When it comes to swallowing difficulties or dysphagia, it can be a severe issue if not taken seriously. If left untreated, it can lead to discomfort, difficulty breathing, and even malnutrition. Fortunately, there are ways to help individuals with dysphagia manage their condition to lead an everyday life. In this article, we’ll take a look at the signs of dysphagia, as well as strategies for managing it.
Table of Contents
What is Dysphagia?
Dysphagia is a difficulty or discomfort when swallowing. It may occur due to physical and neurological disorders. Dysphagia can be uncomfortable and lead to serious health problems if not treated properly.
Physical dysphagia may be caused by problems with the muscles or structures of the mouth, throat, esophagus (the muscular tube leading from the throat to the stomach), or stomach. When assessing a patient with dysphagia, nurses must consider all potential causes of difficulty swallowing to provide the most effective treatment.
What are the Types of Dysphagia?
• Oral dysphagia: Occurs when the patient has difficulty beginning or continuing the process of eating. Problems with the muscles and structures of the mouth, such as a lack of sensation or muscle control, can cause this.
• Pharyngeal dysphagia: Refers to difficulty in passing food through the throat. Anatomical obstructions or neurological disorders may cause this.
• Esophageal dysphagia: Occurs when food sticks in the esophagus, preventing it from adequately reaching the stomach. A narrowing of the esophageal muscles often causes this due to an underlying disorder.
Esophagogastric dysphagia: Occurs when food remains stuck in the stomach after a meal. This may be due to insufficient production of digestive acids and enzymes or a blockage.
What are the Symptoms of Dysphagia?
- Difficulty starting the swallowing process
- Pain while swallowing
- Feeling food sticking in the throat or chest
- A gurgling sound during eating
- Unexpected weight loss or malnutrition
- Regurgitation of food or fluids without warning
- Coughing or choking while eating
What are the Nursing Interventions for Dysphagia?
Nursing interventions for dysphagia can vary depending on the underlying cause of the difficulty swallowing. Common interventions include:
• Positioning: Proper positioning of the patient can help alleviate dysphagia in some cases. This involves appropriately aligning the head, neck, and chest to maximize swallowing function.
• Nutritional Support: Patients with dysphagia often require supplemental nutrition through feeding tubes or other forms of artificial nutrition. Nurses should assess the nutritional needs of the patient and provide appropriate support.
• Oral Care: Poor oral hygiene can contribute to dysphagia, so nurses should assess the patient’s mouth for signs of infection or other problems that could interfere with swallowing.
• Swallowing Therapy: Speech therapists often use exercises and techniques to help patients improve their swallowing ability. Nurses may assist the speech therapist in assessing the patient’s swallowing ability and providing support during therapy sessions.
• Education: Nurses must educate patients and their families about dysphagia and its treatments. This can include information on proper positioning, nutrition, oral care, and strategies for avoiding aspiration.
By understanding the causes of dysphagia and providing appropriate interventions, nurses can help improve swallowing function in patients with dysphagia. With the right care, patients can often recover their ability to swallow food and beverages safely.
Nursing Diagnosis for Dysphagia
• Risk for Impaired Swallowing: This nursing diagnosis can be made when a patient is at risk of experiencing difficulty swallowing due to an underlying medical condition.
• Risk for Aspiration: Patients with dysphagia may be more likely to aspirate food and beverages into their lungs, causing aspiration pneumonia.
• Nutrition: Imbalance, Less than Body Requirements: Patients with dysphagia may have difficulty meeting their nutritional needs due to the inability to consume adequate amounts of food and liquids.
• Activity Intolerance: Difficulty in swallowing can lead to fatigue, weakness, and reduced activity levels.
• Pain: Dysphagia can cause pain or discomfort when eating or drinking.
By assessing the patient’s needs and developing an individualized care plan, nurses can help improve the quality of life for patients with dysphagia. Patients can often regain their ability to swallow safely with appropriate interventions and educational support.
Dysphagia Nursing Care Plan?
• Monitor patients for signs and symptoms of dysphagia: It is essential to regularly assess the patient for any signs and symptoms of dysphagia, including difficulty swallowing, coughing or choking while eating, food intolerance, changes in appetite or weight loss, regurgitation of food and liquids, or drooling.
• Provide assistance with meal preparation: Dysphagic patients may need help with meal preparation, such as cutting food into small pieces or pureeing certain foods.
• Administer swallow evaluations: As part of a dysphagia care plan, an evaluation must be conducted to assess the degree and type of dysphagia. This can include a modified barium swallow study (MBSS) or Fiberoptic Endoscopic Evaluation of Swallowing (FEES).
• Encourage thickened liquids: For patients with dysphagia, thicker liquids can be easier to swallow. The nurse should encourage the patient to use thickening agents and recommend various options, such as honey or pudding mix.
• Administer medications carefully: Medications must be administered slowly and with proper supervision, as some medications can cause further difficulty swallowing.
• Educate the patient: Education is an essential part of dysphagia care. The nurse should provide information about the condition to help the patient better understand their situation and learn strategies for managing it safely and effectively. This may include information on diet modification, safe positioning while eating, and techniques to help with swallowing.
• Monitor nutrition and hydration levels: As dysphagia can lead to nutritional deficiencies, the nurse must monitor the patient’s nutrition and hydration levels. This may include measuring vital signs, following up on lab tests, and monitoring dietary intake. If necessary, referral to a dietician or speech therapist should be considered.
• Provide emotional support: Dysphagia can be a complex condition to manage, and the nurse should provide emotional support and encouragement to help the patient cope with their condition. This may include giving reassurance and listening to any of their concerns.
• Referral for further intervention: Referral to a specialist may be necessary depending on the severity of dysphagia. This can include a speech therapist, occupational therapist, or gastroenterologist for further evaluation and intervention.
• Document all care: As with any nursing care plan, it is important to document all interventions in the patient’s records to ensure proper follow-up and treatment. This includes assessments and evaluations, medications administered, thickening agents used, monitored nutrition levels, and any referrals made.
• Provide a safe environment: The nurse should ensure the patient has a safe environment to eat in and avoid potential hazards such as falling or choking. This includes appropriately positioning while eating and ensuring all utensils are within reach. Additionally, caregivers should know the patient’s limitations and assist.
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In conclusion, dysphagia can be challenging and overwhelming for patients to manage. Fortunately, with the right nursing interventions, and compensatory strategies, it is possible to improve a patient’s ability to swallow safely. Additionally, providing education regarding the cause of dysphagia can help individuals better understand what is occurring and how to best care for themselves.
Mrs. Marie Brown has been a registered nurse for over 25 years. She began her nursing career at a Level I Trauma Center in downtown Chicago, Illinois. There she worked in the Emergency Department and on the Surgical Intensive Care Unit. After several years, she moved to the Midwest and continued her nursing career in a critical care setting. For the last 10 years of her nursing career, Mrs. Brown worked as a flight nurse with an air ambulance service. During this time, she cared for patients throughout the United States.