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15 Cards in this Set
- Front
- Back
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What are some questions to ask when obtaining a feeding history?
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-method/shedule
-diet -onset of & description of problem (context, choke, soc/emo impact) -variability (temp, texture) -compensations made |
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What are some observations to make in a clinical evaluation?
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-cog/alertness/endurance
-body tone/posture/position -airway (fake, real) -can follow instructions? -can self-feed? -obs. all swallow phases |
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What causes premies to be predisposed to swallowing problems?
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-concomitant health issues
-immature neuro system, cog. abilities, anatomy |
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What are some physical differences between the infant and adult swallowing mech.?
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-size/shape of oral cavity
-tongue relative to oral cavity (baby takes up more space) -hyoid vertical -larynx higher -eust. tube more flat -size/posit. of epitglot. |
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What are some disorders associated with premature infants?
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-intercranial hemorrhage
-necrotizing entercolitis -infant respir. distress syndrome -bronchopulmonary dysplasia -congenital heart disease -GERD -CP |
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What are some ways to stimulate a swallow in infants?
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-change physical environment
-make sure child is alert -uneven food textures -change temp. -smell/taste appealing -positioning |
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What are the limitations of a clinical/bedside exam?
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-cant see entire tract/timing of swallow
-cant see peristalsis/strength -can't see residue -not conclusive for aspiration |
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What should an clinical/bedside include?
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-medical hx
-feeding hx -oral mech -obs. feedings -current method of eating - |
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What is observed in the Oral Phase in the clinical/bedside exam?
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-tongue may not propel bolus to back of mouth
-\/ tongue mobility -\/ bolus control -may need food modifications |
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What is observed on the Pharyngeal Phase of the clinical/bedside exam?
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-swallow reflex is triggered
-palate is elevated -phar. peristalsis occurs -delay in swallow reflex -larynx elevates |
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What are some diet modifications that can be made to improve swallow function?
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-mech. altered food (chopped, ground)
-soft food (pasta, caserole) -thin liquids (h2o, broth) -thick liquids (milk shake, cream soups) -thickened liquids (honey, pudding, nectar type consistencies) |
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When should you use instrumental swallow assessment?
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-phar. dysphagia is suspected
-pulmonary status compromised -nutritional status is compromised -not enough info at bedside -asp. after tx implemented -acute incident -need to observe transport or airway protection |
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When would you use FEES(T)?
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-can be used at bedside
-determine if asp. is occurring -determine safety of oral eating -no xray exposure -can be done by SLP -(T) test VF adduction |
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When would you use a MBS?
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-need radiologist and technician
-visualization of all stages of swallow -need liquid barium w/foods or thickener -can view timing, symmetry, pooling, aspirating, chewing |
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What can be done to prevent aspirating (during MBS or in general)?
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-chin down
-turn head to weaker side -change food texture -change bolus size -use a straw of liquids (more control of intake) |
