dysphagia

Question 1

what is the first thing to do with a patient who may have dysphagia?

Answer 1

assess for a gag reflex–> if the gag reflex is present, give the patient a small sip of water to determine if choking occurs

Question 2

what type of diet should a patient with dysphagia follow?

Answer 2

Patients who have dysphagia can have thin (water, juice), honey (honey, yogurt) and spoon thick (pudding, cooked cereals). Food levels for dysphagic include pureed, mechanically altered, advanced/mechanically soft, and regular.

Question 3

who should initial feedings be done by and why?

Answer 3

Initial feedings should be done by an RN, so appropriate interventions can be taken if choking occurs.

Question 4

how should the client sit to decrease risk of dysphagia?

Answer 4

Instruct the client to sit upright and flex the head forward when swallowing to decrease the risk of choking.

Question 5

what are other points to know about dysphagia?

Answer 5

1. If the client exhibits difficulty managing food or fluids, a swallowing evaluation should be done by an SLP. Keep the client NPO until evaluated by the SLP.
2. Have suction equipment available, but feed with care because nasotracheal suctioning increases ICP.
3. . Some clients require an eating environment without distractions to prevent choking.

Question 6

what are signs of increased ICP?

Answer 6

nausea, vomiting, headache, restless, irritability, cranial nerve dysfunction, decreased LOC, pupillary changes, cheyne stokes respirations, decerebrate/decorticate, flaccidity, cushing’s triad, seizures