What is the meaning of risk for aspiration?
(NANDA-I), the nursing diagnosis Risk for aspiration is defined as "the risk for entry of gastrointestinal secretions, oropharyngeal secretions, solids or fluids into the tracheobronchial passages"( 6 ).
What causes increased aspiration?
Obstructive pulmonary disease specifically causes poor forced expiratory volume and increased aspiration risk. Patients with poor dentition, oropharynx abnormalities, impaired swallowing, or esophageal dysmotility also suffer from an increased risk of aspiration.
What are two signs of aspiration?
Aspiration SymptomsFeel something stuck in your throat.Hurt when you swallow, or it's hard to do.Cough while or after you eat or drink.Feel congested after you eat or drink.Have a gurgling or "wet-sounding" voice when you eat.
What are four signs of aspiration?
What are the symptoms of aspiration from dysphagia?Feeling that food is sticking in your throat or coming back into your mouth.Pain when swallowing.Trouble starting a swallow.Coughing or wheezing after eating.Coughing while drinking liquids or eating solids.Chest discomfort or heartburn.More items...
What does higher aspiration mean?
1a : a strong desire to achieve something high or great an aspiration to become famous —usually plural a young man with political/literary aspirations.
How do you reduce aspiration?
Follow these guidelines to prevent aspiration when you're eating and drinking by mouth:Avoid distractions when you're eating and drinking, such as talking on the phone or watching TV.Cut your food into small, bite-sized pieces. ... Eat and drink slowly.Sit up straight when eating or drinking, if you can.More items...•
How do you get rid of aspiration?
Treatment of foreign body aspirationEncourage the person to keep coughing. If the obstruction is mild, they are usually able to cough and clear the blockage themselves.Back blows. ... Abdominal thrusts/Heimlich Maneuver.
What is the best treatment for aspiration?
Aspiration pneumonia is generally treated with antibiotics. Treatment is successful for most people. Make sure you contact your healthcare provider if you have chest pain, fever and difficulty breathing. As with most conditions, the best outcomes happen when aspiration pneumonia is found early.
What are the risk factors for aspiration?
Risk factors for aspiration. A decreased level of consciousness is a major risk factor for aspiration, as is a sustained supine position. Although some authors favor using small-bore feeding tubes to prevent aspiration, there seems to be insufficient data to warrant this action.
Is a nasogastric tube a risk factor for aspiration?
Despite these variations, authors almost uniformly agree that a decreased level of consciousness and a sustained supine position are major risk factors for aspiration. There is less agreement regarding the effect of a nasogastric tube (or its size) on aspiration and on the effect of various formula delivery methods.
Is aspiration a risk factor?
A decreased level of consciousness is a major risk factor for aspiration, as is a sustained supine position. Although some authors favor using small-bore feeding tubes to prevent aspiration, there seems to be insufficient data to warrant this action. Although strong data are lacking regarding feedin …
What are the risk factors for aspiration?
The primary risk factor of aspiration is decreased level of consciousness. Monitor respiratory rate, depth, and effort. Note any signs of aspiration such as dyspnea, cough, cyanosis, wheezing, or fever.
Why do you need antiemetics for gastric aspiration?
Nausea or vomiting places patients at great risk for aspiration, especially if the level of consciousness is compromised. Antiemetics may be required to prevent aspiration of regurgitated gastric contents.
What are the conditions that can be caused by a tracheostomy?
Chronic conditions, like altered consciousness from head injury, spinal cord injury, neuromuscular weakness, hemiplegia, and dysphagia from stroke, use of tube feedings for nutrition, and artificial airway devices such as tracheostomies, may be experienced in the home, rehabilitative, or hospital setting. ADVERTISEMENTS.
What is aspiration pneumonia?
Aspiration is breathing in a foreign object such as foods or liquids into the trachea and lungs and happens when protective reflexes are reduced or jeopardized. An infection that develops after an entry of food, liquid, or vomit into the lungs can result in aspiration pneumonia.
Why is early intervention important?
Early intervention protects the patient’s airway and prevents aspiration. Anyone identified as being at high risk for aspiration should be kept NPO (nothing by mouth) until further evaluation is completed.
What is the pH of gastric aspirate?
Chest x-ray verification of accurate tube placement is most reliable. Gastric aspirate is usually green, brown, clear, or colorless, with a pH between 1 and 5.
Why is an assessment required for nursing?
Assessment is required in order to distinguish possible problems that may have lead to aspiration as well as name any episode that may occur during nursing care. Assess level of consciousness. The primary risk factor of aspiration is decreased level of consciousness. Monitor respiratory rate, depth, and effort.
What causes acid reflux in the esophagus?
Gastroesophageal reflux disease is a disorder of the digestive system that causes stomach acid to flow back up into the esophagus. The backwash of stomach acid that enters an affected individual's esophagus causes inflammation and damage to the esophageal tissues. Acid reflux is the backwash of acid into the esophagus, and gastroesophageal reflux disease describes episodes of acid reflux that occur at least twice per week in an individual.
Why is the esophagus narrow?
An individual who has a swollen and narrowed esophagus is more likely to experience aspiration because food can be redirected into the windpipe easier.
Why is aspiration bad for dysphagia?
An individual who experiences dysphagia may also be affected by aspiration due to their impaired ability to swallow food and liquid effectively. Dysphagia is the medical term utilized to describe when an individual is unable to swallow at all or has a limited ability to move food or liquid into their esophagus without it moving into their lungs.
Why does food move into the windpipe?
Problems with swallowing can cause food to move into an individual's windpipe instead of their esophagus because the epiglottis does not coordinate properly in the process of swallowing, which causes aspiration.
What does it feel like to have dysphagia?
An individual affected by dysphagia will experience symptoms like coughing, choking, a sensation that food is stuck in the throat, persistent drooling, and food coming up through the nose. Dysphagia can occur due to stroke, dementia, head injury, esophageal cancer, mouth cancer, gastroesophageal reflux disease, learning disability, ...
What are the symptoms of Parkinson's disease?
This abnormal activity in an affected individual's brain causes them to experience symptoms like tremors, rigid muscles, impaired posture, poor balance, loss of automatic movements, writing changes, changes in speech, and slowed movement. When a Parkinson's disease patient has problems with swallowing, they can experience aspiration as a result ...
What are the causes of aspiration?
The most common objects that cause aspiration include food, saliva, and stomach contents from vomiting, heartburn, and swallowing. Many individuals describe aspiration as ...
What does it mean when you swallow something?
Aspiration means you’re breathing foreign objects into your airways. Usually, it’s food, saliva, or stomach contents when you swallow, vomit, or experience heartburn. This is common in older adults, infants, and people who have trouble swallowing or controlling their tongue. Most of the time aspiration won’t cause symptoms.
How long does swallowing therapy last?
For many people, swallowing therapy can help prevent aspiration. A session with a therapist usually lasts for one hour.
How do you know if you have pulmonary edema?
In most cases, you won’t know you’ve developed pneumonia or pulmonary edema until you experience other symptoms such as difficulty breathing, coughing with mucus, and more.
Why does food go down the wrong way?
Some people refer to this as food “going down the wrong way.” This can happen due to reduced tongue control or poor swallowing reflexes. The average person can usually cough out a foreign object before it enters the lungs.
What does a doctor check for in a patient with GERD?
They’ll also check for any problems with swallowing or underlying conditions such as GERD.
What happens if you suspect aspiration has developed into another complication?
If they suspect aspiration has developed into another complication, they’ll order tests to see if there’s food or fluid in the lungs. These include:
What causes a reduced tongue control?
It tends to cause aspiration of liquids. abnormal swallow reflex. Without a swallow reflex, the food can roll and fall into the airway. neurological disorders. Some neurological conditions, such as Parkinson’s disease, cause reduced tongue control. esophageal disorders.
What is aspiration pneumonia?
Aspiration pneumonia can be a serious illness, especially for older adults or people with a compromised immune system . As Ed Bice, M.Ed., CCC-SLP and Angela Van Sickle, Ph.D., CCC-SLP recently wrote, “aspiration pneumonia” is actually an ambiguous diagnosis that covers at least 13 different conditions. Speech-language pathologists generally think of aspiration pneumonia as being the result of food, liquid, or saliva entering the lungs. However, aspiration pneumonia may also result from gastroesophageal reflux, vomiting, or a pulmonary infection.
What are the problems with linear thinking?
Bice and Van Sickle (2020) have clearly the problems with the linear thinking that used to be so common in our field: that aspiration leads to aspiration pneumonia which can lead to death.
Is aspiration pneumonia complicated?
It turns out that the development of aspiration pneumonia is far more complicated, and not well-understood even today. This article is not meant to be a comprehensive review, so please check out the references for more reading. But I do want to share a couple of points.
Can dysphagia be treated in isolation?
We don’t have x-ray vision (i.e., get instrumental exams), and dysphagia can’t be treated in isolation (i. e., consider the whole person). It’s complicated and the final answers aren’t known, but we can keep reading to stay up-to-date. Please share this article with others, and please leave a comment with your recommended reading for me!
Can you predict who will get sick from aspiration pneumonia?
Although we can’t predict who will or will not get sick, we do know that there are a number of factors that increase the risk of developing an aspiration pneumonia. I’ve created an easy-to-read handout that I’m finding useful in educating patients, families, and other medical staff.
Do healthy people develop aspiration pneumonia?
Healthy people do not develop aspiration pneumonia, so it’s important to understand how the body responds to stress and illness. Not only do the immune system and muscle function change, but even the microbiome of the mouth, throat, lungs, and digestive tract change. return to top.
Expected Outcomes
Patient will not experience aspiration as observed by clear lung sounds, unlabored breathing, and oxygen saturation within normal limits
Nursing Assessment for Risk For Aspiration
1. Identify patients at an increased risk for aspiration. Patients with impaired swallowing (dysphagia) from a stroke, Parkinson’s disease, or spinal cord injury or suffering neurological damage with the inability to clear secretions require assessment and monitoring when providing anything by mouth.
Nursing Interventions for Risk For Aspiration
1. Keep suctioning equipment at the bedside. Patients at an increased risk for aspirating should have functioning suctioning equipment at the bedside for immediate use.
References and Sources
Maegan Wagner is registered nurse with over 10 years of healthcare experience. She earned her BSN at Western Governors University.
