The patient has weakness of the left arm and hand after a stroke. Which is the best nursing intervention to help maintain the patient's self-esteem during feeding?
a. Delegate feeding to nursing assistive per-sonnel (NAP) to minimize the amount of food spilled.
b. Encourage the patient to self-feed as much as possible.
c. Ensure that foods are pureed so they may be consumed through a straw.
d. Collaborate with speech therapist to im-prove the patient's communication.
B
The nurse maintains and enhances the patient's self-esteem by encouraging the patient with posi-tive reinforcement, acknowledging the patient's progress with self-feeding, and engaging him or her in conversation during feeding. Feeding the patient may reinforce feelings of inadequacy, worthlessness, or embarrassment. Taking food by straw may be contraindicated and increase the risk of aspiration, depending on the patient's neuromuscular coordination for chewing and swal-lowing. Ensuring effective patient communication is expected nursing care for any patient in any setting; however, speech therapy is not indicated.
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