Dysphagia - Peptic Ulcer 1

1.
Discuss a nursing care plan that deals with the responsibility for feeding clients
with dysphagia. Include safe procedures and features of foods to be considered.
Dysphagia is a impaired swallowing involves more time and effort to transfer food or

liquid from the mouth to the stomach. It occurs when the muscles and nerves that help
move food through the throat and esophagus are not working right. It can be a
temporary or permanent complication that can be fatal. Aspiration of food or fluid can
also occur possibly brought about by a structural problem, interruption or dysfunction
of neural pathways, decreased strength or excursion of muscles involved in
mastication, facial paralysis, or perceptual impairment. The swallowing muscles can
become weak with age or inactivity. It is a common complaint among older adults, in
those individuals who have had a stroke, suffered head trauma, have head or
neck cancer, or experience progressive neurological diseases as of multiple sclerosis,
amyotrophic lateral sclerosis, and Parkinson’s disease.
Dysphagia can befall at any age, but it’s more prevalent in older adults.Dysphagia can
befall at any age, but it’s more prevalent in older adults. The causes of swallowing
problems vary, and treatment depends on the cause.
 The components of an initial swallowing assessment

 Assess level of consciousness. Is the person well enough to eat or drink? Is the
person able to sit up and hold her head up? If the person is not able to sit up and
hold up head do not continue. The person is not able to eat or drink at this time.
 Give the person three teaspoons of water. After each teaspoon check for signs of
dysphagia. If signs of dysphagia present do not proceed.
 If the person successfully swallows without signs of dysphagia in stage two give
60ml of water in a glass. Observe for dysphagia. Check if person is able to finish
the glass. If able, proceed to stage four.

 Judge the person's safety in swallowing. Record whether the person is safe to
swallow, is possibly unsafe or definitely unsafe.
 Advice on safe swallowing
 Sit upright at 90 degrees when eating and drinking.
 Do not eat or drink when slouched or lying down.
 Take small bites of food.
 Take small sips of fluid.
 Do not gulp drinks.
 Eat slowly.
 Chew foods well before swallowing.
 Make sure you have swallowed your food or drink before taking more.
 Do not wash down your food with drinks.
 Do not talk when you have food in your mouth.
Nutrition facts
These diets are all nutritionally adequate. However, some patients may have difficulty
taking enough fluid and food to get all the energy and nutrients they need. In this case,
an adjustment to diet or treatment will be required.
Liquids
Fluids are essential to maintain body functions. Usually 6 to 8 cups of liquid (48-64
oz) are needed daily. For some dysphagia patients, this may present problems because
thin liquid can be more difficult to swallow. In this case, fluid can be thickened to
make it easier to swallow.
Calories
The greater problem for some patients is eating enough calories. The whole process of
eating simply becomes too difficult and too tiring. However, calorie and protein
intake can be increased by fortifying the foods the patient does eat.
 Fortify milk by adding 1 cup of dry powdered milk to one quart of liquid milk.
Use this protein fortified milk when making hot cooked creamed soups, sauces,
milkshakes, and puddings. Also add margarine, sugar, honey, jelly, or puréed
baby food to increase calories.
 Add strained baby fruit to juices, milkshakes, and cooked cereals.
 Add 1 jar of strained baby meat to soup, such as strained chicken noodle soup.
 Also add strained baby meats to sauces and gravies, and mix with strained
vegetables.
 Add juice to prepared fruit, cereal, or milkshakes.
2. List at least four dietary treatment guidelines for peptic ulcer disease. Include the
rationale for each
Peptic ulcers are sores that develop in the lining of the stomach, lower esophagus, or
small intestine. They’re usually formed as a result of inflammation caused by the
bacteria H. pylori, as well as from erosion from stomach acids. Peptic ulcers are a
fairly common health problem.
There are three types of peptic ulcers:
 gastric ulcers: ulcers that develop inside the stomach
 esophageal ulcers: ulcers that develop inside the esophagus
 duodenal ulcers: ulcers that develop in the upper section of the small intestines,
called the duodenum
Dietary Fibre & Vitamin A
Research shows that a high fibre diet decreases the risk of developing ulcer disease.
Although both insoluble and soluble fibres demonstrate this association, there is a
stronger association between diets high in soluble fibre and a decreased risk for
developing ulcers.
Foods that are high in soluble fibre include oats, psyllium husk, legumes, flax seeds,
barley, nuts, and certain vegetables and fruits, such as oranges, apples, and carrots.
Good sources of vitamin A include liver, carrots, broccoli, sweet potatoes, kale,
spinach, and collard greens.
Green Tea and Flavonoid-Rich Foods

Emerging research from China shows the potential protective effects of green tea and
other foods that are rich in flavonoids against chronic gastritis, H. pylori infection,
and stomach cancer. Specifically, these foods seem to inhibit the growth of H. pylori.
Flavonoid-rich foods include garlic, onions, and colourful fruits and vegetables such
as cranberries, strawberries, blueberries, broccoli, carrots, and snap peas.
Coffee and Alcohol
Both caffeinated and decaffeinated coffee can increase acid production and exacerbate
symptoms in individuals with ulcer disease. Alcoholic beverages can erode the
protective mucosal lining along the gastrointestinal tract and lead to further
inflammation and bleeding. To minimize symptoms, individuals with ulcer disease
should avoid or limit both coffee and alcohol.
Cranberry Juice Cocktail
Drinking just two 250mL cups of cranberry juice cocktail per day might reduce the
risk of H. pylori overgrowth in the stomach. Concerns about antibiotic resistance
make this finding especially significant because cranberry tannins appear to block the
bacteria without destroying them. When antibiotics are used to eradicate infection, the
bacteria may mutate and become resistant to treatment. Cranberry helps by either not
allowing the bacteria to attach itself or by disengaging it from the body once it is
attached, and prevent inflammation.
Assess Your Individual Tolerance
No evidence suggests that spicy or citrus foods affect ulcer disease, although some
individuals do report worsening of symptoms after eating these types of foods. It is
important to find out what works for you. If you notice that your symptoms get worse
after eating certain foods, then limit or avoid them so you can feel your best, making
sure that you don’t eliminate an entire food group.

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1.

Dysphagia is a impaired swallowing involves more time and effort to transfer food or

 The components of an initial swallowing assessment

Dietary Fibre & Vitamin A

Green Tea and Flavonoid-Rich Foods

Coffee and Alcohol

Cranberry Juice Cocktail

Assess Your Individual Tolerance

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