1、1.Reasons 1.Reasons of drinking of drinking water testwater test2.Advantag2.Advantagesesof drinking of drinking water testwater test3.Methods3.Methodsof drinking of drinking water testwater test4.The 4.The relevant relevant patientspatientsdiet guidancediet guidanceMain content（主要内容）1.early interven
2、tion1.early intervention2.prevent2.preventlung lung infectioninfection（肺炎）（肺炎）MalnutritionMalnutrition（营养不良（营养不良）DehydrationDehydration（脱水）（脱水）AsphyxiaAsphyxia（窒息）（窒息）2Ensure different degrees of swallowing Ensure different degrees of swallowing dysfunction clearlydysfunction clearlyGive correspondi
3、ng nursing interventionGive corresponding nursing interventionAvoid unnecessary indwelling gastric tubeAvoid unnecessary indwelling gastric tubeNasogastric tube can reduce the incidenceNasogastric tube can reduce the incidence（发生率）（发生率）of pulmonary infection effectively in the earlyof pulmonary infe
4、ction effectively in the earlyclassifyclassifysimple simple operation operation 3have treatment have treatment indicationsindicationsclear consciousness clear consciousness able to complete the test able to complete the test Obey instructions Obey instructions in in accordanceaccordance4sit up sit u
5、p 30 ml warm 30 ml warm waterwaterobserveobservethe time the time of swallow of swallow choking choking coughcoughLevel 1Level 1optimaloptimalcan a time to swallow the water smoothlycan a time to swallow the water smoothlyLevel 2Level 2finefinedivide more than 2 times to swallow,but divide more than
6、 2 times to swallow,but without choking cough swallowwithout choking cough swallowLevel 3Level 3mediummediumone swallow,but there are a choke and one swallow,but there are a choke and coughcoughLevel 4Level 4cancanLevel 5Level 5poorpoorin 2 times or more times to swallow,but in 2 times or more times
7、 to swallow,but there are choke and coughthere are choke and coughchoking and cough frequently,and cant swallowchoking and cough frequently,and cant swallow51.Do not need to tell 1.Do not need to tell avoid tensionavoid tension3.After test 3.After test must be accuracymust be accuracy2.Quantity of w
8、ater2.Quantity of waterdiet guidance diet guidance NormalNormalLevel 1,and swallowing in 5 secondsLevel 1,and swallowing in 5 secondsSuspiciousSuspiciousA drink,but drink more than 5 seconds or A drink,but drink more than 5 seconds or twice till level 2.twice till level 2.AbnormalAbnormal3 5 level,a
9、nd divide in light,medium 3 5 level,and divide in light,medium and severe choking coughand severe choking coughassessment resultassessment result(评定的结果评定的结果):):Level 3Level 3Level 5Level 5Level 4Level 4give guidance to swallowing give guidance to swallowing trainingtraininggive swallowing training a
10、nd guide give swallowing training and guide patients to swallowing training on patients to swallowing training on their owntheir ownindwelling gastric tubeindwelling gastric tube8 form and choice form and choiceDilute Dilute LiquidLiquid（稀流质）（稀流质）water,milk,fruit juice,coffeewater,milk,fruit juice,c
11、offeeThick liquidThick liquid（浓流质）（浓流质）cereal beveragecereal beverage（谷物饮料）（谷物饮料）,joined with thickening,joined with thickening agentagent（增粘剂）（增粘剂）of water,soup,eggs,etc of water,soup,eggs,etcSemi-solidSemi-solid（半固体）（半固体）Paste foodPaste food（糊状食物）（糊状食物）SolidSolid（固体）（固体）rice pasterice paste（米糊）（米糊
12、）,vegetables paste,vegetables paste（菜糊）（菜糊）,meat paste,steamed eggmeat paste,steamed egg（蒸水蛋），（蒸水蛋），water lotus root starchwater lotus root starch（水藕粉）（水藕粉）,soft rotten ricesoft rotten rice（烂饭）（烂饭）,bread,rice,bread,rice,chaozhou porridgechaozhou porridge biscuitbiscuit，nuts,etc nuts,etcDry or easily
13、 loose of foodDry or easily loose of foodMore chewing foodMore chewing foodHigh viscousHigh viscous（粘性的）（粘性的）foodsfoodsHot diluteHot dilute（稀的）（稀的）liquid foods liquid foodsthe food have bone or sting(the food have bone or sting(刺刺)such as rice in soupsuch as rice in soup（汤泡饭）（汤泡饭）,lean meatlean meat
14、（稀肉）（稀肉）,porridge,porridgeHybridHybrid（混合的）（混合的）texture of foodtexture of foodcookies,cakes,Fried ricecookies,cakes,Fried ricelarge pieces of meat,peanutslarge pieces of meat,peanutsrice cake,glutinous ricerice cake,glutinous rice（糯米）（糯米）1.Paste1.Paste（糊状）（糊状）foodfoodthick thick liquidliquid（浓流质）（浓流
15、质）2.Paste 2.Paste（糊状）（糊状）foodfoodsemi-solidsemi-solid（半固体）（半固体）dilute liquid paste dilute liquid paste foodfood（稀流质（稀流质 ）solidsolid（固体）（固体）Feeding Feeding tools tools SpoonSpoon（调羹）（调羹）cupcupStrawsStraws（吸管）（吸管）Semi recumbent positionSemi recumbent position（半卧位）（半卧位）and and head forward slightly(hea
16、d forward slightly(头稍前倾头稍前倾)generalgeneralStay in Stay in bedbedLateral position Lateral position 侧卧位侧卧位Sit up straight and head forward bends Sit up straight and head forward bends slightly,and body can tend to the slightly,and body can tend to the contralateral(contralateral(健侧健侧)30 degrees()30 de
17、grees(头稍前倾头稍前倾)坐直头稍前屈位，身体可倾向健侧坐直头稍前屈位，身体可倾向健侧3030度度 get get out of out of bedbedLethargyLethargy（昏睡），（昏睡），sleepiness sleepiness，and and swallowing ability under swallowing ability under moderatemoderateEasy to swallow liquidEasy to swallow liquid，such as,fresh such as,fresh milk,vegetable juice,juic
18、emilk,vegetable juice,juiceThe improvement of The improvement of swallowing function and swallowing function and physical recoveryphysical recoveryEating training,Homogeneous glue(Eating training,Homogeneous glue(均均质胶冻状质胶冻状)or paste food,such as)or paste food,such as CustardCustard（蛋羹）（蛋羹）,batter(,b
19、atter(面糊面糊)Translate to a nearly normal diet Translate to a nearly normal diet and water gradually and water gradually 3-3-4ml4ml1 1spoonspoonSwallowing Swallowing several timesseveral timesrepeatedly repeatedly ororDrink the right Drink the right amount(amount(适量的适量的)of waterof waterGood for breakf
20、ast,lunch eat satisfied,Good for breakfast,lunch eat satisfied,dinner to eat lessdinner to eat lessprinciplesprinciplesLethargyLethargy（昏睡），（昏睡），sleepiness sleepiness Eating while encouraging,offer certain Eating while encouraging,offer certain stimulation to wake upstimulation to wake up mental men
21、tal symptomssymptomsDont open Dont open mouthmouthBe patient to enlightenBe patient to enlighten（开导）（开导）and and inspire,and try to assist intake all the inspire,and try to assist intake all the bookings.bookings.Add a spoonful(Add a spoonful(匙匙)of water in the)of water in the teeth in order to stimu
22、late to open the teeth in order to stimulate to open the mouthmouthEating while encouraging,Eating while encouraging,offer certain stimulation to offer certain stimulation to wake upwake up use nasal feeding if can not use nasal feeding if can not maintain by mouth intake maintain by mouth intake en
23、ough water and heatenough water and heatPharyngeal(Pharyngeal(咽部咽部)movement disordersmovement disordersOral nursingOral nursingshould maintain a seat after a should maintain a seat after a meal more than half an hourmeal more than half an hourcauses,dangerous,training and causes,dangerous,training a
24、nd countermeasures(countermeasures(对策对策)detailed detailed descriptiondescriptionobserve and observe and record closelyrecord closelyPrevent abnormal deglutition(Prevent abnormal deglutition(误咽误咽)and)and aspiration pneumoniaaspiration pneumonia（吸入性肺炎）（吸入性肺炎）Pay Pay attention toattention toSurgical Su
25、rgical treatment.treatment.Dehydration(Dehydration(脱水脱水)and other nutrition)and other nutrition state,and supply timely.state,and supply timely.Aspiration pneumonia(Aspiration pneumonia(吸入性肺炎吸入性肺炎)happen)happen frequently,and swallowing function not frequently,and swallowing function not improveimprove
