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학습 자료 둘러보기 →In amyotrophic lateral sclerosis (ALS), limb spasticity often coexists with bulbar muscle dysfunction. The nurse's immediate priority is to assess swallowing ability because aspiration pneumonia is a leading cause of death. Implement aspiration precautions before addressing mobility or comfort.
A bedside swallowing assessment includes checking for dysarthria, absent gag reflex, and drooling. Observe the patient drinking water for coughing or voice changes, which indicate silent aspiration risk. Keep suction equipment ready and position the patient upright at 90 degrees for all oral intake.
Do not prioritize active ROM exercises for spastic limbs; this can increase tone and does not protect the airway. Muscle relaxants are secondary interventions that follow airway stabilization.
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