Author Question: The FEES and MBS indicate the following: Patient demonstrates difficulty initiating the swallow and ... (Read 111 times)

Alygatorr01285

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The FEES and MBS indicate the following: Patient demonstrates difficulty initiating the swallow and bolus was held in the mouth for an excessive amount of time. Spillage into the larynx is noted with some aspiration.
 
   Identify the diet you would recommend at this time.

Question 2

Select two nutrition problems and complete a PES statement for each.
 
  What will be an ideal response?



izzat

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Answer to Question 1

 Based on this assessment and using the DOSS, recommend a modified diet of Level 4  moderate dysphagia: intermittent supervision/curing, one or two consistencies restricted
This patient has no noted problems chewing, but stated that she feels food gets stuck in her throat  would benefit from a softer diet
 Level 3 (advanced) for most liberal diet
Only need to restrict liquid consistency to be thicker
 Pt had penetration into the larynx with some aspiration
Pt may need cueing, but with some tips, can learn to initiate on her own
 Recommend: Level 3 advanced diet and nectar-thick liquids
The thickness of the liquids/diet consistency depends on what the SLP recommends

Answer to Question 2

 Inadequate oral food/beverage intake related to poor appetite as evidenced by few sips of liquids, soft foods, and trying to take Ensure.
 Inadequate intake from enteral nutrition related to intolerance secondary to uncontrolled diarrhea as evidenced by ___ (more data would be needed regarding the specific amount that was either provided or withheld during this period of time, e.g. only X mL of formula compared to goal rate).
 Malnutrition related to anorexia and SOB as evidenced by consumption of <75 of estimated energy
needs, moderate temporal wasting and reduced handgrip strength.



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