In her article “Management of Dysphagia in stroke patients “Hughes (2011) describes Dysphagia as a common problem in patients that have had strokes, it is the difficulty in swallowing and sometimes pain in swallowing, she goes ahead to explain the occurrence of stroke in patients as the rapid loss of the brain function due to disturbance of the blood supply. She claims that dysphagia management is a very vital aspect in stroke rehabilitation as well as in the reduction of aspiration pneumonia.
The author further states that there are two types of strokes that affect the patients, the ischaemic stroke, this occurs when there is the blockage of an artery that supplies the brain with blood and is the most common type of strikes. On the other hand, a haemorrhagic stroke occurs mainly when there is bleeding around the brain hence reducing the blood supply of the brain, this is however not so common among victims. The article further describes the swallowing process and the stages that the process incur such as the oral stage whereby the tongue collects the food and moves the food around in the mouth so as it can be chewed and after chewing there comes the second stage whereby the food is pushed back in the mouth and food is swallowed. The final stage involves food passing down the esophagus and the author explains how the stroke affects the above stated swallowing process.
The author concludes that the effects and implications of stroke on a person are apparent and therefore greater need to have stroke patients in rehabilitation to ensure his/her nutritional and hydration needs are met. She further concludes that nutrition, positioning and oral hygiene are major aspects in the management of dysphagia and if effectively undertaken, there will be reduced incidences of aspiration pneumonia and as there is increased incidence in strokes, management of dysphagia is very vital.
Three key points drawn from the article
Implications for patients who have a stroke
Stroke can cause impairment in a patient, these are usually external manifestations of pathology, they include; pain, spasticity, muscle weakness, hemianopia and sensory loss. Disability is also another physical implication; this is the change in interaction of the patient and her/his environment. This could mean that the patient can no longer do simple daily chores such as going to the bathroom, gardening, walking and swallowing.
Stroke is a very expensive sickness on patients; medical bills are very high due to the specialized treatment that is required for one to get better. Additionally, the patient will need a personal professional caregiver who will ensure that the patient’s needs are met and maintained. Due to the disabilities and handicap that is involved with stroke, the patient will require machines or equipments that will ease mobility and help in achieving the simple activities that he cannot do because of the stroke. Stroke rehabilitation and dysphagia management are vital processes that need to take place for a stroke patient to be able to recover and this will require a lot of financial backing which could drain the patient.
Psychological and emotional implication
Strokes are never anticipated for hence can bring dramatic changes to the patient’s lives. Most patients are usually overwhelmed, shocked and worried about the changes in their bodies, how to cope with the new changes is also a big implication on the patient. Most patients become hopeless and break down during treatment before they get adjusted to their situation. Some feel that they have lost their identity; there is fear and anxiety in the patients and on the worst case scenario some fall into depression since they cannot cope with their situation (Hughes, 2011)
Management of Dysphagia
Dysphagia can lead to malnutrition, aspiration and dehydration hence it is of great importance that it is well and properly managed. There are several ways to manage the condition.
Hughes, (2011) claims that positioning is an important recommendation to manage dysphagia, the patient is supposed to be correctly positioned to ensure safety during swallowing. It is believed that there are differences in swallowing-related muscles when an individual is lying horizontally and when sitting upright. For a patient suffering from dysphagia, sitting upright is recommended. Positioning is vital since there could be paralysis after stroke and this can block the airway thus aspiration; apart from preventing aspiration, positioning can also prevent choking incidents in patients.
This is also an important aspect during the management of dysphagia since it relies on good oral hygiene. The patient’s lips tongue and mucus membrane is supposed to be hydrated most of the time to avoid infection and dehydration. Dental hygiene and the type of diet, the patient is feeding on, are also supposed to be checked to avoid infectious diseases such as candida.
It is important to assess the patient’s nutrition to avoid malnutrition. There are various tools that are used to determine the nutrition status of a patient and stages are involved to determine where the patient stands in his/her nutrition status.
Stroke is a leading cause of disability in patients and therefore it is important for individuals to undergo rehabilitation to get them back on their feet and achieve a certain level if independence. The rehabilitation starts on admission and can also continue upon discharge of the patient. The success of the process is dependent on good communication between the patient’s family and the medical practioners. (Hughes, 2011)
The process involves therapy for patients that incurred communication disorders, exercises to improve motor skills so as to strengthen muscles as well as mobility training; this includes learning to use walking aids and ankle strength boosters such as a plastic brace. Three ways the information from the article can or cannot be applied to your current or future clinical practice
Patients nutritional status
The article points out that the nurses are responsible for nutritional status of the patients; will help me in my future clinical practice since it will enable me to take full responsibility when it comes to assessing and monitoring the patient’s nutritional status.
Management of dysphagia
The article has helped to understand that nurses are pivotal when it comes to managing the patient’s dysphagia. It will help me to strive to meet the needs of the patients accordingly.
Implications of stroke on patients
As indicated in the article, patients are faced with physical, financial and emotional implications and it will help me in understanding their grievances as well as trying to encourage them, as stroke is not the end of the world.
Stroke is a leading cause of death and disability in recent times; it has various implications such as financial, physical, psychological and emotional implications. It is therefore very important for the patient to be in stroke rehabilitation to ensure independence in doing simple normal activities. Managing of dysphagia is also very important to ensure that the patient does not suffer from aspiration, dehydration, choking and malnutrition. Nurses are most pivotal practitioners, when it comes to stroke and dysphagia management, it is important for them to uphold their services to ensure the patient’s needs are met. The article outlines the various implications of stroke, management of dysphagia, the swallowing process and stroke rehabilitation which is very enlightening.