A nurse is caring for a client who is suffering from dysphagia after a stroke and is currently NPO. Which member of the inter-professional team would the nurse anticipate will be consulted to determine how this client will be safely fed?

A) Speech Therapist: A speech therapist is the appropriate professional for assessing and managing dysphagia, especially in clients who have experienced a stroke. They specialize in evaluating swallowing function, determining the safest consistencies of food and liquids, and providing strategies or exercises to improve swallowing ability. They play a critical role in deciding the safest method of feeding, whether it involves modified diets or alternative feeding methods.

B) Respiratory Therapist: Respiratory therapists focus on assessing and managing respiratory conditions. While they may become involved if there are concerns about aspiration leading to respiratory complications, they do not directly manage dysphagia or feeding issues.

C) Physical Therapist: Physical therapists work primarily on improving gross motor skills, mobility, and physical function. They do not specialize in swallowing disorders or feeding methods, so they are not the primary professionals to consult for issues related to dysphagia.

D) Occupational Therapist: Occupational therapists can assist clients with fine motor skills and daily living activities, which may include feeding. However, they do not specialize in assessing or treating swallowing disorders. Their role would be more focused on helping clients with the practical aspects of self-feeding once safe swallowing methods are established by a speech therapist.

A) Dysphagia: While dysphagia (difficulty swallowing) can occur in individuals with long-term alcohol use, especially if there is coexisting neurological damage or esophageal disorders, it is not specifically associated with vomiting and diarrhea in the context of this scenario. The primary concern here involves electrolyte imbalances.

B) Hypoactive deep tendon reflexes (DTR): Hypoactive DTRs are typically associated with hypermagnesemia rather than hypomagnesemia. In this case, the client's condition is more likely to lead to electrolyte deficiencies, including hypomagnesemia, due to vomiting, diarrhea, and poor nutritional intake.

C) Hypomagnesemia: Chronic alcohol use often results in nutritional deficiencies, and vomiting and diarrhea can further exacerbate this by depleting electrolytes. Hypomagnesemia is a common finding in long-term alcoholics due to poor dietary intake, gastrointestinal losses, and renal losses. This can lead to symptoms such as muscle weakness, tremors, and altered mental status. Hypomagnesemia is particularly concerning because it can affect cardiovascular stability and neuromuscular function.

D) Positive Chvostek sign: A positive Chvostek sign is indicative of hypocalcemia, which can occur secondary to hypomagnesemia. However, it is not as directly associated with chronic alcoholism as hypomagnesemia itself. The positive Chvostek sign involves a facial muscle spasm in response to tapping the facial nerve and indicates neuromuscular irritability due to low calcium levels. While related, the primary electrolyte imbalance expected here is hypomagnesemia.