This nursing care plan and diagnosis with nursing interventions is for the following condition: Risk For Aspiration, Impaired Swallowing, Ineffective Swallowing, Difficulty Swallowing, Dysphagia, Peg Tube Feeding, and Difficulty Chewing.
What are nursing care plans? How do you develop a nursing care plan? What nursing care plan book do you recommend helping you develop a nursing care plan?
This care plan is listed to give an example of how a Nurse (LPN or RN) may plan to treat a patient with those conditions.
Important Disclosure: Please keep in mind that these care plans are listed for Example/Educational purposes only, and some of these treatments may change over time. Do not treat a patient based on this care plan.
Care Plans are often developed in different formats. The formatting isn’t always important, and care plan formatting may vary among different nursing schools or medical jobs. Some hospitals may have the information displayed in digital format, or use pre-made templates. The most important part of the care plan is the content, as that is the foundation on which you will base your care.
Nursing Care Plan for: Risk For Aspiration, Impaired Swallowing, Ineffective Swallowing, Difficulty Swallowing, Dysphagia, Peg Tube Feeding, and Difficulty chewing.
If you want to view a video tutorial on how to construct a care plan in nursing school, please view the video below. Otherwise, scroll down to view this completed care plan.
Scenario: |
An 86 year old female is being transferred to your unit. In report, you received that she has a PEG Tube with feedings that include Jevity 1.2 cal at 75 cc/hr. The PEG tube was placed three days ago and yesterday was when the feedings were started. The nurse tells you the patient’s residuals have been less than 10 ccs and that the patient is tolerating the feeding very well. The patient is to be kept nothing by mouth (NPO) due to her speech evaluation showing “silent aspiration”. Mouth care is to be performed every 4 hours along with lip care. The patient is aphasic and has advanced stage of Alzheimer’s disease. The patients last chest x ray shows “resolving pneumonia in left lower lobe”.
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Nursing Diagnosis: |
Risk for aspiration related to tube feeding as evidence by patient having peg tube with feedings and speech evaluation showing silent aspiration. |
Subjective Data: |
The nurse tells you the patient’s residuals have been less than 10 ccs and that the patient is tolerating the feeding very well. |
Objective Data: |
In report, you received that she has a PEG Tube with feedings that include Jevity 1.2 cal at 75 cc/hr. The PEG tube was placed three days ago and yesterday was when the feedings were started. The patient is to be keep nothing by mouth (NPO) due to her speech evaluation showing “silent aspiration”. Mouth care is to be performed every 4 hours along with lip care. The patient is aphasic and has advanced stage of Alzheimer’s disease. The patients last chest x ray shows “resolving pneumonia in left lower lobe”.
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Nursing Outcomes: |
-Pt’s head of bed will be greater than or equal to 30′ degrees during the hospitalization.-Pt’s mouth will be clean and free from any debris or mucous build-up during hospitalization.
-Pt will tolerate tube feedings well by having less than 30 cc of residual throughout hospitalization. |
Nursing Interventions: |
-The nurse will verbalize and demonstrate to the family and staff about how to keep the head of the greater than 30′ degrees and the importance of doing so every shift.-The nurse will assess for head of the bed placement every shift.
-The nurse will provide mouth and lip care to the patient every four hours through out the hospitalization. -The nurse will check the patients peg tube residual and document residual amounts every shift. |