A practical nurse is assigned to care for an older adult client who has oropharyngeal dysphagia following a cerebrovascular accident (CVA). The client is alert and ready for their afternoon meal. Arrange the following nursing actions in the correct chronological order to safely assist the client with eating and prevent aspiration.
- 1Elevate the head of the bed to a 90-degree high Fowler's position.
- 2Provide gentle oral hygiene to moisten the oral mucosa and stimulate the swallowing reflex.
- 3Place a half-teaspoon of food on the unaffected (stronger) side of the client's mouth.
- 4Instruct the client to tilt their head forward and tuck their chin while swallowing.
- 5Inspect the buccal cavities for pocketed food remnants before offering the next bite.
Answer
The correct sequence ensures airway safety by first positioning the client upright, preparing the oral cavity, placing food on the strong side, using the chin-tuck maneuver during the active swallow, and finally checking for retained food.
Safe feeding for a client with dysphagia is a systematic process. Environmental and postural safety must be established first by positioning the client at 90 degrees. The oral cavity is then prepared via hygiene. During the actual feeding, food must be placed where the client has motor control (the unaffected side), and the airway must be actively protected during the swallow using the chin-tuck technique. Finally, a post-swallow assessment ensures no residual hazards remain by checking for pocketing.
Step-by-Step Solution
Key Concept
Aspiration Prevention and Dysphagia Management