Gellis Jerome 1

Hughes, S.M. (2011). Management of dysphagia in stroke patients. Nursing Older

People, 23(3), 21-24.
Student: Gellis Jerome
Student No:
Date Submitted: February 28, 2014
NURS 260: Pracital theory 2
Professor: Franklin
Humber College ITAL

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Introduction
Stroke is a disorder that cuts of blood supply to the brain. It damages part of the brain and
causes mild to severe problem. When a person encounters a stroke, it can cause a weakness in the
muscle of the throat which can make a person unable to swallow. This difficulty is call
dysphagia. Dysphagia is a disorder that makes it difficult to swallow food or fluids. In this paper,
I will introduce to you three implications on what I have learned after reading two articles about
managing dysphagia in stroke patients. I will emphasize on information that I agree with from
these articles, and how the article has changed my thoughts about patients with dysphagia. I will
also address how these articles reflect my role as a nursing student.

Firstly, Stroke is a very complicated and difficult disorder that no one should have to face
in today's society. I believe; it is a disorder that affects many people all over the world. Not all
stroke patients develop dysphagia; however, when people do develop dysphagia, it makes it very
difficult to swallow. Dysphagia also decreases the ability to taste food in stroke patients. It can
also cause a patient to be malnourished since not enough nutrition is getting into the body
system. A nurse's primary role when taking care of a stroke patient with dysphagia is to assess
the patient ability to swallow. When assessment is done on the patient for swallowing, it allows
the nurse to pick up on any swallowing disorder the patient may encounter when receiving food
or fluids. The nurse can assess for muscle strength in the patient; this will inform the nurse on
the proper nutritional steps to take when providing meal for the patient. It will also help to
prevent aspiration pneumonia for the patients by mouth. Aspiration can happen when patients

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swallow foods or fluids, and it passes through the airway of the lungs and the patient is unable to
feel the sensation. When this happens, it can be very harmful to the patient.
Assessment will guide the nurse on the type of feeding if this should occur; For instance,
providing Nasogastric tube feeding in which the doctor will have to prescribe. According to
Sugiyama, N. (2014), aspiration due to swallowing disorders, specifically delayed trigger of the
pharyngeal stage of swallowing, predisposes such patients to pneumonia. This shows that
avoiding aspiration is very important in stroke patients. Along with the nurse's assessment, stroke
patient also needs rehabilitation to help to get back to daily active living. Assessing a stroke
patient before providing quality care will direct the nurse into the specific care needed
throughout the recovery process. It will also prevent any future complication for the patient.

Next, Stroke patient with dysphagia is at great risk for developing complication. When a
nurse gathers her assessment on a stroke dysphagia patient, the next step is to avoid or stop all
complication the patient may meet. Avoiding complication can also enhance the patients comfort
level while recovering at this stressful time. Complication can happen in so many areas for a
stroke patient. Patients should be comfortable enough to promote his or her quality of life and
avoid depression or any distress. A Therapeutic healing process for the patient is a major priority.
According to CNO online documents (2006), therapeutic nursing services contribute to the
client's health and well-being. This can involve turning the patient regularly to avoid skin
breakdown since he/she may not be able to do so. This will promote healing. The nurse needs to
check patient's intake and output regularly. The patient should be well hydrated at all time to
promote electrolyte balance. If the patient doesn't get enough fluid intakes, he/she will be
dehydrated, and this can cause the patient to become thirsty or eventually lead to death. It is very

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important for the nurse to make sure that the patient is fully hydrated. Nurse should also check
the patient nutrition to make sure the right amount is given to the patient to avoid malnutrition. If
a patient is not getting the right nutrition, it will slow down the healing process. Complication
can be mile or severe for a stroke dysphagia patient if proper assessment is not done by the
nurse. According to the CNO online document (2006), nurses should ensure that the rationale for
performing the procedure is based on achieving the best outcomes for the client. A nurse should
know from the assessment finding which patient need is at highest priority when providing care.
Avoiding complication for the patient promotes healing faster and help on the road to a speedy
recovery.
Finally, promoting safety for a stroke dysphagia patient is the key on the journey to
recovery. A nurse needs to make sure that stroke patients maintain a proper oral hygiene at all
times. This help to prevent any form of oral infection, and it also enhances social visitation.
When patient family or friends stop by to visit, the patient oral hygiene will be presentable.
Dysphagia stroke patient should be given liquid thick or pureed diet to promote easy swallow.
Thicken foods should be the right kind to ensure that sure the patient is getting the proper
nutrition's. Foods like ice cream and jelly should be avoided. According to Hughes, S. M. (2011),
thickened fluid should be use after a thorough assessment of patients and their swallowing status.
The patient should be put upright when feeding. This helps to prevent aspiration which is
mention earlier in my discussion. Sitting upright also strengthen the muscle and promote healing
for patients. Promoting safety for a stroke dysphagia patient involved avoiding infection,
providing proper thick fluid diet intake and keep up proper feeding position. This overall
improves patient's quality of life to a speedy recovery.

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To close, suffering stoke is difficult. Encountering dysphagia in the process limits

patient's ability to perform daily activity. After reading this article, it opens my understanding to
learn more about patient who encounter dysphagia because of stroke. I learn that proper
assessment on a patient promotes healing faster on the road to recovery. These articles help me to
value my role as a nursing student. It helps me to know that without proper assessment patients
life can be at stake. I now know that I can carry the same nursing assessment throughout my
clinical placement. This will help to prevent any form of complication as the overall outcome is
to promote patient safety. I appreciate this article because i was able to walk away with new
knowledge on patient suffering stroke because of dysphagia.

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References

CNO. (2006). Therapeutic nurse-client relationship. Retrieved from

http://www.cno.org/Global/docs/prac/41033_Therapeutic.pdf?epslanguage=en
CNO. (2013). Decisions about procedures and authority. Retrieved from
http://www.cno.org/Global/docs/prac/41071_Decisions.pdf

Hughes, S. M. (2011). Management of dysphagia in stroke patients. Retrieved from

http://web.a.ebscohost.com.rap.ocls.ca/ehost/detail?vid=3&sid=7eb54a62-4912-475aac101dcfedc65b4a@sessionmgr4001&hid=4201&bdata=JkF1dGhUeXBlPWlwLHVybCZzaXRl
PW
Vob3N0LWxpdmUmc2NvcGU9c2l0ZQ==

Sugiyama, N. (2014). A novel animal model of dysphagia following stroke. journal article,
Retrieved from http://web.a.ebscohost.com.rap.ocls.ca/ehost/detail?vid=5&sid=b476488116e142d6-9ad51cc24d24330f@sessionmgr4002&hid=4201&bdata=JkF1dGhUeXBlPWlwLHVybCZzaXRlPW
Vob3N0LWxpdmUmc2NvcGU9c2l0ZQ==