A nurse is assisting in the care of a client at the clinic.

Complete the following sentence by using the lists of options.

The client is at risk for

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due to

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.

Dysphagia is a condition that increases the risk of aspiration, malnutrition, and choking due to impaired coordination of swallowing mechanisms. Nursing care focuses on promoting safe swallowing techniques, reducing aspiration risk, and ensuring adequate nutritional intake. Positioning and swallowing strategies are key components of the care plan. Proper technique helps protect the airway during oral intake.

Rationale:
A. Tilting the client’s head forward (chin-tuck position) during meals helps protect the airway by narrowing the opening to the trachea and facilitating safer passage of food into the esophagus. This position reduces the risk of aspiration by improving control of the swallowing process. It is a recommended intervention for many clients with dysphagia.

B. Encouraging socialization during mealtimes is beneficial for psychological well-being but does not directly address swallowing safety. In clients with dysphagia, distractions during meals may actually increase the risk of choking or aspiration. Focus during feeding should remain on safe swallowing techniques.

C. Providing three large meals per day is not appropriate for clients with dysphagia because large volumes of food increase fatigue and aspiration risk. Smaller, more frequent meals with appropriate texture modifications are preferred to ensure safe and adequate intake.

D. Elevating the head of the bed to 30° is insufficient for safe feeding in clients with dysphagia. A higher elevation, typically 45° to 90° during meals, is recommended to reduce aspiration risk. A 30° elevation is more appropriate for general positioning but not for active swallowing safety during meals.

In a healthcare setting, particularly long-term care facilities, communication and delegation follow a clear chain of command to ensure patient safety and proper resolution of clinical concerns. When an assistive personnel performs an incorrect clinical task, immediate reporting should follow the established supervisory structure. The charge nurse is typically responsible for direct unit oversight and real-time clinical supervision of staff activities. Prompt escalation ensures timely correction of errors and prevention of patient harm.

Rationale:
A. The charge nurse is the immediate supervisor responsible for overseeing daily unit operations and staff performance. Reporting to the charge nurse first allows for rapid intervention, correction of the error, and direct education of the assistive personnel. This ensures patient safety is addressed without unnecessary delay in the chain of communication.

B. The nurse supervisor generally oversees multiple units or shifts and is not the first point of contact for immediate bedside concerns. Although they may become involved in more serious or unresolved issues, the initial report should go through the charge nurse for prompt correction at the unit level.

C. The nurse manager is responsible for administrative functions, staffing, and long-term unit management rather than immediate clinical supervision. Reporting directly to the nurse manager bypasses the appropriate chain of command and may delay timely intervention for the patient-related issue.

D. The risk manager is involved in tracking adverse events and implementing system-wide safety improvements after incidents occur. This role is not involved in immediate clinical supervision or correction of staff errors at the bedside. Reporting to risk management would occur later if the error results in harm or requires formal documentation.