Treatment

Question 1

When would you be more aggressive with allowing pt to have an oral diet, despite pt having mild intermittent aspiration?

Answer 1

-Independent of caregiver with feeding (independently feed self)

-Pt is mobile & physically active

• No complicated medical history (no neurological, cognitive issues)
• no history of recurrent respiratory pneumonia

Question 2

What four factors are important when deciding pt diet?

Answer 2

-Respiratory/Pulmonary function
-Cognitive level (ability to follow directions, understand, remember, etc)
-Eating ability (independent or with support? & do they aspirate 10% of food)
-Pt mobility (are they bedridden or physically active?)

Question 3

When deciding whether to initiate swallowing therapy & therapy type, what should you consider?

Answer 3

1. Pt diagnosis
2. Pt prognosis
3. Reaction to compensatory strategies
4. Severity of pt’s dysphagia
5. Ability to follow directions
6. Respiratory function
7. Availability of caregiver support
8. Pt motivation & interest

Question 4

When considering diet choices, you should consider:

Answer 4

1. Time taken to swallow particular consistence (10sec or less) for every consistency
2. Aspiration (if pt aspirates >10% of every bolus shouldn’t have oral feeding)

Question 5

Factors used to determine the type of non-oral feeding:

Answer 5

1. Pt gastrointestinal history
2. Pt’s preference
3. Cost of feeding and insurance coverage
4. Pt’s medical diagnosis
5. Pt’s behavior

Question 6

Identify the 5 types of compensatory strategies

Answer 6

1. Postural changes
2. Increasing sensory input
3. Modifying volume and speed of food presentation
4. Changing food consistence or viscosity (diet change)
5. Introducing intraoral prosthetics

Question 7

Postural changes potentially change what 2 aspects?

Answer 7

1. The dimension of the pharynx
2. The direction of food

Question 8

List the 6 sensory enhancement techniques

Answer 8

1. Increasing downward pressure with spoon on tongue
2. Sour bolus
3. Cold bolus
4. Bolus that requires chewing
5. Bolus of larger volume (3ml +)
6. Thermal-tactile stimulation

Question 9

Which two sensory techniques are most commonly used for improving trigger of pharyngeal swallow

Answer 9

-Thermal tactile stimulation
-Suck swallow

Question 10

How do you perform thermal tactile stimulation

Answer 10

Firmly rub anterior faucial arch 4 to 5x with a chilled size )) laryngeal mirror

Question 11

Identify the 6 postural changes

Answer 11

1. Chin up
2. Chin down