Symptom Management in Palliative Care
Symptom Management in Palliative Care ( 2 Questions)
A client who has advanced amyotrophic lateral sclerosis (ALS) is receiving palliative care at home. The client has dysphagia and is at risk for aspiration. The client's spouse asks the nurse how to prevent aspiration when feeding the client. Which of the following responses should the nurse make?
The nurse should not advise the spouse to thicken liquids to a honey-like consistency before giving them to the client, as this may increase the difficulty of swallowing and cause choking or aspiration. The appropriate consistency of liquids depends on the individual client's needs and preferences, and should be determined by a speech-language pathologist.
The nurse should instruct the spouse to position the client upright during and after feeding, as this facilitates swallowing and reduces the risk of aspiration. This is an evidence-based practice that promotes safety and comfort for the client.
The nurse should not suggest that the spouse offer small bites of soft foods and encourage chewing well, as this may be too challenging for a client who has dysphagia due to ALS. The client may have impaired oral motor function and muscle weakness that prevent effective chewing and swallowing. The appropriate texture of foods depends on the individual client's needs and preferences, and should be determined by a speech-language pathologist.
The nurse should not recommend that the spouse check the client's mouth for pocketing of food after each bite, as this may be invasive and uncomfortable for
The nurse should instruct the spouse to position the client upright during and after feeding, as this facilitates swallowing and reduces the risk of aspiration. This is an evidence-based practice that promotes safety and comfort for the client.
Incorrect answers:
A) The nurse should not advise the spouse to thicken liquids to a honey-like consistency before giving them to the client, as this may increase the difficulty of swallowing and cause choking or aspiration. The appropriate consistency of liquids depends on the individual client's needs and preferences, and should be determined by a speech-language pathologist.
C) The nurse should not suggest that the spouse offer small bites of soft foods and encourage chewing well, as this may be too challenging for a client who has dysphagia due to ALS. The client may have impaired oral motor function and muscle weakness that prevent effective chewing and swallowing. The appropriate texture of foods depends on the individual client's needs and preferences, and should be determined by a speech-language pathologist.
D) The nurse should not recommend that the spouse check the client's mouth for pocketing of food after each bite, as this may be invasive and uncomfortable for
the client. The spouse should observe for signs of difficulty swallowing or aspiration, such as coughing, choking, drooling, or changes in voice quality.