Final answer:
All given actions should imply. To prevent aspiration in clients at risk, a nurse should take precautions like avoiding mixed food textures, monitoring oxygen levels during feeding, encouraging a forward tilt of the head while swallowing, keeping the client upright during and after feedings, and understanding the swallowing process to employ safe practices.
Step-by-step explanation:
The care for a client with an elevated risk of aspiration involves several actions that the nurse should take to ensure safety and prevent complications. Each step is crucial in its own right. Firstly, avoid mixing foods of different textures in the same mouthful to prevent confusion during the swallowing process. Secondly, monitor oxygen saturation during feeding to ensure that the patient's oxygen levels remain stable. Contrary to tilting the head backwards, which could exacerbate the risk of aspiration, one should actually tilt the head slightly forward when swallowing liquids to guide them down the esophagus more directly. Moreover, maintaining an upright position for at least 30 minutes after a meal helps in utilizing gravity to assist in the digestion process and prevent reflux and aspiration. Lastly, positioning the client upright (45–90 degrees) during feedings also facilitates the safe passage of food and liquids.
Swallowing is a complex process controlled by the nervous system, coordinating both upper respiratory and digestive activities. The risk of food entering respiratory pathways is primarily during the pharyngeal stage of swallowing. The body has protective mechanisms such as the elevation of the larynx and the closing of the epiglottis to prevent aspiration. The soft palate moves upward to close off the nasopharynx, and breathing temporarily ceases (deglutition apnea) to allow food to safely pass into the esophagus.