Student No.

823 111 273

Management of Dysphagia in Stroke Patient

Author: Sarah Michelle Hughes
Student Name: Parita Patel
Student No: 823 111 273
Date of Submission: February 28,2014
Professor: Tamiza Kassam

Student No. 823 111 273

Management of Dysphagia in Stroke Patients

The management of dysphagia in stroke patients is an essential care delivery that nurses
ought to pay close attention to. According to Sarah Michelle Hughes, the author of Management
of dysphagia in stroke patient, patients who suffer who get a stroke are often affected by
complication like dysphagia. A case study conducted on Mr Richard Smith illustrated how the
management of dysphagia in stroke patients can be prevented. The main tactics to control the
dysphagia were nutritional assessment, swallowing, and positioning. Nurses must take the time
to assess stroke patients for dysphagia in order to prevent or reduce the risk of nutritional and
hydration deficiency. Stroke occurs when there is insufficient blood flow (ischemia) to the brain
or a hemorrhage around the brain resulting in loss of brain cells (Lewis, 2014). The content of
the study brought to attention three main goals that can help with the issue; they are assessing
patient holistically, collaboration of a team and appropriate nourishment. When a person suffers
a stroke, parts of the body become weakened or paralyzed, but with a precise rehabilitation
programs the chance of improvement and return to normal activities of daily life are reachable.
The rationale of this paper is to analyze hoe management of dysphagia in stroke patients can help
with future nursing practise.
Assessment of a patient done holistically can help achieve many solutions in a diagnosis.
Looking at the person as a whole can help understand the root problem. The article exhibits the
significance of assessing a patient holistically to make sure hydration and nutritional needs are
met safely and effectively. Mr Smith was prescribed supplements twice a day, alongside his
three pureed meals. Mr Smith, however, soon became reluctant to take the fortified drinks
because he disliked the taste. Various other flavours were trialled but he still declined to take
them. According to Mellor (2009), concordance is determined by patients acceptance of their

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condition and this is linked with how important patients believe they are in managing their
needs (Hughes, 2011). Letting patients have the right to decide their nutrition, their health status
can improve along with their independence.
Nurse plays an important role in the co-ordination and communication amongst the team
members as nurses are with them throughout the day. Effective communication with the different
disciplinarians can help achieve the patients need in an organized manner. Numerous team
members were involved in meeting Mr smiths dysphagia needs, including nurses, the speech
therapist, physiotherapist and doctor (Hughes, 2010). The physician is the initial person to order
necessary intervention and the nurse is responsible for carrying it out. That message is then sent
to the physiotherapist and the speech therapist and any changed made are then gone back to the
rest. The nurses responsibility is to address any concerns that might have arisen during patient
care for a better enrichment of the patients health.
Nourishment of any patient is an essential part of their health. Nurses are well informed
about the needs of patients as they accompany the patient with the feeding and hydration.
Patients with a stroke are more likely to be undernourished because they are unable to chew their
food. One reason why the dietary recommendation had changed was because Mr Smith had
become prone to pocketing his food (Hughes, 2010). Patient with this problem lose their
appetite and decline to eat since they experience discomfort and pain while swallowing. As a
result, patients with dysphagia become malnourished, and they need to be placed on GT feeding
or IV solution in order to supply them with essential nutrients.
In the article, Dysphagia after stroke and its management by Rosemary Martino, it
states that, Patients with dysphagia after stroke have an increased risk for aspiration

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pneumonia (Martino, 2012). Data suggests that aspiration is often the cause of aspiration
pneumonia. Dysphagia needs to be detected early and managed effectively because the
consequences of untreated dysphagia could be serious (Martino, 2012). In order to prevent this
condition, the speech therapist would have to start with an initial assessment and then pass on the
information to prevent aspiration pneumonia. Another way to avoid it would be to use other
feeding methods to reduce the risk of aspiration (Medline Plus, 2014) such as intravenous or
subcutaneous infusions or tube feeding (National Collaborating Centre for Chronic Conditions,
2008). Being a nursing student, I feel that patient care is the essential objective as a caregiver.
Reading this article helped me understand the effects of stroke such as aspiration and aspiration
pneumonia. Immobilization of a persons body can lead to life threatening conditions and leave
them helpless.
In conclusion, this case study helped illustrate the effects of dysphagia due to stroke. This
can be possible with the involvement of staff members, assessment of a patient as whole and
sufficient nourishment. Members of a team working together can create a better understanding of
where the patient stand and can help reduce the risk of dysphagia. Looking at the patients
concerns can help the healing process and can allow the patient believe his needs are getting
managed. Maintaining nutrition and hydration are the main factors that help manage dysphagia
management in a stroke patient. Without nourishment, the patient would not be able heal and get
back to regular. As we age, the risk of many diseases comes our way. Nurses need to maintain
and manage the needs of patients with dysphasia. The ability to successfully achieve those needs
can help maintain dysphasia in patients with strokes. Doing this essay made me realize how
crucial a nurses role is in a patients life.

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References
Hughes, S.M. (2011). Management of dysphagia in stroke patients. Nursing Older People, 23(3),
21-24.
Martino, R., Foley, N., Bhogal, S., Diamant, N., Speechley, M., & Teasell, R. (2005).
Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke
(00392499), 36(12), 2756-2763. Retrieved on February 26,2014 from CINAHL Database.
Medline Plus. (2014). Aspiration Pneumonia. Retrieved on February 26,2014 from
http://www.nlm.nih.gov/medlineplus/ency/article/000121.htm
National Collaborating Centre for Chronic Conditions. (2008). Stroke: National Clinical
Guideline for Diagnosis and Initial Management of Acute Stroke and Transient Ischaemic
Attack (TIA). Retrieved on Febuary 26, 2014 from
http://www.ncbi.nlm.nih.gov/books/NBK53294/