NON-INSTRUMENTAL ASSESSMENT OF
SWALLOWING EXAM WITH 100%
CORRECT ANSWERS { GRADED A+}
Prefeeding assessment - ✔✔Reviewing medical/social history (Hx)
Current nutritional status --> how do they eat?
Assessing WITHOUT any food trials to decide on the next step
Deciding on the next step during prefeeding assessment - ✔✔a) to stop
and do not do any food trials as pt is not a candidate for eating by mouth at
the present time (sleeping, not alert, etc.)
b) to proceed with the assessment and do a quick screening of swallowing
c) to proceed with the assessment and do Clinical (bedside) Assessment
(evaluation) of Swallowing
d) Check Advance Directives re tube feeding (absent/present, if present
what are the pt's requests? you have to consider them in your
recommendations)
Clinical Assessment - ✔✔Bedside evaluation
,Medical Hx and nutritional status - ✔✔Look for significant info related to
medical history, current medical status and swallowing, pt's complaints,
staff/family observations/reports (to answer the questions: why an SLP
consult was requested?)
-Risks for aspiration = safety
-Risks or insufficient oral intake (nutrition and hydration) with the current
diet
What to look for in medical history - ✔✔anything that relates/contributes to
swallowing
-multiple strokes or multiple admissions for swallowing issues
-head and neck cancers
-other surgeries
-bladder cancer and respiratory distress
Be careful for misdiagnoses - ✔✔aphasia versus sensori-motor issues
aspiration pneumonia - ✔✔usually occurs on the RIGHT side
-more vertical route on right side for food to escape
What is patient's current feeding status? - ✔✔check diet order
-PO = per orem (by mouth) --> what diet/food consistencies?
, -NPO = nothing per orem (nothing by mouth) --> short term or long term
(how is the pt receiving nutrition/hydration)?
PO: food consistencies - ✔✔-liquids
-puree
-solids
*You must consider nutrition (calorie intake) and hydration (liquid intake)
*Diet considerations
Diet considerations - ✔✔diabetic, TMJ pain, culture, etc.
-consider the REASONS for thickened liquids/pureed diets/mechanical soft
Dehydration - ✔✔can be a main cause of dysphagia
-lot of people end up in hospital for this
Liquids - ✔✔thin (water)
thick (nectar-thick, honey-thick, puree-thick)
-have no shape: move fast and flow into area because gravity
Thickener - ✔✔slows down movement of liquids
Puree - ✔✔baby food consistency/blended
Solids - ✔✔-regular
-mechanical-soft (chopped)
-soft (over cooked/mushy)
SWALLOWING EXAM WITH 100%
CORRECT ANSWERS { GRADED A+}
Prefeeding assessment - ✔✔Reviewing medical/social history (Hx)
Current nutritional status --> how do they eat?
Assessing WITHOUT any food trials to decide on the next step
Deciding on the next step during prefeeding assessment - ✔✔a) to stop
and do not do any food trials as pt is not a candidate for eating by mouth at
the present time (sleeping, not alert, etc.)
b) to proceed with the assessment and do a quick screening of swallowing
c) to proceed with the assessment and do Clinical (bedside) Assessment
(evaluation) of Swallowing
d) Check Advance Directives re tube feeding (absent/present, if present
what are the pt's requests? you have to consider them in your
recommendations)
Clinical Assessment - ✔✔Bedside evaluation
,Medical Hx and nutritional status - ✔✔Look for significant info related to
medical history, current medical status and swallowing, pt's complaints,
staff/family observations/reports (to answer the questions: why an SLP
consult was requested?)
-Risks for aspiration = safety
-Risks or insufficient oral intake (nutrition and hydration) with the current
diet
What to look for in medical history - ✔✔anything that relates/contributes to
swallowing
-multiple strokes or multiple admissions for swallowing issues
-head and neck cancers
-other surgeries
-bladder cancer and respiratory distress
Be careful for misdiagnoses - ✔✔aphasia versus sensori-motor issues
aspiration pneumonia - ✔✔usually occurs on the RIGHT side
-more vertical route on right side for food to escape
What is patient's current feeding status? - ✔✔check diet order
-PO = per orem (by mouth) --> what diet/food consistencies?
, -NPO = nothing per orem (nothing by mouth) --> short term or long term
(how is the pt receiving nutrition/hydration)?
PO: food consistencies - ✔✔-liquids
-puree
-solids
*You must consider nutrition (calorie intake) and hydration (liquid intake)
*Diet considerations
Diet considerations - ✔✔diabetic, TMJ pain, culture, etc.
-consider the REASONS for thickened liquids/pureed diets/mechanical soft
Dehydration - ✔✔can be a main cause of dysphagia
-lot of people end up in hospital for this
Liquids - ✔✔thin (water)
thick (nectar-thick, honey-thick, puree-thick)
-have no shape: move fast and flow into area because gravity
Thickener - ✔✔slows down movement of liquids
Puree - ✔✔baby food consistency/blended
Solids - ✔✔-regular
-mechanical-soft (chopped)
-soft (over cooked/mushy)
