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CARE PLAN

Nursing Diagnosis

Risk for aspiration related to impaired swallowing ability as manifested by client is coughing and gagging during
feeding

Provide supportive rationale for having selected the priority nursing diagnosis
Impaired gag reflex causes client risk for aspiration and further can lead to foreign object ease access to the lungs

Expected Outcomes Target Intervention Rationale For Evaluation


(Goal Setting) Dates Interventions
The client is expected to After an Position patient at 90- This position helps The client is able to
swallow each meal with no hour degree angle, whether to move the food swallow without
difficulty in passing food from in bed or in a chair or according to the coughing and
mount to stomach wheelchair. Use gravity therefore gagging.
cushions or pillows to this will help to
maintain position prevent aspiration

Offer foods with Solid foods are


consistency that patient prone for blockage
can swallow. Use in the
thickening agents as tracheoesophageal
appropriate. Cut foods area and eventually,
into small pieces. can impede
Semisolid foods like respiration
pudding and hot cereal
are most easily
swallowed.
This removes
Provide oral care after residuals and
meals reduces pocketing of
food that can be
later aspirated
Nursing Diagnosis

Impaired physical mobility related to anxiety from the pain experienced upon physical exertion as manifested by
client verbalizing it to the nurse

Provide supportive rationale for having selected the priority nursing diagnosis
client is risk for muscular atrophy and other related diseases caused by immobility

Expected Outcomes Target Intervention Rationale For Evaluation


(Goal Setting) Dates Interventions
The client is expected to 2 hours Encourage patient to This prevents Client is moving
perform movements perform active range of extremities from from bed to a chair
independently with minimal motion exercises contractures and and bathroom with
assistance further lead to guidance and
permanent supervision. Client
immobility and other is effectively
diseases caused by performing active
Encourage patient to immobility range of motion
move from bed to chair and other exercises
every once in a while This will help to with no assistance
strengthen
abdominal and leg
muscles to prevent
muscle atrophy.
Contraction of
muscle helps venous
return thus prevent
them pooling in
extremities which
can further lead to
clotting cause by
stasis