Clinical Application – Dysphagia
Roy McNamara is a 92-year-old retired pastor hospitalized after a stroke. He is in
stable condition and expected to return home to his wife within a few days. The
couple has a live-in
...
Clinical Application – Dysphagia
Roy McNamara is a 92-year-old retired pastor hospitalized after a stroke. He is in
stable condition and expected to return home to his wife within a few days. The
couple has a live-in caregiver and a daughter who lives nearby. Prior to his
hospitalization, Roy had a good appetite for a variety of foods and maintained his
weight at 170 pounds. He is 5 feet 8 inches tall. After observing him for the past
24 hours, his nurse reports that he coughs when he tries to drink coffee and juice
and leaves some of the solid foods on his tray uneaten. His doctor orders a
barium swallow evaluation, which reveals normal chewing but aspiration of thin
liquids into his lungs. Further evaluation reveals a normal swallow with yogurt
and pudding but not with eggnog. (See Note below)
1. Refer to Table 23-1. What is the most likely cause of Roy’s dysphagia? Based on his
symptoms, what category of dysphagia does Roy likely have? Describe other signs and
symptoms of this type of dysphagia.
Roy is quite old, he is at the age of 92, since he has been struck by a stroke he is put into
the oropharyngeal category. This means that he has problems digesting food from his
mouth and into the esophagus because of never damage. This also causes him to cough
a lot. He lacks energy very much throughout the day, and he barley has any energy to eat
a complete plate.
2. Based on the standardized National Dysphagia Diet recommendations from Table 23-2,
what nutrition prescription would you recommend for Roy? Include your
recommendation for liquid consistencies as well.
Based on the standardized National Dysphagia Diet Roy should be on Level 1, this is
because he is able to chew his food, but he finds difficulty while doing it. Liquids are a
good food option for Roy because they are thicker than water and he will be able to sip
them but will not be at risk for them coming back up. Roy should include foods such as
bananas and mashed potatoes are good for his diet and will be easy for him to swallow.
3. What general information could you provide to Roy’s family and caregiver regarding the
properties and preparation of acceptable meals for Roy
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