A patient is experiencing dysphagia following a recent stroke. The nurse finds the patient is pooling food in one side of his mouth at mealtimes. What nursing interventions should be incorporated in this patient's plan of care?

Question

A) Have the patient increase clear fluids with meals.
B) Feed the patient thickened liquids.
C) Have the patient slightly reclined at mealtimes.
D) Have a volunteer sit and feed the patient.

Answer 1

Ans: B
Chapter: 62
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 5
Patient Needs: D-3
Feedback: Stroke can result in swallowing problems (dysphagia) due to impaired function of the mouth, tongue, palate, larynx, pharynx, or upper esophagus. Stroke patients must be observed for paroxysms of coughing, food dribbling out of or pooling in one side of the mouth, food retained for long periods in the mouth, or nasal regurgitation when swallowing liquids. Swallowing difficulties place the patient at risk for aspiration, pneumonia, dehydration, and malnutrition. A speech therapist will evaluate the patient's gag reflexes and ability to swallow. Even if partially impaired, swallowing function may return in some patients over time, or the patient may be taught alternative-swallowing techniques, advised to take smaller boluses of food, and informed about foods that are easier to swallow. The patient may initially be started on a thick liquid or pureed diet because these foods are easier to swallow than thin liquids. Having the patient sit upright, preferably out of bed in the chair, helps prevent aspiration. The patient's diet may be advanced as he or she becomes more proficient at swallowing. A volunteer should not be assigned to feed the patient due to possible risk of aspiration.