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Paige Lacy
Paige Lacy
Student No. N00835668
March 6, 2015
Paige Lacy
Paige Lacy
Without being able to swallow a patient will not be getting the nutrition
required for a fast recovery. The CNO says that when assessing a
patient it is necessary to communicate and incorporate the
psychosocial needs of clients and their significant others into the plan
of care (CNO, infection prevention). From this nursing implication I
have learned how important it is to determine the swallowing status of
a stoke patient with dysphagia as well as communicate with the
patient to ensure that it is the fastest recovery as possible, if
dysphagia is not treated it could lead to aspiration pneumonia or
death. Reports of pneumonia in patients with dysphagia after stroke
range from 7% to 33%, with conservative estimates at 18% (Rosemary,
2012).
As a second implication, nutrition is essential for recovery from
dysphagia in a stroke patient. In 2009, the British Dietetic Association
launched a program of national descriptors for all adults requiring
modified textures in food and fluids (Hughes, 2011). Assessing a
patients ability to swallow permits the staff team to modify the
textures in food and fluid to accommodate the patients nutritional
needs by either providing soft diet, pureed diet, normal fluids,
thickened fluids, etc. While a patient is eating a nurse should always
assess how the patient is eating, some people tend to pocket their
food in the cheek. When someone pockets their food this can indicate
that their textured dietary requirements need to be reassessed
Paige Lacy
(Hughes, 2011). By pocketing the food in their cheek the patient is not
reaching the nutritional status that is required for a fast recovery.
Another important assessment while caring for patients with dysphagia
after stroke is the proper positioning while feeding. A pilot study by
Kelly et al concluded that there are significant differences in the
swallowing-related muscles when people are horizontal and when they
are sitting upright; the study concluded that sitting upright is the safest
position (Hughes, 2011). I consider nutrition as a key aspect to
assisting a stoke patient to recover from dysphagia because it allows
them to regain strength and energy to restore health quickly. Another
nursing implication for patients who suffer from dysphagia after stroke
is providing oral hygiene.
The BDA states that mouth care should be considered when
assessing and managing patients with dysphagia as the swallowing
process relies on good oral hygiene and hydration (Hughes, 2011). Oral
hygiene assessments are critical to provide a baseline, by assessing
how moist the lips are, mucous membranes and tongue to determine if
the patient is dehydrated. The CNO website states: nursing is the
therapeutic relationship that enables the client to attain, maintain or
regain optimal function by promoting the clients health through
assessing, providing care for and treating the clients health conditions
(CNO, ethics). By providing oral hygiene it allows to assess a persons
hydration, which is fundamental to a patients health status. A patient
Paige Lacy
Paige Lacy
References