Professional Documents
Culture Documents
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Management of Dysphagia i
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patient with dysphagia, assessment of swallowing and positioning, form of diet, nutrition
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status, and oral hygiene should be maintained. Health care providers and family members
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food and push it into the back of the mouth towards pharynx. It
is a voluntary action (Hughes, 2011). Due to neurological and muscular changes the
involuntary actions performed by the muscles of pharynx and esophagus which ensure
that food enters gastrointestinal tract; muscles of larynx which close the epiglottis and
vocal cords that prevent food from entering the trache~cles
of esophagus which
ensure peristalsis movement to make bolus of food enter into the stomach are affected.~
Hence, it becomes important to check if the individual is choking or coughing while
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delayed, initially
swallowing with difficulty, feels food is sticking in the throat, and gagging (Hughes,
2011). Any type of swallowing difficulty due to reduced muscle tone or paralysis can
lead to aspiration pneumonia, in which food or fluids pass into trachea and lungs. In order
to eliminate the risk of aspiration pneumonia, positioning of the patient should be correct
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such' as sitting upright. A study has been conducted (Hughes, 2011) which states that
there is a significant difference in swallowing-related muscles when people are in
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horizontal position or sitting upright. Sitting upright was concluded as the safest position.
Hence, as a nurse it is very essential to know the physiological changes, signs and
symptoms in a patient suffering from stroke. It will help the nurse to determine the right
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choking incidenm~
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~ ~~~ 7. swallowing status. One of the problems after stroke is paralysis. Anyone side right orleft
t.ci50'vj can get affected. Patient can start pocketing food in cheek on the affected side. Texture of
the diet can be soft diet and normal (thin) fluids or pureed diet and thickened fluids.
Apart from textured three meals, patients need additional nutrition through supplements.
Nutritional assessment should start from the time of admission to a healthc:"",, setting an~
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assessment can help in establishing a baseline nutritional needs of a patient and regular
check at intervals can help in establishing goals for the changes to be made. Textured diet,
supplements, nutritional assessment, everything works good if the patient accepts the
condition and co-operates with the situation. However, it is the duty of the nurse to
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practice.
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Managementof DysphagiaiBatients
and
oral hygiene are the important aspects in managing dysphagia after stroke. Thus, a nurse
with a deep knowledge of pathophysiology of stroke and its effects on the person, can
work with other healthcare providers such as doctors, physiotherapists, speech and
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language therapist~ dentisSand take care of the patient in a safe and holistic manner.
References
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