What intervention you will apply during feeding patient with stroke?

RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Medical & Surgical Nursing

Easy

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Explanation

Patients who have had a stroke are at high risk for dysphagia (difficulty swallowing).
Positioning the patient upright (90 degrees or high Fowler's position) is the most critical intervention to prevent aspiration.
This position uses gravity to help guide food and fluids down the esophagus and away from the trachea (airway).
It is a fundamental safety measure to prevent aspiration pneumonia, a serious complication.

Option B: While monitoring vital signs is part of overall patient assessment, it is not a direct, preventative intervention for aspiration during feeding. It is a reactive measure, checked if a problem like choking or aspiration is suspected.
Option C: Feeding a stroke patient quickly is dangerous and directly increases the risk of choking and aspiration. The patient's ability to chew and coordinate a swallow is often impaired and slowed.
Option D: Suctioning is an invasive procedure and is not performed routinely between bites. It is reserved for situations where the patient is unable to clear their own airway, such as during a choking episode.

Clinical Relevance

Nursing practice connection: Use the key finding related to Aspiration precautions for a patient with dysphagia after a stroke to guide bedside assessment, documentation, and the next nursing action.
Aspiration pneumonia is a leading cause of morbidity and mortality in stroke survivors. Correct feeding technique is a critical nursing responsibility.
Nurses are often the first to identify signs of dysphagia (coughing, wet voice, pocketing food) and must initiate a swallow screen and consult with a Speech-Language Pathologist (SLP).
What if? If the patient starts coughing and has a 'wet' or gurgly-sounding voice during the meal, the nurse must stop feeding immediately, help the patient clear their throat, and notify the healthcare provider and SLP for a re-evaluation before resuming any oral intake. Suction equipment should be ready at the bedside.

How to Approach the Question

First, identify the core clinical problem in the question: feeding a patient after a stroke.
Recall the most significant risk associated with this clinical scenario. For stroke patients, the primary risk during feeding is aspiration due to potential dysphagia.
Evaluate each option based on how it addresses the risk of aspiration.
Option A (positioning upright) directly and proactively reduces aspiration risk using gravity.
Options B, C, and D are either reactive (vitals, suctioning) or directly harmful (feeding quickly).
Select the option that represents the most fundamental and proactive safety measure. Proper positioning is always the first step before feeding begins.

Concept Tested & Keywords

Concept Tested: Aspiration precautions for a patient with dysphagia after a stroke.
Stem keywords: intervention, feeding, patient with stroke
Lead-in keywords: What intervention
Clinical cues: The patient has had a stroke, which is a primary risk factor for dysphagia.

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E6 Nursing Fundamentals Potter Perry 12e Part 5 p. 213-215

E6 Nursing Brunner Adult Health 3SA Vol 2 Part 2 p. 71-73