Bedside Or Clinical Observation Flashcards
What is important to note about levels of alertness of a client?
can the client maintain an alert state or do they become drowsy?
How do they react to the clinicians entrance?
If they are drowsy this may compromise their nutrition and hydration needs
What structural abnormalities should you look for?
facial asymmetries
maintenance of labial seal
evidence of VPI resulting in hypernasality and presence of dysphonia
denture retention: this depends on good buccal tone, if not present dentures will slip towards affected side
What is important to note about a patients communication and cogition?
Can they follow commands?
Do they need non verbal cues?
Are they able to maintain their attention and do they fatigue easily?
What is important to note about a patients visual and hearing acuity?
Is the client wearing glasses or a hearing aid?
What is important to note about a patients posture and movement?
Best posture is sitting in a chair in an upright and symmetrical posture with the head slightly flexed.
This may be compromised by neurological conditions or fatigue.
A client who has poor posture may be more likely to experience pulmonary complications
WhHat is important to note about a patients respiration?
Observe the patients breathing at rest.
Listen for raspy shallow breathing which may indicate pulmonary involvement
What is important to note about a patients coughing?
Patients who cough often during the day may be experiencing less frequent triggering of the swallow reflex.
This results in saliva pooling in the laryngopharynx triggering a cough reflex
What is important to note about a patients oral hygiene?
Does the client manage own saliva: do they swallow spontaneously or drool?
Food or fluid residue on mouth or clothes indicates problems with oral stage
What is important to note about a patients diet and hydration?
Note the presence of and the clients reaction to:
IV drip
Feeding tubes
Catheters
Food and drink on table
Dehydration can lead to thick and sticky saliva
