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Nursing Care Plan for Impaired Swallowing

Impaired Swallowing. Swallowing is a unique process that requires good performance of the muscles in the throat , face, tongue, and palate. The presence of the disease, disorders or abnormalities in one of these organs will interfere with the process of swallowing.

Difficulty swallowing or dysphagia. It is usually a sign of a problem in the throat or esophagus (esophageal), tube-shaped muscle that moves food and liquid from the back of the mouth to the stomach. Although dysphagia can happen to anyone, but generally only occur in the elderly, infants, and those who have problems with the nervous system or brain.

There are many causes that can lead to throat or esophagus does not function normally. It could be because of some small things, but some other things that might cause it is a serious disorder. If only having one or two times only, not to worry, the possibility of not having a medical problem. But if trouble swallowing continuously, it is likely to suffer a serious problem that requires proper handling.

In normal circumstances, the muscles in the throat and esophagus will squeeze or contract to move food and liquids from the mouth to the stomach without obstacles. There are two types of problems that can make it difficult for food and liquid move into the esophagus, namely :

1. The muscles and nerves that help move food through the throat and esophagus does not work properly. This can happen because :
  • Suffered a stroke, brain or spinal injury.
  • Problems with the nervous system, such as post - polio syndrome, multiple sclerosis, muscular dystrophy, or Parkinson's disease as well. It could also be caused after diphtheria, syphilis, poisoning, bibulous, and hysteria.
  • Immune system problems that cause swelling or inflammation, and weakness, such as polymyositis or dermatomyositis.
  • Esophageal spasms. This means that the muscles of the esophagus suddenly pressing. Sometimes this can prevent the food to reach the stomach.
  • Scleroderma. In this condition, the tissues of the esophagus become hard and narrow. Scleroderma can also make the muscles become weak lower esophagus, which can cause food and stomach acid back up into the throat and mouth.
2. There is something blocking the throat or esophagus. This may occur because :
  • Gastroesophageal reflux disease (GERD). When stomach acid up into your esophagus, it can cause ulcers in the esophagus, which then can cause scars or wounds. These scars can make a narrow esophagus.
  • Esophagitis. It is an inflammation of the esophagus. It can be caused by many things, such as GERD or an infection or because the pill is stuck in the esophagus. In addition, difficulty swallowing can also be caused by allergic reactions to certain foods or things other airborne.
  • Diverticula. It is a small sac that grows on the wall of the esophagus or throat.
  • Esophageal tumors. Growth in the esophagus may be cancerous or noncancerous.
  • Lymph nodes and tumors that suppress the esophagus.

In addition , dry mouth could make matters worse dysphagia . This is because you may not have enough saliva to help the food from the mouth to enter the esophagus . Dry mouth can be caused by the influence of the consumption of drugs or other health problems.

Dysphagia can come and go at any time, mild or severe, or worse than would occur continuously. If experiencing dysphagia, may be :
  • Food or liquid could not swallow at swallowing the first experiment.
  • Vomiting, choking, or coughing when swallowing.
  • Food or liquid back up into the throat, mouth, or nose after swallowing.
  • Feeling like food or fluid trapped in one or several parts of the throat or chest.
  • Pain when swallowing.
  • Pain or distress in the chest or stomach.
  • Weight loss due to not getting enough food or fluid intake.

Nursing Care Plan for Dysphagia : Impaired Swallowing
will depend on what is causing dysphagia. Treatment for dysphagia includes :
  • Exercise for the muscles to swallow. If there is a problem with the brain, nerves, or muscles, may need to do exercises to train the muscles to work together to help swallow. Also may need to learn how to good posture or how to put food in the mouth in order to swallow either.
  • Change in eating food. The doctor may suggest to avoid or change certain types of foods and liquids to make the process easier to swallow.
  • Dilation (widening). In this treatment, the device is placed into the esophagus, then carefully will expand the narrow areas of the esophagus. Perhaps this treatment should be done several times.
  • Endoscopy. In some cases, a long, thin scope can be used to retrieve the object that is stuck in the esophagus.
  • Food that is stuck mashed with similar chemicals such as papain, that blob can continue down the food into the stomach.
  • Surgery. If there is something blocking the esophagus (such as a tumor or diverticula), may need surgery to remove it. Surgery is also sometimes used in people who have a problem that affects the muscles of the esophagus (achalasia).
  • Drugs. If experiencing dysphagia associated with GERD, the heat in the stomach, or esophagitis, prescription drugs can help prevent stomach acids enter the esophagus. Infections of the esophagus are often treated with antibiotic drugs.

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