Chapter 8 Flashcards
1: Is swallow safety the top priority of the dysphagia management team, along with maintaining nutrition and quality of life of the patient?
Yes, it is
2: Can proper nutrition be achieved by a combination of oral and non-oral diet?
Yes, it can
3: As a fluid becomes more viscous, is it more easily deformed?
No, it becomes more difficult to deform
4: Are most foods or fluids that are eaten non-newtonian?
Yes, they are
5: Is one of the purposes of the International Dysphagia Diet Standardization Initiative to restrict the levels of consistencies for testing when doing fluoroscopic swallow studies?
-No, IDDSI’s purpose is to allow consistent testing and documentation for comparisons across time, patients, and studies
6: Do thickened fluids retain their consistency with time?
-No, it depends on the type of the thickener used
7: True or false: extremely thick (level 4) liquids are suggested for those with poor tongue control, but will increase the risk of post swallow residue.
True
- Should SLPs provide guidelines on modified food and drink preparation to other health care professionals only?
Nope, the patient and their family should be given guidelines as well
- True or false: food texture is not related to chemical senses of taste or odor.
True
- Do all foods and drinks behave similarly in persons with different types and severity levels of dysphagia?
No, foods and drinks may behave differently
- True or false: Even when limits are set for an elderly patient’s oral diet to ensure swallow safety, they should not be so restrictive as to discourage oral intake.
True, we do not want to restrict oral intake
- After the initial diagnosis and recommendation for safer feeding, does the clinician not need to see the patient again?
No, regular follow-ups are necessary
- Is a gastrostomy a permanent fixture once it is in place?
No, gastronomy can be removed and is more of a long-term alternative to other intubation or a temporary feeding method while the patient recovers
- Are nasogastric feeding tubes usually used in patients who will be on long-term nonoral diets?
No, nasogastrics are uncomfortable and for use less than 3 months, gastro tubes are a better long-term option
- Is choice of a nonoral diet via feeding tube made based on the findings of the instrumental swallow examination?
No, other factors like living situation, physical disability and dentition should be considered as well.
- T/F: Once a feeding tube is in place in the elderly, it is best to discontinue swallow exercises as they only make the patient more frustrated because he/she cannot eat orally.
False, even with elderly patients, swallowing treatment plans should still encourage oral feeding
- Should patients with degenerative neuromuscular diseases be placed on a feeding tube after they can no longer eat anything by mouth and show signs of malnutrition?
No, they should be placed on feeding tubes when they have the desire to maintain nutrition and before they can no longer eat orally
- Will getting the prescribed amount of calories allow a patient to recover from malnutrition?
Yes, it will
- Does malnutrition in hospital patients have comorbidities unrelated to the underlying diagnosis?
Yes, it does
- Is a pH test of tube aspirate is recommended for all types of tube-feeding?
No, the ph test of tube aspirate is only recommended for NG tubes
- Should elderly patients be allowed to eat a liberal diet in order to maintain their social status and outside living activities as long as safety of swallowing is preserved in the diet?
Yeah!
- Which professional is mainly responsible for monitoring the nutritional status of the patient?
Registered dietician
- Proper nutrition can have which 2 benefits?
It can provide increased strength
It can build immune status
- Standardization of foods through analysis of their properties will help in which 3 ways?
- Improving test to test reliability
- Allowing a comparison of FEES and MBS results more carefully
- Calculating nutrition requirements
- The key to recommending thickened fluids is to… (2 things)
- protect the anyway and ensure maximal swallow safety
- minimize residue post swallow
- Viscosity represents a characteristic of a liquid that can be described more simply as…
Thickness
- What 3 factors might limit a patient’s intake of recommended thickened fluids?
- Limited access to thickened fluids
- Patient is unused to the change in taste and texture
- Patient feels that thickened fluids do not quench their thirst
- Who may benefit from the Free Water Protocol?
Only individuals who are mobile and have good cognitive functions
- 2 examples of minced and moist foods include…
- thick and smooth cereal
- mashed banana
- For patients who require long-term nonoral feeding, gastrostomy tubes are preferred for which 4 reasons?
- They last longer and therefore require less replacing
- They are more comfortable than other forms of enteral feeding
- They are more fixed in place and do not dislodge easily
- Patients do not find them as disfiguring
Describe the food texture according to IDDSI:
31. Regular
Daily foods of different textures
Describe the food texture according to IDDSI:
32. Pureed
Blended food with any type of additional liquid to achieve a smooth, extremely thick fluid
Describe the food texture according to IDDSI:
33. Soft
Foods that require little chewing, can be naturally so or processed to achieve this texture
Describe the food texture according to IDDSI:
34. Minced and moist
Finely mashed or minced solids with thick and smooth sauces
Describe the food texture according to IDDSI:
35. Liquidized
Blended food and any type of additional liquid to achieve a smooth, moderately thick fluid
Where does the nutrition delivery method enter the body and end in the body?
36. Intravenous/peripheral parenteral nutrition; central total parenteral nutrition
Peripheral veins
Where does the nutrition delivery method enter the body and end in the body?
37. Jejunostomy
External opening on the abdomen to the small intestines
Where does the nutrition delivery method enter the body and end in the body?
38. Gastrostomy/percutaneous endoscopic gastrostomy
External opening on the abdomen to the stomach
Where does the nutrition delivery method enter the body and end in the body?
39. Nasogastric tube
Nose to stomach
Where does the nutrition delivery method enter the body and end in the body?
40. Nasoduodenal/nasojejunal
Nose to intestine
- What is rheology?
The study of deformation and flow of matter
- What are the two variables in rheology that influence the properties of a liquid?
Viscosity and density
- Diets catering to patients with dysphagia should take into consideration which 4 things?
- Amount
- Consistency
- Viscosity
- Timing
- Thickeners are used in treating swallowing disorders to change what property of the liquid or food?
The viscosity;
thickeners change the viscosity of thin liquids and foods, making them easier to swallow
- A creep test is used to determine how materials__________________when put under stress
Deform:
A creep test is used to determine how materials deform when put under stress
- A fluid with no single constant value of viscosity is called a…
Non-newtonian fluid
- List three categories of foods that are not well tolerated by those with dysphagia
1: crumbly and non-cohesive foods
2: mixed consistency foods
3: sticky foods
- Feeding that occurs by way of entering through the intestine is called….
Jejonoscopy feeding
- Define presbyphagia.
Presbyphagia refers to characteristic changes in the swallowing mechanism of otherwise healthy adults
