Question on swallowing precautions

Nurses Education

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I've been wondering this for a few weeks now, and I think I'll get some good feedback here.

If a patient has swallowing difficulty so severe that he/she has to be on pudding thick liquid with a 1:1 assist and only allowed to be fed by speech or RN staff, wouldn't that qualify him/her to be NPO with a feeding tube placed? Perhaps the patient refused the feeding tube?

I've seen patient in the past who were NPO, on tube-feeds and allowed to eat for pleasure under the supervision of speech.

What do you guys think?

Im a student, don't have a whole lot of experience with this stuff, but enough that it strikes me kind of odd......

Infection risk is another thing to consider. In those who are chronically bedbound or ill, a feeding tube is another potential harbor for some very nasty infections.

Specializes in Transitional Nursing.
i can assure you there are many pts on fdg tubes who are not eligible to eat foods by mouth...

unless one's intent was to cause serious harm or death. ;)

also, fdg tubes do not prevent thirst, and so, a fdg tube would not address that particular problem with your pt.

continue on giving good mouth care, that is helpful.

and there is a reason that only skilled personnel can feed this pt...as it is too easy in causing a pt to aspirate.

i appreciate your compassion, but i do believe you will understand so much more when you advance in your studies.

good luck to you.

leslie

I didn't mean to imply that I was under the impression all FT patients could eat for pleasure......

Our FT's have flushes built in, so although they don't help thirst per-se, they provide hydration.

My problem is that if only skilled personnel can feed him, (namely only one in particular ever does) obviously his risk of aspiration is huge, and thus wouldn't that make him a FT candidate? That was my main question, which has pretty much been answered. Just wanted to clarify. Thanks for your insight.

What are HIS wishes?

There are many things to consider when opting for artificial nutrition, which is what a feeding tube is. You don't know what is in his Advanced Directives or what conversations have been held between him and his proxies, proxies and Physicians, him and his Physicians.

Why is a good question to ask. It is how we learn. You can always ask the Nurse that cares for him. "As a student, I was wondering if a feeding tube has been considered? In this particular patient's case, what are the risk versus benefit for a feeding tube?" There just maybe dynamics you aren't aware of.

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