About
Passing of fluid or foods into the lungs/ trachea instead of into the esophagus.
Assess
Difficulty with swallowing, coughing after intake of fluids, choking with food or fluids, crackles with auscultation of lung sounds, shortness of breath
Complications
Pneumonia, airway obstruction
Diagnosis
- Ineffective airway clearance related to impaired gag reflex.
- Impaired gas exchange related to aspirated fluids.
- Impaired swallowing related to neurological dysfunction.
Goals
- The client will be able to identify ways to decrease aspiration during meals.
- The client will demonstrate effective swallowing.
- The client will maintain a patent airway.
Interventions
- Assess clients gag reflex.
- Assess the client during feeding noting any difficulty in swallowing, delayed swallowing, pocketing of food, coughing, or choking.
- Consult dietary or speech pathology if symptoms continue or worsen to have a diagnostic work-up.
- Hold patient NPO if choking or coughing is evident during feeding.
- Encourage client to chew food and swallow and give client ample amount of time to follow commands.
- Provide thickened fluids, as indicated, to prevent aspiration of thin liquids.
- Maintain suction equipment at the bedside and perform suctioning frequently to remove excess secretions.
- Monitor for signs of dehydration or malnutrition.
- Teach client appropriate techniques to facilitate swallowing ( chewing completely, small bites, do not rush, maintain an upright position)
- Keep client upright after meals for up to one hour to prevent regurgitation.
- Monitor for signs and symptoms of complications, especially difficulty in breathing, decreased pulse oximetry, tachypnea, crackles or wheezes upon auscultation, etc).
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