A nurse is contributing to the plan of care of a client who has had a stroke and is experiencing severe dysphagia with choking and coughing while eating.
Which of the following nutritional therapies should the nurse expect to include in the plan of care?

 

Choice A rationale

NPO (nothing by mouth) might be a temporary measure immediately following a stroke if aspiration risk is very high. However, prolonged NPO can lead to malnutrition and dehydration, hindering recovery. Nutritional support is crucial for stroke patients, so alternative feeding methods should be explored.

Choice B rationale

Total parenteral nutrition (TPN) is a method of providing nutrients intravenously, bypassing the gastrointestinal tract. It is usually reserved for patients with severe gastrointestinal dysfunction or when enteral feeding is not feasible or tolerated. While it provides nutrition, it carries risks of infection and metabolic complications and is not the first-line treatment for dysphagia.

Choice C rationale

A mechanical soft diet consists of foods that are easy to chew and swallow, reducing the risk of choking and aspiration in patients with mild to moderate dysphagia. This diet provides necessary nutrients while minimizing the effort required for safe oral intake, promoting better nutrition and hydration compared to NPO.

Choice D rationale

Supplements via NG tube provide enteral nutrition directly into the stomach or small intestine, bypassing the oral cavity and pharynx. This is an appropriate nutritional therapy for patients with severe dysphagia who cannot safely swallow even modified textures, ensuring adequate caloric and nutrient intake to support recovery and prevent malnutrition.