What safety precaution should you take for a patient that has a risk of aspiration?

Inhaltsverzeichnis Show

1. Identify patients at high risk
2. Consider the effect of patient medications
3. Perform oral care
4. Modify oral intake
5. Consider a team approach
6. Make sure suction is available
What precautions should be taken for clients at risk for aspiration?
What are aspiration precautions in nursing?
Which of the following is most important for a patient who is under aspiration precautions?
What should the nurse do before feeding a patient who is at risk for aspiration?

Every good nurse knows that the job involves much more than simply treating the patient’s current illness or injury. Instead, nurses should try to anticipate potential complications that could arise for their patients and implement measures to prevent them from happening.

Preventing aspiration pneumonia is one example. Studies suggest that patients with aspiration pneumonia have a higher morbidity and mortality than those with community-acquired pneumonia. Let’s take a look at some strategies that nurses can employ to help their patients avoid this dangerous syndrome.

1. Identify patients at high risk

Technically, any patient can aspirate, but most healthy individuals can tolerate small amounts of aspirated material with little effect. However, certain patients are at higher risk to aspirate and develop complications. This includes those who:

Are elderly
Have a swallowing disorder
Have impaired mental status
Have a history of seizures or stroke
Frequently vomit
Have dental problems

Recognizing those at high risk allows the nurse to take proactive precautions.

2. Consider the effect of patient medications

Several medications increase the likelihood of aspiration. Sedatives are the most commonly implicated, but it is important to be aware of the others. Opioids, hypnotics, anti-anxiety medications, and muscle relaxers can affect the patient’s ability to swallow. Anticholinergics and calcium channel blockers relax the esophageal sphincter. Alcohol, anticholinergics and anesthetics can affect a patient's ability to cough and gag.

It may be helpful, if appropriate, to discontinue or decrease these medications. However, when this is not possible, patients should be closely monitored.

3. Perform oral care

When oral hygiene is performed regularly, it decreases the amount of oral bacteria. Less bacteria in secretions lowers the risk of infection.

4. Modify oral intake

Allowing patients to eat in a relaxed environment without distractions may be helpful in minimizing aspiration. Patients should also be fed smaller amounts at a time.

Patients with difficulty swallowing may need the consistency of their food modified so that it is safer and easier to eat. Thickened liquids or alternating solid and liquids may be better tolerated. Sticky, stringy, dry and chewy foods should be avoided. Dairy products may also cause difficulty since they may cause an increase in mucous.

5. Consider a team approach

Speech and occupational therapy can be very helpful. Having patients work with these disciplines to improve their swallowing technique and strengthen the underlying physiology may decrease the risk of aspiration. Proper positioning and the use of special adaptive feeding tools should also be addressed.

6. Make sure suction is available

Frequent suctioning of oropharyngeal secretions may be needed for patients who have difficulty swallowing or coughing to clear their airway. In-wall or portable suction should be properly set up and ready to go for these patients.

Monitor patients while feeding. If any signs of aspiration are noted, the patient should be suctioned immediately.

Aspiration pneumonia can be a very serious medical condition, especially for patients who are already compromised. By incorporating these interventions into their patient care, nurses can help prevent this dangerous complication.

References

Lanspa, M. J., Jones, B. E., Brown, S. M., & Dean, N. C. (2012). Mortality, morbidity, and disease severity of patients with aspiration pneumonia. J. Hosp. Med Journal of Hospital Medicine, 8(2), 83-90. doi:10.1002/jhm.1996

Smith, L. H. (2009). Preventing Aspiration: A Common and Dangerous Problem for Patients With Cancer. Clinical Journal of Oncology Nursing, 13(1), 105-108. doi:10.1188/09.cjon.105-108

Editor's note: This blog was originally from May 2016. It has been re-published with additional up to date content.

Topics: Medical Suction

What precautions should be taken for clients at risk for aspiration?

Preventing Aspiration.

Avoid distractions when you're eating and drinking, such as talking on the phone or watching TV..

Cut your food into small, bite-sized pieces. ... .

Eat and drink slowly..

Sit up straight when eating or drinking, if you can..

If you're eating or drinking in bed, use a wedge pillow to lift yourself up..

What are aspiration precautions in nursing?

PREVENTION OF ASPIRATION DURING HAND FEEDING:.

Sit the person upright in a chair; if confined to bed, elevate the backrest to a 90-degree angle..

Implement postural changes that improve swallowing. ... .

Adjust rate of feeding and size of bites to the person's tolerance; avoid rushed or forced feeding..

Which of the following is most important for a patient who is under aspiration precautions?

The most important precaution to prevent aspiration, however, is to put any at-risk patient on NPO status until a dysphagia evaluation can be conducted by a speech and language pathologist.

What should the nurse do before feeding a patient who is at risk for aspiration?

Anyone identified as being at high risk for aspiration should be kept NPO (nothing by mouth) until further evaluation is completed. Keep head of bed elevated when feeding and for at least a half hour afterward. Maintaining a sitting position after meals may help decrease aspiration pneumonia in the elderly.