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Zorluk: OrtaBasic Care and Comfort

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.

  1. Assist the client into a high-Fowler's position prior to providing food or liquidsCevap
  2. B
    Supply a drinking straw to help the client consume beverages more easily
  3. Instruct the client to tuck their chin downward toward the chest while swallowingCevap
  4. D
    Place small amounts of food on the right side of the client's mouth to stimulate chewing
  5. Perform oral hygiene care for the client both before and following the mealCevap
  6. F
    Transition the client to a semi-Fowler's position immediately after the meal is finished

Cevap

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.

Adım Adım Çözüm

1
Analyze the client's clinical presentation.
The client has right-sided paralysis and difficulty swallowing (dysphagia).
Understanding the deficits is crucial to identifying interventions that protect the airway and ensure safe nutrition.
2
Determine proper positioning during and after meals.
A high-Fowler's position and the chin-tuck maneuver are identified as necessary safety measures.
These specific anatomical positions utilize gravity and narrowing of the trachea to prevent food and liquid from entering the airway.
3
Identify supportive basic care routines related to feeding.
Providing oral hygiene before and after meals is selected as a priority comfort and safety measure.
Pre-meal oral care improves the sensory experience of eating, while post-meal care removes leftover food that could be silently aspirated.

Anahtar Kavram

Dysphagia Management and Aspiration Precautions
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