The nursing instructor is discussing aspiration with the level I nursing students. The instructor would tell the students that which client is at the greatest risk for aspiration?
A) A stroke client with dysarthria
B) An ambulatory client with Alzheimer's disease
C) A 92-year-old client who needs help with activities of daily living (ADLs)
D) A client with severe, deforming rheumatoid arthritis
Ans: A
Feedback: Aspiration may occur if the patient cannot adequately coordinate protective glottic, laryngeal, and cough reflexes. The muscles that become paralyzed in dysarthria are the same ones used for swallowing. This increases the client's risk of aspiration. Clients with Alzheimer's disease that are still ambulatory probably do not have the voluntary muscle problems that occur later in the disease. Clients that need help with ADLs or have severe arthritis should not have difficulty swallowing unless it exists secondary to another problem.
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