Term
| what is the top priority in assessment goals? |
|
Definition
|
|
Term
| What are three clinical signs of aspiration/penetration? |
|
Definition
1. coughing with eating
2. choking at mealtimes
3. wet-sounding respiration |
|
|
Term
|
Definition
| food getting into the larynx - but it able to get out before becoming aspiration |
|
|
Term
| what are three causes of aspiration pneumonia? |
|
Definition
1. aspiration of food
2. aspiration of stomach acid
3. aspiration of oral secretions |
|
|
Term
| safety is the first thing we assess, then what is the second goal that we assess? |
|
Definition
| how efficiently is the patient swallowing? |
|
|
Term
| what are three things what we assess when looking at how efficiently a person is swallowing? |
|
Definition
1. is the patient feeding himself/herself?
2. is the patient able to maintain adequate intake with the current diet?
3. which mealtime elements present problems for the patient? |
|
|
Term
| do problems with swallowing efficiency present a safety hazard? |
|
Definition
| they can! we need to be aware that these two things go hand in hand. |
|
|
Term
| what are some different ways that an SLP can help the patient swallow safely/efficiently |
|
Definition
1. dietary change
2. postural support/modifications
3. give them techniques to protect the airway
4. make the caregivers aware of the patient's needs |
|
|
Term
| what are the four steps in a bedside eval? |
|
Definition
1. conduct an oral mech exam
2. observe swallowing
3. probe possible strategies to assist patient
4. make recommendations (eg: further assessment, diet change, direct treatment, staff/family education, etc.) |
|
|
Term
| when are we more likely to see aspiration? |
|
Definition
|
|
Term
| the thicker a liquid is, the more likely we will see what? |
|
Definition
| stasis- the liquid doesn't move past where it landed |
|
|
Term
| what four things do we observe in an oral mech exam? |
|
Definition
| symmetry, range of motion, strength, and sensitivity |
|
|
Term
| which variety of liquid consistency leads to more residue? poorer control? |
|
Definition
residue: thicker consistency
control: thinner consistency |
|
|
Term
| during a swallowing observation what do we listen for? |
|
Definition
| cough, gag, choke, splutter |
|
|
Term
| what do we watch for in a swallowing observation? |
|
Definition
| leakage, delayed swallow, residue and deteriorating performance |
|
|
Term
| what are two things we can try? |
|
Definition
1. behavioral changes (take smaller bites, instructions to clear throat and swallow again, etc.)
2. positional changes |
|
|
Term
| what does VFSS stand for? What is it sometimes called? |
|
Definition
| videofluoroscopic swallowing study - also called a modified barium swallow |
|
|
Term
| what does a VFSS use to obtain videos of patients swallowing radiopaque material? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| which test can provide unequivocal documentation of penetration/aspiration? |
|
Definition
|
|
Term
| what does FEES stand for? |
|
Definition
| fiberoptic endoscopic evaluation of swallowing |
|
|
Term
| which test uses a nasal endoscopy to view the pharynx while the patient swallows? |
|
Definition
|
|
Term
| what are advantages of the FEES test? |
|
Definition
| less expensive, portable, no radiation, no barium |
|
|
Term
| what are some options for a change in diet? |
|
Definition
| total parenteral nutrition, tube feeding, pureed diet, thickened liquids, mechanical soft, advanced, regular diet with thickened liquids, etc. |
|
|
Term
| what are three considerations when changing a patient's diet? |
|
Definition
1. nutrition: intake
2. nutrition: absorption
3. family buy-in |
|
|
Term
| what views do we want to see in a VFSS? |
|
Definition
| lateral and a/p views are helpful |
|
|
Term
| what test do we want to use when we need absolute clarity about penetration or aspiration? |
|
Definition
|
|
Term
| does the FEES give you absolute evidence of aspiration? |
|
Definition
|
|
Term
| what kind of patients get TPN? |
|
Definition
| patients who can't handle food going to the "gut" |
|
|
Term
| which tubes require surgery? |
|
Definition
|
|
Term
| what is a gastrostomy (g-tube)? |
|
Definition
| going through the gastric system |
|
|
Term
| what is a jejunostomy (j-tube)? which patients get this type of tube? |
|
Definition
| an opening in the small intestine - used for people who are more fragile. |
|
|
Term
| is chewing involved in a mechanical soft diet? |
|
Definition
| yes - but just a little bit |
|
|
Term
| what would an advanced diet look like? |
|
Definition
| giving the patient a steak that doesn't need as much chewing as opposed to one that requires a lot of chewing |
|
|
