Aspiration
Aspiration occurs when a foreign substance accidentally enters the ________.
What is Lungs/Airway?
A dysphagia screening is completed...
What is on admission for patients at risk for possible aspiration (i.e. stroke, AMS) and PRN with any status changes.
Step 1 Pre-Screening Checklist:
If the answer is yes to any of the pre-screening questions what do you do?
Stop the screening; the patient has FAILED. Notify the Doctor. The patient remains NPO and a formal speech evaluation must be completed.
Patients receiving tube feedings should have the head of bed elevated _____ degrees unless contraindicated.
What is 30-45 degrees?
A sign should be placed in the room to alert aspiration precautions. The patient and ________ should be educated on aspiration prevention.
What is Family?
The medical term for difficulty swallowing is...
What is Dysphagia?
True or False: All suspected stroke patients will undergo a formal evaluation by a Speech Therapist.
What is True
STEP 2 Section 1: If all answers are No in this section what do you do?
The patient has PASSED and can proceed to the swallow evaluation.
Patients receiving oral feedings should have the head of bed elevated ______ degrees.
What is 45-90 degrees?
A staff member should stay with the patient during _________ to prevent aspiration.
What is Meals/Feedings?
Identify 3 risk factors that can increase the risk of aspiration
What is: Neurological disorders such as Stroke, Multiple Sclerosis; Breathing disorders such as Chronic Obstructive Pulmonary Disease; Defects in throat or vocal cords; Medicines such as narcotics or sedatives; Old age; Laughing or inhaling when food or fluids are in your mouth.
The nurse will confirm that a dysphagia screening is completed prior to administering anything _______ after an acute neurological change has occurred.
What is orally or by mouth?
How much water is used to perform the dysphagia screening?
90 mL or 3 ounces
Avoid providing bites of food with ______ consistencies to prevent aspiration.
What is Mixed/Different?
Teach patient to remain upright after meals for __-__ minutes to promote digestion and decrease aspiration risk.
What is 30-60 minutes?
When someone doesn't display any signs of choking, coughing or respiratory distress when they inhale a foreign substance is...
What is Silent Aspiration?
The dysphagia screening is documented in this intervention in Meditech
What is Dysphagia Screening intervention?
The head of bed be should be at this elevation when performing the dysphagia screening if not contraindicated
What is 80-90 degrees
True or false: It is recommended to advocate for continuous tube feedings rather than bolus feedings to prevent aspiration.
What is True?
You should provide your patient encouragement during feedings. Name one thing you should encourage/remind your patient to do during feedings.
What is: Take small bites of food; chew thoroughly; remind patient to swallow frequently.
List 2 Signs and Symptoms of Aspiration
What is Acute respiratory distress (coughing, hypoxia, or cyanosis) especially during eating or drinking.
Hoarse voice especially after drinking. Signs of pneumonia (increase respiratory rate, pleurtic chest pain, chills, fever)
If the patient passes the dysphagia screening what do you do?
If the patient PASSES:
What is call doctor to order a diet and the patient can receive PO medications?
The patient must do this in order to pass the dysphagia screening
What is drink 90 mL continuously without stopping and without signs of aspiration (i.e coughing, choking, throat clearing, or change in speech)
List 2 interventions you should complete when feeding a patient at risk for aspiration.
What is Maintain HOB elevation; use unaffected side if the patient has had a stroke; give sips of water in between bites avoiding use of a straw; minimize distractions; provide rest; check patients mouth for food residue after meals and perform oral care.
You should teach your patient and family to __________ use of any opioids or sedatives to help decrease the risk of aspiration.
What is Limit / Minimize / Decrease?