Which function would the nurse consider in the plan of care when a client has dysphagia
Dysphagia, simply put, is when someone has difficulty eating. They are unable to chew or swallow food or liquids from their mouth to their stomach. Dysphagia itself is not a disease, but rather a condition that occurs from a range of illnesses, diseases, accidents or treatments such as stroke, cancer treatments, head and neck injuries, cerebral palsy, Parkinson’s and dementia to name a few. These diseases and treatments can cause the nerves and muscles in the mouth and throat to weaken
or become paralyzed, making it difficult for someone to chew, move the food in their mouth and swallow effectively. Show
Dysphagia can also occur in the elderly who are otherwise healthy and have no illnesses or diseases. For example, many elderly people experience tooth and muscle loss (in the cheeks and tongue) and that can affect chewing. They can also have reduced saliva flow. Many medications can cause side effects such as dry mouth or reduced cognition. Finally, when someone ages,
they can also have reduced nerve function in their mouth which can affect their ability to taste, feel the texture or temperature of the food in their mouth. All these factors can contribute to improper chewing and swallowing response which would normally help push the food down from mouth to their stomach safely. Consequences of DysphagiaAccording to the American Stroke Association, up to 65 percent of stroke patients may experience dysphagia. In long-term care settings such as assisted living residences or nursing homes, more than 60 percent of residents have dysphagia. We tend to take swallowing for granted, but swallowing is a complicated process that uses lots of nerves and muscles. Chewing and swallowing are automatic processes for us and unless something goes wrong, we don’t tend to pay attention to it. However, if we were to cough and choke during mealtimes, this can cause quite an alarm and we have to stop whatever we are doing and concentrate on recovering before continuing our meal. For those with dysphagia, they may not even know that their food or drink is going down the wrong way into their throat and lungs and they be silently aspirating. The effects from untreated dysphagia can be damaging;
Because of these outcomes, your loved one can be at further
risk of other complications like constipation, poor wound healing, increased susceptibility to more infections and weakened muscles. They are not only at risk of having caloric, vitamin and mineral deficiencies because of their irregular and decreased intake of food and fluids, but they can also have psychological issues as well due to their dependence on their others for food and different meal types than they are used to. All this can add to increased anxiety and low mood which can affect
their intake, leading to weight loss and malnutrition. By getting a referral to see a Speech Therapist and Dietitian early and paying attention to their diet and swallow function, your loved one will feel better, prevent nutrition-related problems, and prevent hospitalisation. As we all are aware, hospital stays can be costly, traumatic for both the patient and their families. By following good nutrition practices, your loved one can stay independent for as long as possible. And as a carer, you will be more able to support him/her in living out a meaningful life for their remaining days. Nutrition Goals in Dysphagia
What You Can DoWhen difficulty in swallowing becomes a problem due to an illness or disability, then your loved one has to concentrate when they are eating or drinking and anyone helping them also needs to give their full attention.
AvoidBe careful with these foods and only use if their Speech Therapist says it’s safe.
Additional Considerations for:MalnutritionThis serious condition occurs when your loved one suffers from a low appetite and food intake with weight loss as their caloric needs cannot be met when they have dysphagia. It’s important to ensure that we identify and act early by getting a referral to a Dietitian. Dietitians can assess the problem and recommend a meal plan that will help
your loved one recover from malnutrition.
*Be careful with the consistency of the foods and only use if their Speech Therapist says it’s safe. DehydrationMany people with dysphagia don’t feel the thirst sensation, by then, they may already be
dehydrated, so it’s important to keep offering them fluids at the appropriate thickness for them ( especially so if they are unable to communicate) regularly to prevent complications.
Aspiration PneumoniaYour loved one can aspirate if the food, saliva or stomach acids is inhaled into their lungs instead of being swallowed into their esophagus and stomach. As a result, it can cause swelling or infection of the lungs. Therefore, it is important for anyone who is caring for your loved one to keep a lookout for signs of aspiration. Call their doctor right away if you observe:
Myths and Facts
People with dysphagia can be silently aspirating. We are not able to hear when it happens. Keep a look out for the other signs of aspiration and ensure your mother is being regularly followed up by a Speech Therapist. They can help to assess if your mother is taking food and liquids into her lungs.
A feeding tube is a way for someone to get the nutrition they need if they are not eating enough by mouth or if they have dysphagia, however, it is not true that they can
never eat again. A feeding tube is reversible and can be a good way to get the nutrition your grandmother needs while her swallowing improves. Regular assessments with her Speech Therapist can determine whether the tube can be removed and she can eat orally again. We also recommend reading Your Guide to Oral Nutritional Supplements (ONS) and Apps For Diabetics: 5 Aspects To Look Out For. Helpful Products from Health Food Matters
At Health Food Matters, their team of healthcare experts and food technologist develop scrumptious Delisoft Easy Meals which are nutritious and they come in different textures. They also carry a range of snacks and desserts from their Special Pantry to provide an extra boost for those who struggle getting enough nutrition every day. At Jaga-Me, we believe that healthcare should be a social good – it is a basic human need, and should be available to as many people as possible. We aim to deliver the highest quality care through innovation and a commitment to building meaningful relationships. Save travelling and long wait times at the hospitals. Get specialised medical treatments: Jaga-Me: Your Trusted Medical Home Care Professional Which procedure would the nurse expect as a treatment option for a client newly diagnosed with Guillain?B. “Plasmapheresis or immunoglobin therapies are treatment options available for this syndrome but are most effective when given within 4 weeks of the onset of symptoms.”
Which term would the nurse use to document observing the characteristic gait associated with Parkinson disease?Another case that we would commonly identify is the gait of Parkinson's disease. It's a posture that's characterized by universal flexion. Every joint is flexed and the patient typically will take very small steps. This is called a festination gait.
Which therapeutic communication technique is used when the nurse and a client have a conversation?Active listening involves showing interest in what patients have to say, acknowledging that you're listening and understanding, and engaging with them throughout the conversation. Nurses can offer general leads such as “What happened next?” to guide the conversation or propel it forward.
Which procedure would be considered as a treatment option for a client newly diagnosed with Guillain Barre Syndrome?The two major interventions to treat GBS are plasmapheresis and intravenous immunoglobulin (IVIg).
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