Risk for aspiration? Yes or no?

bonnieL123 · Mar 25, 2005

I did a care plan on my Pt that suffered from a stroke and has a G-tube.
For one of my Nursing diagnosis, I chose "risk for aspiration, r/t G-tube..."
My instructor handed it back with a comment "He has a G-Tube - why is he at risk for aspiration?"
Now I'm questioning it myself. It seemed like a no-brainer when I chose it, and in a way it still does, but this particular instructor is *ALWAYS* right.

Here are some NANDA's For G Tube

Risk for fluid voulme deficit r/t diarrhea or excessive vomiting

Altered nutrition: less than body requiremnts r/t anorexia

Risk for injury related to aspiration of stomach contents into the respiratory tract from difficulty swallowing.

Hope this helps;

Bonnie

raindrop · Mar 25, 2005

Here are some NANDA's For G Tube
Risk for fluid voulme deficit r/t diarrhea or excessive vomiting
Altered nutrition: less than body requiremnts r/t anorexia
Risk for injury related to aspiration of stomach contents into the respiratory tract from difficulty swallowing.
Hope this helps;
Bonnie

Thanks Chica! Is it safe to say that he can be classified as "anorexic?"

I'm not sure I understand the last one in bold. How can he aspirate stomach contents into his RT from difficult swallowing...while he's NPO? I do realize that another Risk factor for his aspiration is D/T him pocketing his saliva - is saliva considered "stomach content," then? :stone

bonnieL123 · Mar 25, 2005

Thanks Chica! Is it safe to say that he can be classified as "anorexic?"
I'm not sure I understand the last one in bold. How can he aspirate stomach contents into his RT from difficult swallowing...while he's NPO? I do realize that another Risk factor for his aspiration is D/T him pocketing his saliva - is saliva considered "stomach content," then? :stone

What was the purpose of placing the g-tube. Was it because of vomiting and nausea? Because they do not normally insert a g tube for a stoke. Patient's are NPO, unless they are being feed thru this tube.

**canoehead, BSN, RN** · Mar 25, 2005

If he is at risk for regurgitating his stomach contents then he is at risk for aspiration. Apparently this patient does not regurgitate stomach contents, but why? Has he had a surgical procedure? is he missing an esophagus? what?

raindrop · Mar 26, 2005

Hi.

Ok, he had a stroke that which left him flacid on one side, and also affected his swallowing, tongue movement & speech.

I guess when I chose that dx I thought that he could be "at risk" b/c the tube could displace while infusing. I also chose that dx b/c he was having a very difficult time swallowing his saliva.

Hmmmmm. I really want to do well on this particular care-plan. Does the DX ( below) make sense, and is it something u would choose for my patient considering the details I just provided. He is NPO, but I'm assuming saliva is considered stomach contents since it is part of the digestion process. Please correct me if I'm wrong.

Risk for injury related to aspiration of stomach contents into the respiratory tract from difficulty swallowing.

suzanne4, RN · Mar 26, 2005

If he is having difficulties with swallowing, then he is deifnitely at risk for aspiration. It means that he is having difficulty in keeping his secretions clear. The G-tube would have been placed so that he can get nutrition thru this, you do not want to keep someone just on IV fluids, the gut is much better. He is at minimal risk for aspiration from the G-tube, it is his oral secretions that can cause him the most problems.

If there is a problem with nausea, the tube can also be placed in the jejunum to prevent this.

raindrop · Mar 27, 2005

Thanks Suz!

PennyLane, RN · Mar 27, 2005

I would probably say "Risk for aspiration as evidenced by difficulty swallowing secondary to stroke". This to me is the most clear--he's at risk of aspirating saliva. I don't think saliva is considered stomach contents--that would be digestive acids and whatever food/liquid is in the stomach.

babynursewannab · Mar 30, 2005

One would be surprised at how much at risk pts are for aspiration. In the CVICU, I just had a patient that had both an entotracheal tube (ETT) for breathing WITH a cuff and an Oral gastric (OG) tube for food. She was aspirating right and left....saliva, regurg, emesis...you name it.

I think the teacher here was not telling you that your dx was incorrect, but instead, just wanted you to do some critical thinking to pursue the dx in depth.

-Alyssa, RN