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aspiration
foundations exam 3
| Question | Answer |
|---|---|
| aspiration | the entry of food, fluid, or foreign materials into the trachea and lungs |
| examples of things that can be aspirated | oropharyngeal secretions, food/drink/medications? gastric contents/emesis (vomit) |
| dysphagia | difficulty swallowing, the inability to swallow |
| causes of dysphagia | poor dental health, cancer (and treatments for cancer), neurologic disease (CVA, Parkinson's, dementia) |
| What does dysphagia put you at risk for? | aspiration |
| When can aspiration happen? | when protective reflexes (such as coughing) are reduced or impaired |
| infection related to aspiration | aspiration pneumonia |
| Why do we care about aspiration pneumonia? | high mortality, morbidity, increases LOS and ICU admission |
| Inflammation related to aspiration | aspiration pneumonitis |
| Why do we care about aspiration? | oxygenation/ diffusion impaired |
| How can aspiration impair diffusion/ oxygenation? | aspirated contents can enter alveoli and CO2 and O2 can't get in and out |
| Main goal when caring for patients at risk for aspiration | prevention |
| Aspiration prevention | identify patients early who may be at risk for aspiration, general survey- LOC, speech, healthy history factors, HOB elevated |
| Assessment for aspiration | assess LOC, note any signs of aspiration, coughing, choking, throat clearing, gurgling or "wet" voice during or after swallowing |
| primary risk factor for aspiration | decreased LOC |
| signs of aspiration | dyspnea, cough, cyanosis, wheezing or fever |
| Aspiration interventions | Elevate HOB when feeding and after, inform physician instantly of decrease in cough/ gag reflexes or difficulty in swallowing, position patients with a decreased LOC on their side, aid pt with oral intake, provide foods with consistency pt can swallow |
| should you give oral fluids to a comatose patient? | no! |
| do straws increase or decrease the risk of aspiration? | increase |
| What kind of liquids are easiest to aspirate? | thin liquids |
| modifications of food/fluid texture to reduce aspiration | nectar thick, honey thick, pudding thick |
| dysphagia/ aspiration risk factors following CVA | age greater than or equal to 65, hx pneumonia, severe dysarthria, more than 2 chronic diseases, bilateral brain injury or lesion location in brainstem |
| dysarthria | difficulty with speech |
| risk factors for dysphagia not just CVA | older adults: age related changes in airway protective mechanisms and in the swallowing process; underlying pulmonary disease, muscoskeletal disorders, immunosupression |
| things that get your attention regarding aspiration | hx, choking, immediate or delayed cough, drooling, altered voice quality, throat clearing, absent swallow, decreased O2 sats |
| Where do we typically see pneumonia when patients aspirate? | right upper lung |
| who is at risk for aspiration? | altered or declined mental status, history of dysphagia, aspiration, or aspiration pneumonia, residual food in mouth after swallowing, neurologic disorders, presence or recent removal of trach, poor dentition, GI tubes, cervical collor |
| neurologic disorders that put patients at risk for stroke | traumatic brain injury, stroke, parkinson disease, multiple sclerosis, and dementia |
| bedside swallow screen tools | available for RN to access pt swallowing ability at the bedside |
| Who are the bedside swallow screen tools used for? | patients determined at risk for aspiration |
| What is best practice for swallowing evaluation? | SLP consult |
| How is aspiration diagnosed? | speech therapy consult, registered dietician consult, Chest x ray, swallowingstudies |
| How is aspiration treated? | bronch, antibiotics |
| aspiration precautions | HOB elevation, NPO until cleared by SLP, supervised feeding, avoiding straws, thickened liquids, monitoring (coughing, throat clearing, gurgly voice after eating), oral care, educating patients |
| how can oral care help reduce risk of aspiration? | reduces oral bacteria that can be aspirated |
| educating patients to prevent aspiration | swallowing techniques, small bites, positioning |
Created by:
camrynfoster