngeal stage swallowing disorder
Diagnosis of oral and pharyngeal stage swallowing disorder
Treatment of oral and pharyngeal stage swallowing disorder

25
Q

What do we not do?

A

Insert or reinsert Nasogastric tubes
Evaluate nutritional intake plan on non-oral feeding regimes
Suction via trachea
Independently insert the endoscope for fibreoptic endoscopic evaluations of swallowing (FEES) assessments
Diagnose and manage oesophageal disorders

26
Q

What are ways to minimise medicolegal issues?

A

Follow SPA code of ethics
Follow guidelines in the SPA position paper
Keep patients and family involved
Maintain your professional development
Refer to more experienced staff if ever in doubt
Keep accurate records and documents
Ensure you work in a safe clinical environment

27
Q

Where do we see dysphagic patients?

A 
Hospitals 
 - Acute
 - rehab
 - extended care
Community health
Nursing homes
Education department/school settings
Specialist centres
28
Q

What is involved in acute care?

A

Need to be aware of general medical condition
Aim is to eliminate risk of aspiration through compensatory techniques
Patient’s role is often passive
Daily visits
Ongoing monitoring
Bedside evaluation

29
Q

Our role in rehabilitation

A

Comprehensive instrumental evaluation
Patient medically stable and able to be active in rehab
Aim: rehabilitation of the swallow - active intervention using rehabilitation techniques and compensatory techniques
Intensive therapy

30
Q

What is our role in long term care?

A

Optimising oral intake and quality of life relating to oral intake
Sensitivity to ethical and legal issues
Counselling and education of patient and carers
Aim - ongoing slow stream rehab and maintenance of function
Predominantly clinical reassessment/review. Review through instrumental assessment may be warranted
Less frequent monitoring

31
Q

What is our role in palliative care?

A

Aim - optimising quality of life and ensuring safe oral intake
Clinical evaluations only
Compensatory intervention only
Patient choices
Counselling and support - patient and carers
Consultative model - implementing appropriate response as changej in status reported

32
Q

What other professions are involved in dysphagia management team?

A 
Medical staff
Nursing
Dietician
OT 
PT
Social worker
Dentist
The patient
Family
Support workers
33
Q

Who specifically might you meet on the medical staff?

A 
Intensivist
Respiratory 
Gastroenterology
Radiology
Gerontology
General medical
Otolaryngology
Neurology
Oncology
Paediatrics
Surgical - ENT, plastics, maxillofacial, cardiology

Dysphagia (5 decks)

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