UWOLRD NCLEX RN
COMPREHENSIVE STUDY
GUIDE
2020
, FUNDAMENTALS OF NURSING
BASIC CARE AND COMFORT
DYSPHAGIA DIET
Clients with dysphagia are at risk for aspiration and aspiration pneumonia. Dietary modifications and swallowing
rehabilitation measures can reduce the risk of aspiration in clients who can tolerate oral feedings. Specific techniques
include the following:
o Modification of food consistency (pureed, mechanically altered, soft)
o Thickened liquids
o Having the client sit upright at a 90-degree angle
o Placing food on the stronger side of the mouth to aid in bolus formation
o Tilting the neck slightly to assist with laryngeal elevation and closure of the epiglottis
Some clients who have suffered a cerebrovascular accident (CVA) are also left with visual impairment such
as hemianopsia; in this condition, a person sees only a portion of the visual field from each eye. A client with a right-
sided CVA may have left-sided hemianopsia. Having the client turn the head during a meal will help the client see
everything on the plate
Adding milk to mashed potatoes will alter the consistency; if the consistency is too thin, the client will be at increased
risk of aspiration.
Using a straw for drinking liquids might cause increased swallowing difficulty and choking. Controlling liquid intake
through a straw is more difficult than drinking straight from a cup or glass.
BREAST PROSTHESIS
A breast prosthesis is an artificial appliance that is fitted to the external chest wall or inserted into a female client's
undergarments to simulate previous symmetry after a mastectomy or breast trauma.
, This is an option for clients who are not interested in, or are not candidates for, breast reconstruction surgery. This
appliance assists in the promotion of well-being, body image, and sexuality.
When evaluating the use of a breast prosthesis, nurses should assess the client for body image disturbance using
open-ended questions and therapeutic communication
NON-THERAPEUTIC COMMUNICATION TECHNIQUES
, THERAPEUTIC COMMUNICATION
INTERPRETER
Clients from many cultures will be more responsive if the interpreter is the same gender, especially when the condition
is highly personal or sensitive
The nurse should maintain good eye contact when communicating with the client. The interpreter should translate the
client's words literally.
Communication is with the client, not the interpreter. The nurse should use basic English rather than medical terms,
speak slowly, and pause after 1-2 sentences to allow for translation
Providing simple instructions about upcoming actions in the order they will occur will be easier for the client to
understand. For example, the nurse can indicate that there will be surgery and then a follow-up visit as opposed to,
"You'll follow up with the health care provider after your procedure"
COMPREHENSIVE STUDY
GUIDE
2020
, FUNDAMENTALS OF NURSING
BASIC CARE AND COMFORT
DYSPHAGIA DIET
Clients with dysphagia are at risk for aspiration and aspiration pneumonia. Dietary modifications and swallowing
rehabilitation measures can reduce the risk of aspiration in clients who can tolerate oral feedings. Specific techniques
include the following:
o Modification of food consistency (pureed, mechanically altered, soft)
o Thickened liquids
o Having the client sit upright at a 90-degree angle
o Placing food on the stronger side of the mouth to aid in bolus formation
o Tilting the neck slightly to assist with laryngeal elevation and closure of the epiglottis
Some clients who have suffered a cerebrovascular accident (CVA) are also left with visual impairment such
as hemianopsia; in this condition, a person sees only a portion of the visual field from each eye. A client with a right-
sided CVA may have left-sided hemianopsia. Having the client turn the head during a meal will help the client see
everything on the plate
Adding milk to mashed potatoes will alter the consistency; if the consistency is too thin, the client will be at increased
risk of aspiration.
Using a straw for drinking liquids might cause increased swallowing difficulty and choking. Controlling liquid intake
through a straw is more difficult than drinking straight from a cup or glass.
BREAST PROSTHESIS
A breast prosthesis is an artificial appliance that is fitted to the external chest wall or inserted into a female client's
undergarments to simulate previous symmetry after a mastectomy or breast trauma.
, This is an option for clients who are not interested in, or are not candidates for, breast reconstruction surgery. This
appliance assists in the promotion of well-being, body image, and sexuality.
When evaluating the use of a breast prosthesis, nurses should assess the client for body image disturbance using
open-ended questions and therapeutic communication
NON-THERAPEUTIC COMMUNICATION TECHNIQUES
, THERAPEUTIC COMMUNICATION
INTERPRETER
Clients from many cultures will be more responsive if the interpreter is the same gender, especially when the condition
is highly personal or sensitive
The nurse should maintain good eye contact when communicating with the client. The interpreter should translate the
client's words literally.
Communication is with the client, not the interpreter. The nurse should use basic English rather than medical terms,
speak slowly, and pause after 1-2 sentences to allow for translation
Providing simple instructions about upcoming actions in the order they will occur will be easier for the client to
understand. For example, the nurse can indicate that there will be surgery and then a follow-up visit as opposed to,
"You'll follow up with the health care provider after your procedure"
