What is the role of the nurse in caring for a patient with dysphagia?
Dysphagia (inability to swallow properly) is a common and significant complication that occurs in about 40-60% of stroke victims. Show Patients with dysphagia have trouble swallowing solids or liquids without aspirating the contents into the bronchopulmonary tract. They may also find it hard to chew or move their tongues adequately to prepare food for the swallowing action. Proper assessment and early management is essential, as dysphagia is associated with high rates of morbidity and mortality. Subscribe for FREE to the HealthTimes magazine Ideally, the nurse looking after a stroke victim should strive to observe for dysphagia, monitor for and report any complications such as infection, and monitor for signs of dehydration and malnutrition. Dysphagia can lead to:
Assessment findings indicative of increased risk of dysphagia, aspiration, and pneumonia:
FEATURED JOBSIdentification of dysphagia in stroke victims: A patient is more likely to be suffering from dysphagia if some of the following factors are present: palatal asymmetry, impaired pharyngeal response, being male, being more than 70 years old, and not being able to clear the oral cavity completely. A nurse should also observe the patient’s ability to move the mouth spontaneously, e.g. licking lips, smiling, speaking well (i.e. is it intelligible?). There are various screening methods for identifying dysphagia, such as a swallow test. Patients can be tested to see how well they swallow food of different consistencies and textures, e.g. water, then thickened fluids, then mashed foods, then more solid foods. Afterwards, patients should be assessed for any delayed coughing. Vital signs should also be monitored, as a patient’s temperature will rise when aspirating food, whilst oxygen saturation levels may fall. Additionally, the incidence rate of identifying dysphagia was found in one study to be higher when a clinician trained in swallowing was involved, and highest when instruments such as videofluroscopy were involved. Dysphagia assessments are important – one multicentre study found that when a standardised screening protocol for dysphagia was used on stroke victims, the risk of aspiration pneumonia decreased. The patient should also be referred to a speech pathologist for a thorough clinical assessment. Speech pathologists can formally assess for dysphagia, and recommend strategies for eating and swallowing. They can also teach patients how to exercise the muscles involved in swallowing. Important practice points for managing patients with dysphagia:
Sources *This article passed Copyscape Premium on 2 June 2016 at 2:58 GMT. How do you care for a dysphagia patient?Dietary modifications. Amounts to be given at one meal/drink. Swallowing strategies. General Safe Swallow recommendations (e.g. advice on alertness, posture, advice to stop the patient eating or drinking if showing signs of aspiration)
How can a nurse help a patient with dysphagia?More interventions:. Avoidance of certain foods or fluids.. Upright position during eating.. Allowance of time to eat slowly and chew thoroughly.. Provision of high-calorie meals.. Use of fluids to help facilitate passage of solid foods.. Monitoring of the patient for weight loss or dehydration.. What is important when supporting a person with dysphagia?When assisting someone with dysphagia to eat and drink, it is important to always follow the advice and recommendations from their healthcare professional with regard to diet texture, thickness of fluids and positioning and strategies to increase the safety of their swallow.
What is dysphagia in nursing?Dysphagia literally means difficulty eating or swallowing.
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