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. “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.
Bronchospasm is an abnormal contraction of the smooth muscle of the bronchi, narrowing and obstructing the respiratory airway, resulting in coughs, wheezing or difficulty in breathing. The chief cause of this condition is asthma, although it may also be caused by respiratory infection, chronic lung disease or an allergic reaction to chemicals. The mucosa lining of the trachea may become irritated and inflamed, which secretes mucus, causing it to be caught in the bronchi and triggers coughing.
Stroke occurs when the blood supply to the brain is blocked or condensed. Blood works to transport oxygen and other beneficial substances to the body’s cells and organs, as well as the brain. There are two main types of strokes that are known as Ischemic strokes and Hemorrhagic strokes. When the blood vessels that provides for the brain becomes congested, is it referred to as ischemic stroke, the most common stroke within adults. Blood clots, a cluster of blood that sticks together, are the cause of Ischemic strokes. Ischemic strokes also takes place when arteries become backed up with plague, leaving less blood to flow. Plague is cholesterol, calcium and fibrous and connective tissue that sticks to the walls of blood vessels. Ischemic strokes eternally damage the brain and cause a person's body to no longer function habitually.Some risk factors that may increase stroke are high cholesterol, diabetes, high blood pressure, and obesity. Some stroke factors are also due to old age or having a family that has a history of strokes. Men are more likely to have a stroke but the most st...
•Jose symptoms is derived from a disorder called Gastroesophageal reflux disease (GERD) occurring in the digestive system with the consumption of food, irritating the esophagus generally causing notable clinical symptoms such as the following: vomiting, chronic cough, angina, & regurgitation immediately after the consumed food. Jose's experience of the lump in his throat is caused by esophageal sphincter pressure.
In this article, you are informed about a disease that is occurring more often in our society. It is commonly referred to as “heartburn” but is more appropriately named acid reflux disease or gastroesophageal reflux disease (GERD). Most people suffer from this disease, but think nothing of it. Perhaps they have felt it after a big meal, lying down after eating, during pregnancy, or even when bending over. Most people feel that GERD occurs after eating spicy foods, when in fact the major cause of GERD is fatty foods and the quantity of foods eaten.
A big part of Dysautonomia is knowing what it is, its symptoms, and causes. First, Dysautonomia is an umbrella term which describes multiple problems throughout the body. Such as dysfunction of the autonomic nervous system which controls functions of the body like the cardiovascular system, gastrointestinal system, metabolic system, endocrine system. Those who get Dysautonomia have trouble regulating these systems. Second, Dysautonomia can be life threatening and ranges from mild to disabling. Those who have Dysautonomia report increased symptoms after illness, trauma, or immunizations and children tend to struggle more than adults with basic functions of life. Dysautonomia tends to affect more females than males; it has a female to male ratio of 5-1. This disease is not very well known or heard about in society because it is such a rare disease (“What is Dysautonomia? What Causes Dysautonomia?”). Third, Dysautonomia can be diagnosed in different forms and with other diseases. Most people get diagnosed with another disease along with Dysautonomia. Some of these diseases or conditions that Dysautonomia is diagnosed with are Diabetes, Rheumatoid Arthritis, and Parkinson’s disease. People can also be diagnosed in different forms such as; Neurally Mediated Syncope (chronic condition where blood pools and there is a decrease in blood pressure and heart rate), Pos...
The patient is a 55-year-old man admitted to the hospital for dehydration secondary to vomiting. The physical examination of the patient revealed dry mucous membranes and vital signs as follows: Pulse 110, blood pressure 100/60, and respirations of 20.
Garcia, Jane M., Edgar Chambers, Megan Clark, Jennifer Helverson, and Ziad Matta. "Quality of Care Issues for Dysphagia: Modifications Involving Oral Fluids." Journal of Clinical Nursing 19 (2010): 1618-624. Blackwell Publishing.*
Unpleasant breathlessness that comes on suddenly or without expectation can be due to a serious underlying medical condition. Pneumonia can impact the very young and very old, asthma tends to affect young children, smokers are at greater risk of lung and heart disease and the elderly may develop heart failure. However, medical attention always needed by all these conditions as it can affect any age group and severe breathlessnes. There are short and long term causes of dyspnea. Sudden and unexpected breathlessness is most likely tend to be caused by one of the following health conditions. There is accumulating evidence that in many patients, dyspnea is multifactorial in causes, and that in most patients, there is no single, all-encompassing explanation for dyspnea.
Myatt, John, and Kevin Haire. "Airway Management in Obese Patients." Current Anaesthesia & Critical Care 21.1 (2010): 9-15. Web.
The aim of this essay is a reflective account in which I will describe a newly acquired skill that I have learned and been able to implement within my role as a trainee assistant practitioner. (T.A.P.) for Foundation for Practice. I have chosen to reflect upon neurological observations on patients that will be at risk of neurological deterioration. Before I begin any care or assessments, I should have a good theoretical underpinned knowledge, of the skill that I am about to put into practice, and have a good understanding of anatomy and physiology, in order to make an accurate assessment of a patients neurological status. I will be making a correct and relevant assessment to identify any needs or concerns to establish the patient’s individualized care, and make observations to determine an appropriate clinical judgement.
c) Symptoms The main symptoms of stroke can be remembered with the word FAST: Face-Arms-Speech-Time. Face – the face may have dropped on one side, the person may not be able to smile or their mouth or eye may have dropped. Arms – the person with suspected stroke may not be able to lift both arms and keep them there because of arm weakness or numbness in one arm.
Hinkle, Janice, and Kerry Cheever. “Management of Patients with Chronic Pulmonary Disease." Textbook of Medical-Surgical Nursing, 13th Ed. Philadelphia: Lisa McAllister, 2013. 619-630. Print.
The patient may no longer be able to orally take in food, and the artificial means of feeding may worsen the patient’s quality of life. The concept of food cessation is often difficult for the patient’s friends and family to understand and accept, especially because food is essential to life, and eating is a sociocultural experience. Family must be reminded that to feed the patient may do more harm than good. However, until the time that oral intake stops, nurses must be providing other ways to increase the patient’s nutrient intake. The performance of symptom assessments and the development of plans of care should begin at the time of diagnosis and continue throughout the remainder of the patient’s life. These assessments and plans of care are both critical to preventing the onset of early malnutrition and to maintaining the patient’s quality of
Sleep Apnea (cessation of air flow at the mouth for greater than 10 seconds) can
Like Cassie in the book I regularly purged, Cassie died, her esophagus ruptured during her last purge. Two years had passed since I started purging what little I decided to eat and like Cassie it had started to take a toll on my esophagus. One day after a stressful class and a fight with friends I raced into the mint green bathrooms of my school I was determined to get control back; I did a quick check to ensure stalls we empty before falling on my knees in front of what I thought was my saviour. I plunged my fingers to the back of my throat before I felt the familiar release, but instead of the normal food that came up the water in the bowl was stained red. For the first time I realized I was no longer in control, Instead of perfecting myself, I was scarred and if I didn't stop I too, would be