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tville01
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Paitents who have a hard time eating or swallowing
dysphagia
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What is the goal when creating a diet for a patient with dysphagia
- Meet nutritional needs
- Preven aspiration
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What are causes of acute dysphagia
- CVA
- sizerue
- trauma
- surgery
- anoxia
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What are some causes of progressive dysphagia
- dementia
- Parkinson's
- MS
- ALS
- Myathenia gravis
- tumors
- cancer
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What are the warning signs of dysphagia
- Communication issues
- Collecting food in mouth
- Spitting food
- Unable to control tounge
- Coughing before/after swallowing
- Choking
- Excessive drooling
- Food regurgitating through node &mouth/tract tube
- Increased meal time
- Resisting food
- Recurring respiratory infections
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Who normally evaluates the patients ability to swallow solids and liquids so they can be placed on a diet
Also aid in teaching swallowing techniques
speech therapist
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What are diets based on for patients with dysphagia
- What food they like
- Swallowing ability
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What are the features of food that should be taken into account and can be modified
- Texture
- Cohesivness
- Density
- Viscosity
- Temp
- Taste
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What are the 3 levels of dysphagia diets
- Pureed
- Mechanically altered
- Advanced
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What are the benefits of thickening liquids
Prevents aspiration
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What is something to watch for when giving a patient liquid thickener
Can lead to dehydration
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What thickness level is the least restrictive and get most nutrients from cream based soups and supplements
Nectar/syrup
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Whick level of thickener is used for patients with increased risk of aspiration or significant dysphagia
Honey thick
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Which thickener level is the most restrictive, used with severe levels of dysphagia, and needs an IV for fluid
These patients need to be monitered for dehyration
Pudding thick
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Why should you only mix a small amount of thickener at a time
Fluid thickens while standing
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As a nurse, what are some things you need to do to make feeding time easier on a patient with dysphagia
- 90o , bend forward slightly, tuck chin
- Remain upright 20-30 min after meal
- Eliminate distractions
- No liquids to "wash down" food
- Use thickeners as ordered
- Encourage small bites
- Allow adequate time
- Look for retained food in mouth
- Watch for aspiration signs
- Document intake & difficulties
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What are some swallowing aids
- Talking about food before a meal
- Tart foods
- Patient licks jelly from lips
- Have patient hum, pucker, or whistle
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What happens when we talk about food before a meal to a patient
- Stimulates saliva which helps:
- form bolus
- Aids in chewing and swallowing
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Why give a patient with dysphagia tart or sour foods
to stimulate saliva
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Why do we make a dysphagia patient lick jelly from their lips, pucker, hum, or whistle
to strenghthen mouth muscles
may help a patient place mouth over a spoon or fork
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What is a CHO diet/diabetic diet
- CHO- 55-60%
- Protein- 10-20%
- Lipids- <30%
- Fiber- 20-35g
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When on a CHO diet what levels chould be evaluated
- Glucose
- Serum lipids
- kcals
- diet
- insulin/medication
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What are low residue diets
Food to minimize elemination by reducing fecal volume
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What foods are restricted on a low residual diet
- High fiber
- Milk & milk products
- Fried foods
- Pepper
- Alcohol
- Heavy seasonings
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What diet manages malabsorption, chronic pancreatitis,
Fat controlled diet
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Why are medium chain triglycerides used with high intake of CHO and protein in a fat controlled diet
easier to digest
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What foods are restricted on a fat controlled diet
- Didlipidemia should also restrict:
- saturated fats
- sodium
- hydrogenated food products
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What may sometimes be replaced on a fat controlled diet
enzymes
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