Procedures for Feeding a Client and Potential Complications (Nursing)

00:04 Hey guys, welcome to the skill feeding a patient.

00:07 This is going to come in handy more than you might think.

00:10 There's several patient populations, where you may need this skill, such as, a patient with dementia for example, very commonly in a patient with a stroke diagnosis, or a patient with an altered level of consciousness.

00:24 So, let's take a look at some of the equipment you're going to need.

00:27 A table to put the food or an overbed table, a towel, hand wipes or some sort of mechanism, for hand hygiene, soap, wash cloths and also disinfectant, for the table itself.

00:42 So, before we get started, this is a key point that many times, we forget to check, especially, with your stroke patients for example.

00:50 We need to check the patient orders, for the type of diet and aspiration precautions.

00:56 What I mean by that, is several different patient diagnoses, some of those can cause difficulty in swallowing, a really common one is a stroke patient for example.

01:07 Then, we want to perform our hand hygiene, provide privacy and explain the procedure to the patient.

01:14 Now, this is the key time, with we're feeding a patient, we're usually doing this, because the patient can't do it for themselves.

01:21 So, here's a great time to assess the patient's neurological and their functional status.

01:27 Now, once we've done this, we want to assist the patient to the appropriate position.

01:31 Now, this is really important, just think about if you're going to eat, you need your head of bed as high as possible, just make sure that you know this is safe for your patients.

01:42 And it's a great idea, to assist the patient in washing their hands, by using either a washcloth or hand wipes, before we get started.

01:51 You want to go ahead and put a towel over the patient's chest, to make sure we don't dirty their gown.

01:56 And if you're using an over bed table, great time to make sure we clean off the surface, so, they have a clean place to place their food.

02:05 Now, we can put our food on the overbed table, where the patient can reach it.

02:11 Once we receive the patient's food, we're going to set up the patient's tray and prepare the food as indicated.

02:17 This could mean, we're cutting up that food in small bites for the patient.

02:21 Now, if the patient can, allow them to self-feed, as much as possible, if this is safe.

02:27 Now, when you're talking about assisting in feeding, if the patient, can direct you to food choices that they want next, this is ideal.

02:36 Also important, to allow time between each bite and monitor closely for swallowing issues.

02:43 So, just know many times on a shift, we get really busy and we want to hurry up the patient's meal, just be diligent and make sure the patient is swallowing safely.

02:54 After the patient has finished their meal, we can go ahead and remove the tray.

02:59 And it's a great time to assist the patient in cleaning their face and their hands after their meal, and we can remove that towel from their chest.

03:07 Now, it's important to assist the patient in a comfortable position, but also note, that their head of bed may need to be up, to facilitate digestion.

03:16 Now, perform your hand hygiene and make sure you take note, of how much the patient had to eat or to drink and document this thoroughly.

03:25 Let's take a look at some special considerations regarding feeding a client.

03:30 Now, some potential complications that could occur is aspiration.

03:35 Guys, this one's a biggie, what we mean by this, is, someone could have a bite, it could go down in their windpipe, instead of their esophagus to their stomach.

03:44 This could block their airway, and airway obstruction is another issue and could cause difficulty breathing in your patient.

03:51 The other thing to note, if a patient aspirates, they could also get down in their lungs, they can get a really severe infection and cause really bad complications and outcomes for your patient.

04:04 Now, let's take a moment and look at this slide.

04:07 A lot of times we think feeding a patient is not a big deal, but these are common signs and things that we need to look for, that could be saying, “Hey the patient's not tolerating the swallowing or this meal very well.” Now, if any of these signs come up, we need to stop feeding the patient or letting them have anything to drink and consult the physician.

04:30 A speech therapist may need to reassess the patient, to see if they're safe for swallowing.

04:36 So, let's take a look at these, so, one of the first ones is coughing.

04:40 This may seem kind of benign to you, it may not seem a big deal, because many times patients just cough.

04:46 However, if someone ingests something and there's lots [coughing] of small coughing, that's a bad sign, they're trying to clear their throat, that means it's not going down their esophagus, it could be going down the windpipe.

05:02 Also, if a patient is drooling, what that means is, they usually don't have a lot of control or facial muscle control, because maybe of the stroke, that could be pocketing and again going down the wrong windpipe.

05:14 And just kind of we had talked about is pocketing food.

05:18 What I'm talking about is again, as a health care provider, we tend to be in a hurry, we’ll give a patient a bite, that bite may stay in their cheek and they don't actually swallow it.

05:28 Now, you can imagine if you just keep putting food in the patient's mouth and their pocketing, pocketing, pocketing, you would think you would see it, kind of like a squirrel here, but actually, the patient can aspirate and save on to this food later and it can go down their windpipe and into their lung.

05:45 Here's another one, [demonstrating excessive swallowing], if the patient is excessively swallowing a lot, that also may mean they're having trouble passing the food through their esophagus, we need to stop feeding the patient at this point too.

06:00 Again, make sure you're working with your speech therapist, if you see any of these things, make sure you stop and alert someone.

06:07 If a patient has difficulty swallowing because of pain, this is also a concern.

06:12 And of course, if someone has chest discomfort or heartburn or something else that comes up.

06:18 In any signs of abnormal issues when they're swallowing or eating their meal, again, please stop consult the physician or your speech therapist.

06:27 Thanks for watching.