A nurse is planning care for a client who has dysphagia.
The nurse should plan to assist with the request of a referral to which of the following members of the health care team?

Choice A rationale

Vanilla pudding is often restricted in dysphagia diets due to its smooth, slippery texture, which can be difficult to control in the oral cavity and increases the risk of aspiration into the airway. Individuals with dysphagia may have impaired swallowing mechanisms, making thin, liquid-like consistencies particularly hazardous.

Choice B rationale

Cranberry juice is a thin liquid and poses a significant aspiration risk for a patient with dysphagia. Thin liquids are difficult to manage in the mouth and throat, increasing the likelihood of the liquid entering the trachea instead of the esophagus. Patients with swallowing difficulties often require thickened liquids to improve bolus control.

Choice C rationale

Beef broth is a clear liquid and, similar to cranberry juice, presents a high risk of aspiration for a patient with dysphagia. Its thin consistency makes it challenging for individuals with impaired swallowing to control its movement, potentially leading to it entering the airway and causing respiratory complications.

Choice D rationale

Orange gelatin, while seemingly semi-solid, often melts into a thin liquid in the mouth due to body temperature. This change in consistency makes it difficult to control and increases the risk of aspiration in patients with dysphagia. Gelatin's slippery texture further compounds this risk.

Choice A rationale

Sublingual medications are designed to be absorbed directly into the bloodstream through the highly vascular mucous membranes under the tongue. Dissolving it in water and administering it through an NG tube would bypass this route, potentially altering the drug's absorption and effectiveness, as it would then be processed through the gastrointestinal system.

Choice B rationale

Administering the medication under the client's tongue ensures that it is absorbed sublingually, bypassing the gastrointestinal tract. This is the intended route for this medication, allowing for rapid absorption and avoiding potential interactions or degradation in the digestive system. The rich blood supply under the tongue facilitates quick entry into systemic circulation.

Choice C rationale

Requesting an oral formulation might be an option if the sublingual route is absolutely contraindicated, but it doesn't address the immediate situation. Oral medications have different absorption rates and may be unsuitable for a client with an NG tube if they have swallowing difficulties or other gastrointestinal issues.

Choice D rationale

Crushing a sublingual medication and administering it through an NG tube is inappropriate. This alters the intended drug delivery mechanism and could lead to unpredictable absorption, potential blockage of the NG tube, and loss of the medication's intended effect. Sublingual formulations are not designed for enteral administration.