医学课件洼田饮水试验及相关饮食指导

1、1.Reasons of drinking water test2.Advantagesof drinking water test3.Methodsof drinking water test4. The relevant patientsdiet guidanceMain content（主要内容）1.Reasons of drinking water teReason1.early intervention2.preventlung infection（肺炎）Malnutrition（营养不良）Dehydration（脱水）Asphyxia（窒息）2Reason1.early inter

2、vention2.prAdvantagesEnsure different degrees of swallowing dysfunction clearlyGive corresponding nursing interventionAvoid unnecessary indwelling gastric tubeNasogastric tube can reduce the incidence（发生率） of pulmonary infection effectively in the earlyclassifysimple operation 3AdvantagesEnsure diff

3、erent degrequirementshave treatment indicationsclear consciousness able to complete the test Obey instructions in accordance4requirementshave treatment indMethodssit up 30 ml warm waterobservethe time of swallow choking coughLevel 1optimalcan a time to swallow the water smoothlyLevel 2finedivide mor

4、e than 2 times to swallow, but without choking cough swallowLevel 3mediumone swallow, but there are a choke and coughLevel 4canLevel 5poorin 2 times or more times to swallow, but there are choke and coughchoking and cough frequently , and cant swallow5Methodssit up 30 ml warm waterPay attention :1.D

5、o not need to tell avoid tension3.After test must be accuracy2.Quantity of waterdiet guidance Pay attention :1.Do not need MethodsNormalLevel 1,and swallowing in 5 secondsSuspiciousA drink, but drink more than 5 seconds or twice till level 2.Abnormal3 5 level, and divide in light, medium and severe

6、choking coughMethodsNormalLevel 1,and swallTreatment and nursing intervention(治疗及护理干预)assessment result(评定的结果):Level 3Level 5Level 4give guidance to swallowing traininggive swallowing training and guide patients to swallowing training on their ownindwelling gastric tube8Treatment and nursing interve

7、nDiet Guidance form and choiceDilute Liquid（稀流质）water, milk, fruit juice, coffeeThick liquid（浓流质） cereal beverage（谷物饮料）, joined with thickening agent（增粘剂） of water, soup, eggs, etcSemi-solid（半固体）Paste food（糊状食物）Solid（固体） rice paste（米糊）, vegetables paste（菜糊）, meat paste, steamed egg（蒸水蛋），water lotus

8、root starch（水藕粉）, soft rotten rice（烂饭）, bread, rice, chaozhou porridge biscuit， nuts, etcDiet Guidance form and choiceDAvoid to chooseDry or easily loose of foodMore chewing foodHigh viscous（粘性的） foodsHot dilute（稀的） liquid foodsthe food have bone or sting(刺)such as rice in soup（汤泡饭）, lean meat（稀肉）,

9、porridgeHybrid（混合的） texture of foodcookies, cakes, Fried ricelarge pieces of meat, peanutsrice cake, glutinous rice（糯米）Avoid to chooseDry or easily Feeding order 1.Paste（糊状） foodthick liquid（浓流质）2.Paste （糊状）foodsemi-solid（半固体）dilute liquid paste food（稀流质 ）solid（固体）Feeding tools Spoon（调羹）cupStraws（吸管

10、）Feeding order 1.Paste（糊状） foodEating guidance-positionSemi recumbent position（半卧位）and head forward slightly(头稍前倾)generalStay in bedLateral position 侧卧位Sit up straight and head forward bends slightly , and body can tend to the contralateral(健侧) 30 degrees(头稍前倾)坐直头稍前屈位，身体可倾向健侧30度 get out of bedEating

11、 guidance-positionSemi r食物的形态Lethargy（昏睡）， sleepiness ，and swallowing ability under moderateEasy to swallow liquid，such as, fresh milk, vegetable juice, juiceThe improvement of swallowing function and physical recoveryEating training, Homogeneous glue(均质胶冻状) or paste food , such as Custard（蛋羹）, batt

12、er(面糊)Translate to a nearly normal diet and water gradually 食物的形态Lethargy（昏睡）， sleepiness Oral food intake（摄食入口量）3-4ml1spoonSwallowing several timesrepeatedly orDrink the right amount(适量的) of waterOral food intake（摄食入口量）3-4ml1S进食物的分配和方法Good for breakfast, lunch eat satisfied, dinner to eat lessprinc

13、iplesLethargy（昏睡）， sleepiness Eating while encouraging, offer certain stimulation to wake up mental symptomsDont open mouthBe patient to enlighten（开导） and inspire, and try to assist intake all the bookings.Add a spoonful(匙) of water in the teeth in order to stimulate to open the mouth进食物的分配和方法Good f

14、or breakfast, lTongue muscle movement paralysis(偏瘫) caused by mixing failureEating while encouraging, offer certain stimulation to wake up use nasal feeding if can not maintain by mouth intake enough water and heatPharyngeal(咽部) movement disordersOral nursingshould maintain a seat after a meal more than half an hourTongue muscle movement paralysMatters needing attention(吞咽训练的注意事项)causes, dangerous, training and countermeasures(对策)detailed descriptionobserve and record closelyPrevent abnormal deglutition(误咽) and aspiration pneumonia（吸入性肺炎）Pay attention toSurgical trea