CHAPTER 11: BARRIERS TO ADEQUATE NUTRITION Flashcards
What neurological conditions can result in dysphagia?
▪ Parkinson’s
▪ Stroke
▪ MS
▪ Cerebral palsy
What are some nursing interventions for a patient experiencing dysphagia?
▪ Lightly stroke their chin or throat while they’re eating to promote swallowing
▪ Thicken thin liquids
• Thin liquids are not safe aka plain water, you need to add a thickener to them or you need to get some thickened liquids which are easier for them to swallow
▪ Check your pt mouth for food pockets before feeding them more
• Food pocket=don’t actually swallow the food, they will tuck it in between their teeth and their cheeks
▪ Encourage pt to tuck chin against their chest to swallow more easily
▪ Monitor pt during meals and have suction equipment available
What education should be provided to families who are economically disadvantaged or lack access to healthy foods?
- Avoid canned, boxed, or processed foods which are often high in calories, fat, and sodium
- Encourage to choose frozen fruits and vegetables which are more affordable and last a pretty long time in the freezer
- Teach pt to read food labels to know which items high fat sodium calories and type of thing and which ones have are more healthy
- If they cannot physically get to a grocery store: arrange for meal delivery services
- Refer to dietician and social services
What nursing care should be provided for those who are malnourished, nauseated, or early satiety and/or anorexia?
- Offer multiple small meals per day rather than few large ones
- Limit liquids at meal time (should be drinking in-between meals)
- Cold or room temperature meals are less smelly (decrease nausea)
- Oral care before and after meals
- Increase patient intake by providing supplement drinks in-between meals
- Encourage to consume more food in the morning (when nausea is less and appetite better)
- Do not fill up on low calorie foods, consume small amounts of foods that have high protein, high calorie, nutrient dense ingredients
What nursing care should be provided to the visually impaired?
- When deliver their tray, describe what is on their tray using a clock face
- Provide large handle utensils (easier for them to find and grasp)
What care should be provided for patients experiencing poor dentition (i.e., lost teeth, dental caries, new dentures)?
- For children, screen and teach about healthy eating
- Fluoridated tooth paste
- Basic dental screen for all clients
What care should be provided for patients experiencing cognitive disorders?
- Social service referral or shop with a friend or family member and using a list
- Watch out for nutritional deficits
- Give few nutritious, choices
- Keep eating environment the same and distractions to a minimum
- Remind pt to chew and swallow; stroke chin and throat to promote swallowing
What care should be provided for patients experiencing altered sensory perception?
- Social service referral or shop with a friend or family member and using a list
- If have food aversion or nausea when eating eat cold foods
- If can’t taste spicy or tangy foods
- If unusual taste in mouth suck on hard candies, mints or chewing gum
- Avoid empty calories
What care should be provided for patients experiencing impaired swallowing?
- Diet and thickened fluids based on speech language pathologist order
- Give time to eat
- Avoid distractions
- Rest before eating
- Tuck chin when swallowing or arch tongue in back of throat
What care should be provided for patients experiencing mechanical fixation of the jaw?
- Encourage fluids
- Teach to put straw into space between jaws
- Consult dietician to use liquid meal plan