Thickened Liquids
Frazier Water Protocol
Swallow General
Purpose of Splints
Splint Precautions
Wheelchair Positioning
100
True or False: You should thicken someone's liquids as soon as they cough when they swallow.
False. Why?
100
True or False: Residents without teeth/with dentures do not need to brush their mouth/gums before given regular water.
False - Bacteria is still present throughout the mouth. Their gums/mouth need to be brushed.
100
True or False: Aspirating food/liquid is always the cause of aspiration pneumonia.
False! Why?
100
Why are splints recommended or used by our residents?
To protect skin, joints and bones from further injury
100
TRUE or FALSE
Some doctors may allow the resident to walk to the bathroom with help and not use the back brace, but most often a brace needs to be used when out of bed
TRUE
The resident is at high risk of further injury follow surgery and should not be able to
BENDING LIFTING TWISTING
100
How many pillows should be used on top of the BLUE depressurizing seat cushions?
None
200
What are two benefits of thickened liquids?
Prevention of aspiration, Easier to control/manage, reduce coughing, lower risk of aspiration.
200
Can a mechanical soft diet have crust on their sandwiches?
NO
200
Case Example: The pt looks like he's "eating/swallowing fine", but the SLP recommended close supervision. Why should someone be present with the pt when eating?
The pt has swallow deficits that put them at high risk of choking, even if they appear to be doing okay.
200
What is an immobilizer used for?
to stabilize a femur fracture (Upper leg/thigh)
200
Where does the splint need to be stored so the next shift can find it easily to use?
In the bathroom
In a RED Bag
200
Why is it important to be sure the resident is sitting upright in a wheelchair during meals?
SAFE SWALLOW
Increase nutritional intake
300
If the resident is on thickened liquids and they are not happy or seems to be struggling, what should you do?
Notify the SLP.
300
When can patients be given regular water when on the FWP?
Prior to each meal and 30 mins after each meal/snack/meds, as long as oral care has been completed.
300
True or False: An SLP treats all stages/phases of swallowing.
False - GI or ENT treat the esophageal stage of swallowing.
300
Is there a difference between a Right and Left Palm Protector?
Yes
300
What needs to be done to the patient's hand(s) before putting a splint on and when taking a splint off?
Wash and dry thoroughly
Check the skin for Red area (like a start of a blister)
300
How often should a resident's positioning in a wheelchair be checked?
About Every 2 hours
400
True or False: You can give someone crushed medication with a thickened liquid.
FALSE - Whole pills with thickened liquid or in puree. Crushed medications HAVE to be in a puree.
400
Example Case: You just brushed George's teeth to give him regular water. The nurse comes in and gives him his medications with a puree. Can you still give him the regular water?
No - He needs to brush his teeth again prior to drinking regular water.
400
Will you know when the pt aspirated?
You may not. 60% of patients silently aspirate.
400
Why is it necessary to use both Sling and Swath?
to Support the shoulder and keep the arm into the side of the body to allow the fracture to heal.
400
TRUE OR FALSE: It's alright to have the splint too loose, just not too tight.
FALSE!
too loose will allow rubbing and form blisters.
400
How can you provide pressure relief of the tail bone for a patient using a customized wheelchair?
Tilt the wheelchair back up to 45*
500
What are two cons of thickened liquids?
Reduced quality of life, Dehydration, Increased throat residue, More likely to cause pneumonia if aspirated, Cannot completely prevent aspiration pneumonia alone, Cannot give liquids in crushed medications, Silent Aspiration
500
Why is oral care an ESSENTIAL/IMPORTANT part of the FWP?
It eliminates the bacteria in the mouth. If the pt aspirates, they are only bringing water into the lungs.
500
What are two consequences of dysphagia?
Malnutrition, Dehydration, Aspiration Pneumonia, Compromised General Health, Chronic Lung Disease, Choking, Death
500
Why is education provided Yearly about nutrition, safety and joint/skin protection?
IT IS THE LAW!
500
How many fingers should fit under the straps of a splint to be sure it is NOT too tight?
2 fingers
500
What piece of equipment on the wheelchair needs to be present when pushing a resident down the hallway?
Leg rests