Final answer:
The nurse is correct in reporting dysphagia when a patient exhibits symptoms such as incomplete lip closure, abnormal movements of the mouth, tongue, and lips, and a change in voice quality after eating. These observations suggest issues with the voluntary phase of swallowing or possible aspiration. A normal gag reflex does not indicate dysphagia.
Step-by-step explanation:
Dysphagia and Symptoms Indicating Its Presence
Dysphagia refers to difficulty in swallowing or the sensation of food being stuck in the throat or chest. A nurse would identify dysphagia by observing certain symptoms in a patient. Notable symptoms indicating dysphagia include incomplete lip closure, which may lead to difficulty keeping food in the mouth, and abnormal movements of the mouth, tongue, and lips, which are necessary for the voluntary phase of deglutition or swallowing. A change in voice quality after eating could suggest aspiration or food entering the airway, and difficulty speaking, with a slow, weak voice may reflect a disturbance in the coordination of the muscles and nerves involved in both speaking and swallowing.
The presence of a normal gag reflex is not indicative of dysphagia, as this reflex is a protective mechanism and its absence rather than presence would be concerning. When assessing for dysphagia, a nurse should also watch out for respiratory issues such as shortness of breath, wheezes or stridor, hoarseness, pain with swallowing, and cough. These can be associated with dysphagia as complications or secondary symptoms.
Understanding the phases of deglutition is crucial. During the voluntary phase, a patient must have control of the muscles to initiate swallowing. In the pharyngeal phase, muscles must contract properly to prevent aspiration and move the bolus into the esophagus, and in the esophageal phase, the bolus moves through the esophagus into the stomach, which requires proper muscular and neural function.