A client is recovering in the rehabilitation unit with right-sided hemiparesis and moderate dysphagia secondary to a recent cerebrovascular accident. Which interventions should the practical nurse implement to promote comfort and safe oral intake during meals? Select all that apply.
- Assist the client into a high-Fowler's position prior to providing food or liquidsAnswer
- BSupply a drinking straw to help the client consume beverages more easily
- Instruct the client to tuck their chin downward toward the chest while swallowingAnswer
- DPlace small amounts of food on the right side of the client's mouth to stimulate chewing
- Perform oral hygiene care for the client both before and following the mealAnswer
- FTransition the client to a semi-Fowler's position immediately after the meal is finished
Answer
The correct interventions are to position the client upright in a high-Fowler's position, instruct the client to use a chin-tuck maneuver when swallowing, and perform oral hygiene care before and after eating.
Positioning the client upright in a high-Fowler's position uses gravity to help food travel down the esophagus and significantly reduces the risk of it entering the airway. Furthermore, the chin-tuck maneuver narrows the airway opening and widens the esophageal opening, providing mechanical protection against choking. Providing oral hygiene before meals enhances taste and salivary flow, while post-meal oral care is critical to remove any food particles pocketed in the mouth, which could later be aspirated.
Step-by-Step Solution
Key Concept
Dysphagia Management and Aspiration Precautions