Dysphagia is the medical term for difficulty in swallowing. In this article, we’re going to give you the full explanation of the nursing care plan for dysphagia with examples.
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In nursing, it can be defined as a disorder in the mechanical process of ingestion and/or a disorder of the chemical process of digestion caused by many factors such as stroke, surgery, neurologic diseases, trauma, or psychological disorders.
Symptoms include coughing when eating or drinking, choking, inability to swallow foods and liquids, and frequent indigestion/heartburn.
As a nurse, knowing the patient’s history of dysphagia is important in establishing an appropriate plan of care.
Is the dysphagia new or old?
How do they feel about swallowing?
It can be helpful to assess how well they are tolerating their food and liquids, what kind of foods they can handle, which consist of purees or thickened liquids to whole forms.
Identifying the factors that affect their diet including texture, temperature, method of feeding (tolerated vs. not tolerated), dietary consistency is important for creating a plan.
Patient education is an integral part of care.
A nurse can teach an individual to adapt to changes in their condition such as chewing more thoroughly, keeping their head elevated when eating, and relaxing during mealtimes.
These strategies can be used for patients with swallowing disorders.
Other examples include chewing gum, sipping liquids slowly instead of gulping them down, eating smaller bites, using taller glasses, and using both hands to hold the glass.
Relieving symptoms of dysphagia/impaired swallowing is most often done by improving safe swallowing techniques for individuals with neurological disorders through No products found..
The patient may need to be fitted with a feeding tube.
There are also surgical procedures available for swallowing disorders such as a pharyngotomy or esophagectomy which involve removing parts of the throat and esophagus, respectively.
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Table of Contents
Nursing care plan for dysphagia/impaired swallowing
As described in the introductions, dysphagia can be caused by a variety of factors including neurological disorders or surgeries.
Therefore, it is important to assess the patient’s history before creating a plan for care.
There are many factors that affect their ability to swallow such as texture, consistency, heated/cooled foods, and liquids, etc.
Patient education is an integral part of care.
A nurse can teach an individual to adapt to changes in their condition such as chewing more thoroughly, keeping their head elevated when eating, and relaxing during mealtimes.
These strategies can be used for patients with swallowing disorders. As a nurse, there are various steps to take when caring for a patient with dysphagia.
Key steps include analyzing the situation, creating a plan of care, and carrying out the plan.
Step 1: Analyze the situation
When a nurse is assessing a patient’s condition, they must first establish what stage of dysphagia the individual is in to determine which methods or techniques will help improve dysphagia/swallowing dysfunction.
Step 2: Creating a plan of care
Once the nurse has analyzed the situation, they must create a detailed plan of care that is tailored to each individual patient’s needs.
They can write this in an individualized care plan on their medical chart.
For example, if there are certain foods that an individual is having difficulty swallowing, they can include in their plan of care a diet that consists of purees or thickened liquids.
Step 3: Carrying out the plan
After a nurse has created a plan for each patient, it is important to make sure it is carried out in order to improve their health and wellbeing.
If there are instructions to follow, the nurse must make sure these instructions are followed correctly.
For example, if an individual has been instructed to No products found., the nurse must ensure that they do this.
Nursing assessment
When a nurse is assessing their patient, they must establish the stage of dysphagia.
Step 1: Analyze the situation
There are different stages of dysphagia that should be assessed by the nurse.
These include acute, subacute, and chronic. It can be helpful to ask other medical staff involved in the patient’s care about their medical history.
Step 2: Create a nursing diagnosis
Once the nurse has gathered information, they want to create an accurate nursing diagnosis that will serve as a basis for their care plan.
The following are examples of nursing diagnoses that could be used when caring for a patient with dysphagia:
- impaired swallowing
- risk for aspiration
- diarrhea related to altered bowel elimination patterns
- imbalanced nutrition
- acute pain related to difficulty swallowing
- chronic sorrow related to loss of nourishment
Step 3: Create an individualized care plan
Once the nurse has completed steps 1 and 2 it is time for them to create an individualized care plan that is tailored to each patient’s needs.
This includes writing out detailed instructions of what measures are being taken by the nurse, when these measures are being taken and how often they are taking place.
These parameters may be more manageable for some patients while others may require more frequent or prolonged interventions.
Nursing interventions
After a nurse has carried out the nursing assessment, they have to come up with individualized care plan interventions.
There are several nursing interventions that can be used when caring for a patient with dysphagia.
Some of these include:
- Managing acute or chronic pain
- Monitoring bowel elimination pattern
- Providing oral hygiene and self-care education
- Creating an individualized care plan to meet each patient’s needs
- Preventing the development of infection
- Maintaining patency of the upper airway
- Providing nutritional support
- Eliminating or reducing risk factors that lead to dysphagia/swallowing dysfunction.
The following are various techniques that can be used when caring for a patient with dysphagia/impaired swallowing.
Step 1: Thickened liquids
Thickened liquids are an effective way to improve the ability of someone with dysphagia to swallow safely.
No products found. are added to the liquid in order to thicken them.
This will aid in the process of swallowing.
Step 2: Pureed foods
The use of pureed foods is another effective way to ensure that individuals with dysphagia are able to swallow safely, as it allows for more food consistency when eating solid or semi-solid foods.
It is important to remember that the foods an individual eats must be well-mashed or finely chopped to ensure a smooth consistency.
Step 3: Feeding utensils & devices
There are several different types of feeding utensils and devices that can aid in swallowing safety for those with dysphagia.
For example, eating utensils such as spoons are used to feed people who have trouble holding or grasping objects.
Another device that can be used is a syringe with a feeding tube attached, which allows the person to drink foods and liquids without having to chew.
Step 4: Modifications to foods
There are different ways in which food can be modified/altered to allow for easier swallowing.
One way is by breaking down the food consistency, which can be done through chopping, pureeing, or mashing certain foods.
Another effective way to make it easier to swallow is by choosing softer foods that are not hard (i.e., crackers/crispbreads).
Step 5: Lifestyle changes
Individuals with dysphagia need to follow certain lifestyle adjustments that will allow them to be able to swallow safely.
For example, they should limit their intake of foods and liquids prior to going to bed as well as stay upright for at least 1 hour after eating or drinking.
They should also chew the food thoroughly before swallowing it and take smaller bites of food.
Step 6: Postural drainage
Postural drainage is a technique that can be used by the nurse to help aid in the clearance of secretions from the lungs.
This is done by changing the position of the patient and performing certain maneuvers, such as having them cough or perform breathing techniques.
Step 7: Wound care
Providing appropriate wound care is an integral part of the treatment plan for individuals with dysphagia.
See also: Wound Care Nurse Interview Questions
This means brushing their teeth daily or whenever they are at risk for developing ulcers on the gums, tongue, or lining of the mouth.
See also: Dental Nurse Interview Questions
The nurse will also want to ensure that the patient has adequate oral hygiene, which includes flossing.
Step 8: Follow-up assessments
Once an individual with dysphagia is receiving the care they will need to undergo follow-up assessments so that the nurse can monitor their swallowing function and evaluate whether or not there are any changes in their condition.
This may be done through several different ways, such as x-rays or fiberoptic endoscopic evaluation of swallowing.
In summary, all these nursing interventions aim to reduce the risk of aspiration and ultimately improve the patient’s quality of life.
Conclusion: Nursing care plan for dysphagia
Through this article, we have learned that there are several different ways in which people with dysphagia can be cared for and given the proper treatment.
We have discussed some of the caregiving techniques such as thickened liquids and modified foods to help get a better understanding of how these patients should be treated.
The main objective is to ensure that they are swallowing safely while caring for their wounds and remaining free of infections.
A good nursing care plan for impaired swallowing/dysphagia includes all the following nursing interventions, but it is important to remember that these are only suggested because every person has different needs.
Nurses will need to work closely with doctors and other members of the interdisciplinary team to come up with effective treatments for each individual case.
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