Which interventions help to prevent aspiration during eating for a client with a tracheostomy? (Select all that apply.)
a. Provide close supervision for the client during eating and drinking.
b. Add liquids to foods to make them thinner and easier to swallow.
c. Inflate the tracheostomy cuff tube to maximum pressure before starting.
d. Let the client indicate readiness for another bite when being fed.
e. Have the client tuck the chin down and forward while swallowing.
f. Instruct the client to dry swallow to clear food particles from the throat.
g. Place the client in a semi-Fowler's position for an hour after eating.
A, D, E, F
The client with a tracheostomy will require close supervision, even if the client is feeding himself or herself. Do not rush the client. Allow him or her to indicate when ready for another bite. Teaching interventions should include instructing the client to tuck the chin down and forward while swallowing to encourage food to move down smoothly. Dry swallowing helps remove food residue. Food may actually become easier to aspirate if it is thinner in texture. The nurse should not initiate adding air to inflate the cuff of a tracheostomy tube further without a physician's order; if possible, the cuff should be deflated during eating. Placing the client in a semi-Fowler's position after the meal will not prevent aspiration.
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