Dysphagia :: Health, Diseases

Dysphagia Surviving a severe stoke often leads to a new problem. Almost half of patient affected by severe stroke develop difficulty in swallowing that is known as dysphagia. People in this condition have trouble in holding food and fluid in their mouth or swallowing. When food passes from the mouth into oropharynx and laryngopharynx, it enters the esophagus and muscular contraction propels it to the stomach, but when process goes wrong the food and fluids re-enter the esophagus which is known as reflux (Nozarka, 2010). There are factors that disrupt normal swallowing. These include stroke, age-related changes, medication and neurological disease (Nozarko, 2010). Signs of dysphagia are cough during eating, change in voice tone or quality after swallowing, abnormal movements of the mouth, tongue or lips and slow, weak, precise, or uncoordinated speech. Other signs of the disease are abnormal gag, delayed swallowing, incomplete oral clearance or pocketing, regurgitation, pharyngeal pooling, delayed or absent trigger of swallow, and inability to speak consistently (Potter & Perry, 2009). Dysphagia can leads to aspiration pneumonia. During aspiration, the food or fluid passes through the vocal folds and enters the airway. It can be caused by impaired laryngeal closure or overflow of food or liquids retained in pharynx. This increases the risk of choking and aspiration pneumonia. Through coughing the body tries to free from aspiration that helps to clear food and fluid from lungs. However, silent aspiration is very dangerous because food and fluid penetrate the airway and move deep into the lungs that cause major respiratory problems. Dysphagia also results to malnutrition and dehydration. This increases the risk for pressure ulcer (Nozarko, 2010). Assessment of the gathered data leads to a nursing diagnosis. A client who is a stroke survivor complains in difficulty when swallowing that is associated to deficit in oral, pharyngeal, or esophageal structure or function. In this case the nursing diagnosis is impaired swallowing related to neurological problem (Ackley & Ladwig, 2011). As a caregiver of a client in this condition, setting goals and outcome is needed. The goal and outcome for a client suffering from dysphagia are; the client can effectively swallow without choking within seven days, and the client will be free from aspiration evidence by clear lung sound within five days (Ackley & Ladwig, 2011). To meet the goals and outcomes for this patient first determine the severity of dysphagia. â€Å"If a person has mild dysphagia, simply provide a suitable and advice about eating slowly and sitting upright while eating may enable the person to remain well nourished [sic] and problem free† (Nozarka, 2010, para.