Dysphagia Final

Front 1

Hydration

Back 1

➢ H2O makes up 60% of our body
➢ Vital for normal cell functions
➢ Regulated by kidneys, cardiovascular
system, pituitary gland, parathyroid
glands, adrenal glands, & lungs
➢ H2O flows freely across all body membranes

Front 2

Causes of Dehydration

Back 2

➢ Excessive Water Loss
 Fever
 burns
 hyperventilation
 prolonged mech.ventilation
 watery diarrhea
 infection
 diuresis

➢ Insufficient Water Intake
 Unable to perceive or
respond to thirst
 Comatose, confused
 NPO without sufficient IV maintenance
 Unable to swallow

Front 3

Results of Dehydration

Back 3

 Inc. Na+ concentration
 Dec. K+ concentration

Front 4

Types of Dehydration

Back 4

➢ Hypernatremia
➢ Hypovolumia

Front 5

Hypernatramia

Back 5

 Pure water depletion
 Excess sodium (Na+) concentration in extra-cellular fluid causes H2O to decrease

Front 6

Hypovolumia

Back 6

 Mistaken for hypernatremia
 Equal loss of H2O & Na+, or extra-cellular fluid volume decrease
 Simply: loss of fluid from the circulatory system

Front 7

Dehydration Info

Back 7

➢ A portion of the general population may
be chronically and mildly dehydrated.
(Kleiner, 1999)
➢ Normal aging is associated with changes
in body composition, thirst perception,
renal function, and hormonal regulatory
mechanisms required to maintain the
balance of water and sodium in the body.
➢ Dehydration is a serious and common problem encountered in health care.
➢ It is the most common fluid and electrolyte disturbance in the geriatric population.
➢ Xerostomia, which can significantly and
negatively impact nutrient intake reportedly
affects more than 70% of the geriatric
population.
➢ Cognitive and communicative impairments
often interfere with a patient’s ability to
express a need for food and liquids
➢ Compromised mobility, dexterity, and visual
acuity can lead to decreased fluid intake.

Front 8

Dehydration can lead to a variety of health consequences including:

Back 8

• changes in drug effects
• infections
• poor wound healing
• pressure sores
• decreased urine volume
• urinary tract infections
• falls
• confusion
• lethargy
• constipation
• altered cardiac function
• acute renal failure
• weakness
• declining nutritional intake

Front 9

Dehydration and Dysphagia

Back 9

➢ Patients with restricted intake of thin liquids may find it difficult to consume the daily recommended intake of six to eight cups of fluid via thickened liquids
➢ Patients often find thickened liquids to be unpalatable, and frequently refuse to drink them.

Front 10

Use of Thick Liquids

Back 10

➢ Dysphagic stroke patients receiving thickened liquids failed to meet fluid intake requirements. (Finestone et al.,2001)
➢ Castellanos et al. (2004) surveyed the prevalence of thickened liquid use in 252 randomly selected, skilled nursing facilities across the U.S.
➢ Approximately 20% of freestanding skilled nursing facilities nationally and 25,470 residents were studied.
➢ A mean of 8.3% (range 0% to 28%) of residents were receiving thickened liquids.
➢ Thickened water was provided to residents in 91.6% of the institutions.
➢ Thickened liquids, as a dysphagia intervention, continue to be highly recommended.