The nurse is caring for a client hospitalized with a facial stroke. Which diet selection would be suited to the client?
A. Roast beef sandwich, potato chips, pickle spear, iced tea
B. Split pea soup, mashed potatoes, pudding, milk
C. Tomato soup, cheese toast, Jello, coffee
D. Hamburger, baked beans, fruit cup, iced tea
Correct Answer: B. Split pea soup, mashed potatoes, pudding, milk
The client with a facial stroke will have difficulty swallowing and chewing, and these food items mentioned provides the least amount of chewing. Consult with a speech therapist to evaluate gag re?exes; assist in teaching alternate swallowing techniques, advise the patient to take smaller boluses of food, and inform the patient of foods that are easier to swallow; provide thicker liquids or pureed diet as indicated.
Option A: The patient would have difficulty in chewing meat. Observe the patient for paroxysms of coughing, food dribbling out or pooling in one side of the mouth, food retained for long periods in the mouth, or nasal regurgitation when swallowing liquids. Have the patient sit upright, preferably on a chair, when eating and drinking; advance diet as tolerated.
Option C: This group would still require more chewing. Prepare for GI feedings through a tube if indicated; elevate the head of bed during feedings, check tube position before feeding, administer feeding slowly, and ensure that the cuff of the tracheostomy tube is in?ated (if applicable); monitor and report excessive retained or residual feeding.
Option D: The following food items would require more chewing and, thus, are incorrect. Avoid hard, chewy foods as these can be difficult to prepare, and choose a soft easy chew diet (such as pasta dishes, fish, well-cooked meats, and vegetables). Try smaller mouthfuls as these are easier to control and less likely to spill from the mouth.