The nurse is delegating the feeding of an older adult client to ancill

The nurse is delegating the feeding of an older adult client to ancillary personnel. Which of the following should the nurse include in the instructions as possible warning signs of dysphagia (difficulty swallowing)? (Select all that apply.)

1. Delay in swallowing food
2. Easily triggered gag reflex
3. Absence of a gag reflex
4. Uncoordinated speech
5. Disinterest in eating
6. Pocketing food

ANSWER

ANS: 1, 2, 3, 4, 6
Signs of dysphagia include the following: cough during eating; change in voice tone or quality after swallowing; abnormal movements of the mouth, tongue, or lips; and slow, weak, imprecise, or uncoordinated speech. Abnormal gag reflex, delayed swallowing, incomplete oral clearance or pocketing, regurgitation, pharyngeal pooling, delayed or absent trigger of swallow, and inability to speak consistently are other signs of dysphagia.