神外二区小讲课：洼田饮水试验及相关饮食指导

Drinkingwatertest&TherelevantguidanceofdietGuangzhouMedicalUniversity主讲人:石彩兰指导老师:朱美玲2017.03.24洼田饮水试验及相关饮食指导*1.Reasonsofdrinkingwatertest2.Advantagesofdrinkingwatertest3.Methodsofdrinkingwatertest4.Therelevantpatients’dietguidanceMaincontent（主要内容）Reason*1.earlyintervention2.preventlunginfection（肺炎）Malnutrition（营养不良）Dehydration（脱水）Asphyxia（窒息）Advantages*EnsuredifferentdegreesofswallowingdysfunctionclearlyGivecorrespondingnursinginterventionAvoidunnecessaryindwellinggastrictubeNasogastrictubecanreducetheincidence（发生率）ofpulmonaryinfectioneffectivelyintheearlyclassifysimpleoperationrequirements*havetreatmentindicationsclearconsciousnessabletocompletethetestObeyinstructionsinaccordanceMethods*situp30mlwarmwaterobservethetimeofswallowchokingcoughLevel1optimalcanatimetoswallowthewatersmoothlyLevel2finedividemorethan2timestoswallow,butwithoutchokingcoughswallowLevel3mediumoneswallow,butthereareachokeandcoughLevel4canLevel5poorin2timesormoretimestoswallow,buttherearechokeandcoughchokingandcoughfrequently,andcan'tswallowPayattention:1.Donotneedtotellavoidtension3.Aftertestmustbeaccuracy2.QuantityofwaterdietguidanceMethodsNormalLevel1,andswallowingin5secondsSuspiciousAdrink,butdrinkmorethan5secondsortwicetilllevel2.Abnormal3~5level,anddivideinlight,mediumandseverechokingcoughTreatmentandnursingintervention(治疗及护理干预)*assessmentresult(评定的结果):Level3Level5Level4giveguidancetoswallowingtraininggiveswallowingtrainingandguidepatientstoswallowingtrainingontheirownindwellinggastrictubeDietGuidanceformandchoiceDiluteLiquid（稀流质）water,milk,fruitjuice,coffeeThickliquid（浓流质）cerealbeverage（谷物饮料）,joinedwiththickeningagent（增粘剂）ofwater,soup,eggs,etcSemi-solid（半固体）Pastefood（糊状食物）Solid（固体）ricepaste（米糊）,vegetablespaste（菜糊）,meatpaste,steamedegg（蒸水蛋），waterlotusrootstarch（水藕粉）,softrottenrice（烂饭）,bread,rice,chaozhouporridgebiscuit，nuts,etcAvoidtochooseDryoreasilylooseoffoodMorechewingfoodHighviscous（粘性的）foodsHotdilute（稀的）liquidfoodsthefoodhaveboneorsting(刺)suchasriceinsoup（汤泡饭）,leanmeat（稀肉）,porridgeHybrid（混合的）textureoffoodcookies,cakes,Friedricelargepiecesofmeat,peanutsricecake,glutinousrice（糯米）Feedingorder1.Paste（糊状）foodthickliquid（浓流质）2.Paste（糊状）foodsemi-solid（半固体）diluteliquidpastefood（稀流质）solid（固体）FeedingtoolsSpoon（调羹）cupStraws（吸管）Eatingguidance-positionSemirecumbentposition（半卧位）andheadforwardslightly(头稍前倾)generalStayinbedLateralposition侧卧位Situpstraightandheadforwardbendsslightly,andbodycantendtothecontralateral(健侧)30degrees(头稍前倾)坐直头稍前屈位，身体可倾向健侧30度getoutofbed食物的形态Lethargy（昏睡），sleepiness，andswallowingabilityundermoderateEasytoswallowliquid，suchas,freshmilk,vegetablejuice,juiceTheimprovementofswallowingfunctionandphysicalrecoveryEatingtraining,Homogeneousglue(均质胶冻状)orpastefood,suchasCustard（蛋羹）,batter(面糊)TranslatetoanearlynormaldietandwatergraduallyOralfoodintake（摄食入口量）3-4ml1spoonSwallowingseveraltimesrepeatedlyorDrinktherightamount(适量的)ofwater进食物的分配和方法Goodforbreakfast,luncheatsatisfied,dinnertoeatlessprinciplesLethargy（昏睡），sleepinessEatingwhileencouraging,offercertainstimulationtowakeupmentalsymptomsDon'topenmouthBepatienttoenlighten（开导）andinspire,andtrytoassistintakeallthebookings.Addaspoonful(匙)ofwaterintheteethinordertostimulatetoopenthemouthTonguemusclemovementparalysis(偏瘫)causedbymixingfailureEatingwhileencouraging,offercertainstimulationtowakeupusenasalfeedingifcannotmaintainbymouthintakeenoughwaterandheatPharyngeal(咽部)movementdisordersOralnursingshouldmaintainaseatafteramealmorethanhalfanhourMattersneedingattention(吞咽训练的注意事项)causes,dangerous,trainingandcountermeasures(对策)detaileddescriptionobserveandrecordcloselyPreventabnormaldeglutition(误咽)andaspirationpneumonia（吸入性肺炎）PayattentiontoSurgicaltreatment.Dehydration(脱水)andothernutritionstate,andsupplytimely.Aspirationpneumonia(吸入性肺炎)happenfrequently,andswallowingfunctionnotimprove*Thankyouforyoulistening!**