Question

PN 105 Fundamentals of Nursing I Concept Map: Care of the Patient with Impaired Communication (Aphagia Miss Anna Mae Alcott, a 67-year-old black female, has been on your unit for about the days. Her admitting diagnosis was stroke secondary to an embolus to the right side of the brain She also has a history of Diabetes Mellitus, tvne 1 and is on Lantus Insulin 80 units at 9PM daily. She cries and becomes easily frustrated when she tries to answer questions the staff asks which further interferes with her ability to communicate to make her needs known. She has been a leader in her church and community for over 25 years and now will not allow her church family to visit her Now please go to your concept map 067410, Female Stroke secondary to an embolus to the right side of the brain. Diabetes mellitus typel Reviewed 1/20 I insulin 80 units -

Pn 105 fundamental of nursing 1 :Care of the patient with aphagia

Aphagia

Answer 1

Stroke refers to the decrease bloodsupply to the part of brain tissue. The most common causes of stroke are due to blocked artery or hemorrhagic artery.

Aphagia defined as inability of an individual to swallow.

Nursing diagnosis:

Impaired swallowing related to facial paralysis as evidenced by lack of toungue action to form bolus.

Goals :

`- Patient verbalizes ability to swallow food without aspiration.

- Patient and caregivers understands the way to prevent choking and appropriate manuevers to prevent choking.

Interventions:

- Assess the ability of patient to swallow and also check the gag reflex. This reveals the ability of patient to swallow with out aspiration.

- Encourage patient to drink small sips of water as even aspiration will not cause harm to the patients.

- Provide oral hygiene before feeding as it improves appetite.

- Make ready suction apparatus ready at the bed side to treat any emergency aspiration.

- Maintain 90 degree angle with head flex this helps in opening of esophagus and the trachea to close.

- Ask patient to hold food on the unaffected side.

- Assess the ability of the patient to obey commands this draws attention patient on proper concentration during eating.

- Stop feeding in case of suddden coughing, sneezing.

- Maintain upright position after a meal to decrease the chance of aspiration.

- Encourage the patient to do facial exercises to improve muscular strength and thereby promoting easy swallowing.