A nurse is assessing clients on a rehabilitation unit. Which clients are at greatest risk for asphyxiation related to inspissated oral and nasopharyngeal secretions? (Select all that apply.)
a. A 24-year-old with a traumatic brain injury
b. A 36-year-old who fractured his left femur
c. A 58-year-old at risk for aspiration following radiation therapy
d. A 66-year-old who is a quadriplegic and has a sacral ulcer
e. An 80-year-old who is aphasic after a cerebral vascular accident
ANS: A, C, D, E
Risk for asphyxiation related to inspissated oral and nasopharyngeal secretions is caused by poor oral hygiene. Clients at risk include those with altered mental status and level of consciousness (traumatic brain injury), dehydration, an inability to communicate (aphasic) and cough effectively (quadriplegic), and a risk of aspiration (aspiration precautions). The client with a fractured femur is at risk for a pulmonary embolism.
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