To best assist a patient with dysphagia, the nurse should ...

[bcretired]

To best assist a patient with dysphagia, the nurse should implement which action(s)? (select all that apply.)
 
  a. Encourage practice swallowing before the meal.
  b. Coach the patient to chew thoroughly.
  c. Assist the patient to sit upright with the head forward and chin tucked.
  d. Offer fluid during the meal.
  e. Give the patient thin liquids, such as wa-ter.

Question 2

The patient with Addison disease is receiving IV fluids for rehydration. The nurse should carefully monitor the patient for which potential problem?
 
  a. Hypotension
  b. Hyperglycemia
  c. Hypokalemia
  d. Hypernatremia

[Tonyam972]

Answer to Question 1

A, B, C, D
To assist a patient with dysphagia (trouble swallowing), the nurse should encourage practice swallows and visualize the larynx rising. Coaching the patient to chew thoroughly while sitting upright, and offering appropriate liquids are actions that decrease likelihood of aspiration. The nurse should administer thickened liquids.

Answer to Question 2

A
The patient with Addison disease is at risk for an addisonian crisis. During an addisonian crisis, decreased levels of cortisol result in decreased sensitivity of the blood vessels to sympathetic stimulation. It is the sympathetic stimulation that maintains vascular tone. Lack of vascular tone causes vasodilation, producing hypotension. Addisonian crisis requires immediate fluid replace-ment therapy in order to prevent irreversible shock. Intravenous hydrocortisone is given along with sodium, fluids, and dextrose until blood pressure becomes stable. The hydrocortisone is then tapered off slowly. Hyperkalemia must also be addressed with insulin, Kayexalate, and loop diuretics, and by monitoring arrhythmias and the patient's intake and output. Hypoglycemia is treated with IV glucose and with glucagon as needed; blood glucose is monitored every hour.