Evaluate the results of swallowing studies as ordered.Ī video-fluoroscopic swallowing study may be indicated to determine the nature and extent of any oropharyngeal swallowing abnormality, which aids in designing interventions.ĩ.
Regurgitation indicated the decreased ability to swallow food or fluids and an increased risk for aspiration.Ĩ. Check for food or fluid regurgitation through the nares. Pocketed food may be easily aspirated at a later time.ħ. Check for residual food in the mouth after eating. If aspirated, little or no harm to the patient occurs.Ħ. Assess the ability to swallow a small amount of water. These are all signs of swallowing impairment.ĥ. Observe for signs associated with swallowing problems (e.g., coughing, choking, spitting of food, drooling, difficulty handling oral secretions, double swallowing or major delay in swallowing, watering eyes, nasal discharge, wet or gurgly voice, decreased ability to move tongue and lips, decreased mastication of food, decreased ability to move food to the back of the pharynx, slow or scanning speech). Check for coughing or choking during eating and drinking.Ĥ. Coordinated function of muscles innervated by these nerves is necessary to move a bolus of food from the mouth to the posterior pharynx for controlled swallowing.ģ. Evaluate the strength of facial muscles.Ĭranial nerves VII, IX, X, and XII control motor function in the mouth and pharynx. When reflexes are depressed, the patient is at increased risk for aspiration.Ģ. The lungs are usually protected against aspiration by reflexes as cough or gag.
Do not rely on the presence of a gag reflex to determine when to feed. Ask the patient to cough test for a gag reflex on both sides of the posterior pharyngeal wall (lingual surface) with a tongue blade. Ask the patient to swallow feel the larynx elevate. Assess the ability to swallow by positioning the examiner’s thumb and index finger on the patient’s laryngeal protuberance. Nursing Assessment and RationalesĪssessment is necessary to determine potential problems that may have lead to dysphagia as well as handle any difficulty that may appear during nursing care.ġ. The causes of swallowing problems vary, and treatment depends on the cause. It is a common complaint among older adults, in those individuals who have had a stroke, suffered head trauma, have head or neck cancer, or experience progressive neurological diseases as of multiple sclerosis, amyotrophic lateral sclerosis, and Parkinson’s disease. Dysphagia can befall at any age, but it’s more prevalent in older adults.ĭysphagia can befall at any age, but it’s more prevalent in older adults. The swallowing muscles can become weak with age or inactivity. It can be a temporary or permanent complication that can be fatal.Īspiration of food or fluid can also occur possibly brought about by a structural problem, interruption or dysfunction of neural pathways, decreased strength or excursion of muscles involved in mastication, facial paralysis, or perceptual impairment. It occurs when the muscles and nerves that help move food through the throat and esophagus are not working right. What is dysphagia?ĭysphagia or impairment in swallowing involves more time and effort to transfer food or liquid from the mouth to the stomach. By utilizing this guide, you will enhance your ability to effectively manage and support patients with dysphagia, ensuring their safety and well-being. This guide equips you with valuable insights into conducting thorough nursing assessments, implementing evidence-based interventions, establishing appropriate goals, and identifying nursing diagnoses related to dysphagia. Utilize this comprehensive nursing care plan and management guide to provide exceptional care for patients with dysphagia or those at impairment in swallowing.
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