Fundamentals of Nursing Q 523
Which of the following statements is incorrect about a patient with dysphagia?
A. The patient will find pureed or soft foods, such as custards, easier to swallow than water.
B. Fowler’s or semi Fowler’s position reduces the risk of aspiration during swallowing.
C. The patient should always feed himself.
D. The nurse should perform oral hygiene before assisting with feeding.
Correct Answer: C. The patient should always feed himself.
A patient with dysphagia (difficulty swallowing) requires assistance with feeding. Feeding himself is a long-range expected outcome. Dysphagia is defined as objective impairment or difficulty in swallowing, resulting in an abnormal delay in the transit of a liquid or solid bolus. The delay may be during the oropharyngeal or esophageal phase of swallowing.
Option A: The Academy of Nutrition and Dietetics has created a diet plan for people with dysphagia. The plan is called the National Dysphagia Diet. The dysphagia diet has 4 levels of foods. Level 1 foods are foods that are pureed or smooth, like pudding. They need no chewing. This includes foods such as yogurt, mashed potatoes with gravy to moisten it, smooth soups, and pureed vegetables and meats.
Option B: While eating or drinking, it may help to sit upright, with the back straight. The client may need support pillows to get into the best position. It may also help to have few distractions while eating or drinking. Changing between solid food and liquids may also help the swallowing. Stay upright for at least 30 minutes after eating. This can help reduce the risk for aspiration.
Option D: After meals, it’s important to do proper oral care. The SLP (speech-language pathologist) can give the client instructions for the teeth or dentures. Make sure to not swallow any water during the oral care routine. While on a dysphagia diet, the client may have trouble taking in enough fluid. This can cause dehydration, which can lead to serious health problems. Talk with the healthcare team about how it can be prevented. In some cases drinking thicker liquids may make some of the medicines work less well. Because of this, the client may need some of the medicines changed for a while.