A nurse is supervising an assistive personnel who is feeding a client who has dysphagia. Which of the following actions by the AP should the nurse identify as correct technique?
Providing a 10 min rest period prior to meals
Elevating the head of the client’s bed to 30 degrees during mealtime
Instructing the client to place her chin toward her chest when swallowing
Withholding fluids until the end of the meal
The Correct Answer is C
a. Providing a 10-minute rest period prior to meals:
This action is not specifically related to feeding technique for clients with dysphagia. While providing a rest period before meals may be beneficial for some clients, especially those who experience fatigue or dyspnea, it is not a standard technique for managing dysphagia during mealtime.
b. Elevating the head of the client’s bed to 30 degrees during mealtime:
The head of the bed should be elevated to at least 45–90 degrees during meals to minimize the risk of aspiration. A 30-degree elevation is insufficient for safe swallowing and increases the likelihood of aspiration.
c. Instructing the client to place her chin toward her chest when swallowing:
This technique, known as the chin-tuck maneuver, helps reduce the risk of aspiration in clients with dysphagia by improving airway protection and directing food and liquid down the esophagus instead of the trachea. It is a widely recommended method to promote safe swallowing.
d. Withholding fluids until the end of the meal:
Fluids should not be withheld until the end of the meal as they are often necessary to help the client swallow food safely and prevent choking. Thickened fluids may be prescribed for clients with dysphagia to aid in safe swallowing.
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Related Questions
Correct Answer is A
Explanation
a. Transport the client to the operating room without verifying informed consent:
This option suggests an urgent response, prioritizing the immediate need for surgery over the formal process of obtaining informed consent. In certain emergency situations, such as when a patient's life or health is in imminent danger and obtaining consent is not feasible, healthcare providers may proceed with treatment or surgery to prevent further harm or loss of life. However, this approach should be guided by established protocols, legal considerations, and the principle of providing the best possible care for the patient.
b. Delay the surgery until the nurse can obtain informed consent:
This option advocates for ensuring that the patient's autonomy and rights are respected by obtaining informed consent before proceeding with surgery. While obtaining consent is essential, delaying surgery may not always be feasible or advisable in emergency situations where prompt intervention is necessary to prevent deterioration of the patient's condition. However, if circumstances allow, making efforts to obtain informed consent is ethically and legally preferable.
c. Obtain telephone consent from the facility administrator before the surgery:
This option proposes seeking consent from a designated authority within the healthcare facility, such as a facility administrator, via telephone. While this approach may be practical in some cases, it may not always be sufficient to ensure that the patient's rights are fully respected, particularly if the administrator does not have the legal authority to provide consent on behalf of the patient. In emergency situations, obtaining consent from a legally authorized representative of the patient, if available, is generally preferred.
d. Ask the anesthesiologist to sign the consent:
This option involves delegating the responsibility of signing the consent form to another member of the healthcare team, in this case, the anesthesiologist. However, consent for surgery should ideally be obtained directly from the patient or their legally authorized representative, as they are the ones who have the right to make decisions about their medical care. Relying on another healthcare provider to sign the consent form may not adequately protect the patient's autonomy and legal rights.
Correct Answer is B
Explanation
a. Root cause analysis:
Root cause analysis is a method used to identify the underlying causes of problems or adverse events. It involves systematically investigating an issue to determine the primary factors that contributed to its occurrence. Root cause analysis aims to identify not only the immediate causes but also the underlying systemic or process-related factors that led to the problem.
b. Benchmarking:
Benchmarking involves comparing an organization's performance, processes, or outcomes to those of other organizations or industry standards that are recognized as leaders or best practices. It allows organizations to identify areas for improvement by learning from the successes and best practices of others. Benchmarking can help organizations set performance targets, improve processes, and achieve excellence in various areas.
c. Risk benefit analysis:
Risk-benefit analysis is a method used to evaluate the potential risks and benefits associated with a decision, action, or intervention. It involves assessing the likelihood and severity of potential risks and comparing them to the expected benefits or outcomes. Risk-benefit analysis helps decision-makers weigh the advantages and disadvantages of different options to make informed decisions that maximize benefits while minimizing risks.
d. Structure audit:
A structure audit is an evaluation of the organizational structure, policies, procedures, and resources in place within an organization. It assesses the adequacy and effectiveness of the organizational infrastructure in supporting the delivery of services or achieving organizational goals. Structure audits help identify strengths and weaknesses in the organization's structure and processes, providing insights into areas that may require improvement or enhancement.
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