The nurse observes care for a client with post-stroke dysphagia. Which actions require follow-up? Highlight the actions that increase aspiration risk.
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Choose your responses, then check the answer.
Explanation
Oral intake before screening, placing food on the weak side, reclining during feeding, and continuing after coughing with a wet voice increase aspiration risk. Positioning, prescribed textures, small amounts, pocket checks, and oral care support safer intake.
Quick answer Follow up on giving water before swallowing clearance, placing food on the weak side, feeding while the client is reclined, and continuing the meal after coughing and a wet voice appear.
Why this is correct Post-stroke dysphagia raises the risk of aspiration pneumonia, dehydration, and malnutrition.[2] Feeding should follow screening and the individualized swallowing plan; coughing or a wet voice during intake signals that the trial should stop for reassessment.
Easy analogy or mental picture Think of swallowing as a railroad switch that must send food toward the esophagus instead of the airway. Upright posture, the correct texture, and slow small amounts help the switch; rushing or feeding through warning signs sends traffic toward the wrong track.
Memory hook Screen, sit up, prescribed texture, small bites, stop at cough.
NCLEX decision rule Before feeding a neurologically impaired client, verify swallowing status and the specific plan. During intake, monitor voice, cough, breathing, fatigue, and oral pocketing rather than assuming that one successful swallow makes the whole meal safe.
Why the other choices are wrong Upright positioning, small amounts at a slow pace, prescribed texture, checking for pocketed food, and oral care are protective actions when they match the speech-language pathology plan.
References
[1]
NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing
[2]
NCBI Bookshelf: Swallowing After StrokeNational Library of Medicine