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单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,*,*,Drinking water test&,The relevant guidance of diet,Guangzhou Medical University,主讲人,:,石彩兰,指导老师,:,朱美玲,2017.03.24,洼田饮水试验及相关饮食指导,1.Reasons of drinking water test,2.Advantages,of drinking water test,3.Methods,of drinking water test,4.The relevant patients,diet guidance,Main content,（主要内容）,Reason,3,1.early intervention,2.prevent,lung infection,（肺炎）,Malnutrition,（营养不良,）,Dehydration,（脱水）,Asphyxia,（窒息）,Advantages,4,Ensure different degrees of swallowing dysfunction clearly,Give corresponding nursing intervention,Avoid unnecessary indwelling gastric tube,Nasogastric tube can reduce the incidence,（发生率）,of pulmonary infection effectively in the early,classify,simple operation,requirements,5,have treatment indications,clear consciousness,able to complete the test,Obey instructions,in accordance,Methods,6,sit up,30 ml warm water,observe,the time of swallow,choking cough,Level 1,optimal,can a time to swallow the water smoothly,Level 2,fine,divide more than 2 times to swallow,but without choking cough swallow,Level 3,medium,one swallow,but there are a choke and cough,Level 4,can,Level 5,poor,in 2 times or more times to swallow,but there are choke and cough,choking and cough frequently,and cant swallow,Pay attention:,1.Do not need to tell,avoid tension,3.After test,must be accuracy,2.Quantity of water,diet guidance,Methods,Normal,Level 1,and swallowing in 5 seconds,Suspicious,A drink,but drink more than 5 seconds or twice till level 2.,Abnormal,3 5 level,and divide in light,medium and severe choking cough,Treatment,and nursing,intervention(,治,疗及护理干,预,),9,assessment result,(,评定的结果,):,Level 3,Level 5,Level 4,give guidance to swallowing training,give swallowing training and guide patients to swallowing training on their own,indwelling gastric tube,Diet,Guidance,form and choice,Dilute,Liquid,（稀流质）,water,milk,fruit juice,coffee,Thick liquid,（浓流质）,cereal beverage,（谷物饮料）,joined with thickening agent,（增粘剂）,of water,soup,eggs,etc,Semi-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 root starch,（水藕粉）,soft rotten rice,（烂饭）,bread,rice,chaozhou porridge,biscuit,，,nuts,etc,Avoid to choose,Dry or easily loose of food,More chewing food,High viscous,（粘性的）,foods,Hot dilute,（稀的）,liquid foods,the food have bone or sting(,刺,),such as rice in soup,（汤泡饭）,lean meat,（稀肉）,porridge,Hybrid,（混合的）,texture of food,cookies,cakes,Fried rice,large pieces of meat,peanuts,rice cake,glutinous rice,（糯米）,Feeding order,1.Paste,（糊状）,food,thick liquid,（浓流质）,2.Paste,（糊状）,food,semi-solid,（半固体）,dilute liquid paste food,（稀流质）,solid,（固体）,Feeding tools,Spoon,（调羹）,cup,Straws,（吸管）,Eating guidance-position,Semi recumbent position,（半卧位）,and head forward slightly(,头稍前倾,),general,Stay in bed,Lateral 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 bed,食物的形态,Lethargy,（昏睡），,sleepiness,，,and swallowing ability under moderate,Easy to swallow liquid,，,such as,fresh milk,vegetable juice,juice,The improvement of swallowing function and physical recovery,Eating training,Homogeneous glue(,均质胶冻状,)or paste food,such as Custard,（蛋羹）,batter(,面糊,),Translate to a nearly normal diet and water gradually,Oral food intake,（摄食入口量）,3-4ml,1,spoon,Swallowing several times,repeatedly,or,Drink the right amount(,适量的,)of water,进食物的分配和方法,Good for breakfast,lunch eat satisfied,dinner to eat less,principles,Lethargy,（昏睡），,sleepiness,Eating while encouraging,offer certain stimulation to wake up,mental symptoms,Dont open mouth,Be 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,Tongue muscle movement,paralysis(,偏瘫,),caused by mixing failure,Eating while encouraging,offer certain stimulation to wake up,use nasal feeding if can not maintain by mouth intake enough water and heat,Pharyngeal(,咽部,)movement disorders,Oral nursing,should maintain a seat after a meal more than half an hour,Matters needing,attention,(,吞,咽训练的注意事,项,),causes,dangerous,training and countermeasures(,对策,),detailed description,observe and record closely,Prevent abnormal deglutition(,误咽,)and aspiration pneumonia,（吸入性肺炎）,Pay attention to,Surgical treatment.,Dehydration(,脱水,)and other nutrition state,and supply timely.,Aspiration pneumonia(,吸入性肺炎,)happen frequently,and swallowing function not improve,Thank you for you,listening!,
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