Exam (elaborations)
CD 663 (HEATHER_CORNISH24) STUDY GUIDE EXAM QUESTIONS AND ANSWERS
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CD 663 (HEATHER_CORNISH24) STUDY GUIDE EXAM QUESTIONS AND ANSWERS
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CD 663 (HEATHER_CORNISH24) STUDYGUIDE EXAM QUESTIONS AND
ANSWERS
What is swallowing/deglutition - Answer-All processes, functions and acts associated
with introduction of food/material to be swallowed, including preparing, transferring, and
transporting to stomach
What is a bolus - Answer-food, liquid, or material placed in mouth for ingestion
What is dysphagia - Answer-- the result of a physiologic change in the muscles needed
for swallowing
- a swallowing disorder that may involve signs and symptoms of mouth, pharynx, larynx,
and/or oesophagus
Example of dysphagia - Answer-- delay in the propulsion of a bolus as it transits from
the mouth to the stomach
- misdirection of the bolus
What is a feeding disorder - Answer-- impairment in the process of food transport
outside the alimentary pathway (difficulty manipulating food prior to swallow)
- disordered placement of food in mouth
Feeding disorder in adults/children - Answer-weakness or incoordination in hands/arms
Feeding disorder in infants/children - Answer-failing to develop or demonstrate
developmentally appropriate eating/drinking behaviors
How many SLPs report regularly service to dysphagic patients (ASHA technical report) -
Answer-47%
How many SLPs working in hospitals and residential health care settings report
regularly service to dysphagic patients - Answer-91%
Is dysphagia a disease - Answer-no, it is a disorder caused by disease or medical
diagnosis
What adult populations are affected by dysphagia - Answer-- stroke
- head injury,
- progressive neurological diseases (ALS, Parkinsons)
- Alzheimers
- head and neck cancers
- tracheostomy
,- vocal fold dysfunction (paralysis/paresis)
How is age related to dysphagia - Answer-individuals 85 and older were 18 times more
likely to have a diagnosis of dysphagia compared to those under age 25
What CHILD populations are affected by dysphagia - Answer-- prematurity/low birth
weight
- cerebral palsy
- craniofacial anomolies
- failure to thrive/pediatric undernutrition
- developmental disability
How many children with CP have swallowing disorder at some point - Answer-85-90%
Why do we care about dysphagia - Answer-- health risk (aspiration, malnutrition,
dehydration)
- quality of life (normal adults = 580 swallows per day, social)
Dysphagia: priorities and concerns of SLPs - Answer-- adequate nutrition and hydration
- safety of patient during oral feeding (adults)
- enteral or tube feeding
Is oral feeding an appropriate goal of all clients - Answer-no
Who should be NPO - Answer-patients aspirating 10% or more of bolus despite all
possible adjustments
SLP role in swallowing and feeding disorders - Answer-- clinical swallowing and feeding
assessment (oral mech exam, bedside exam of swallow/feeding)
- perform instrumental assessments as appropriate (video fluoroscopy/MBS/VFS/VFSS
and endoscopy/FEES)
- identify normal and abnormal swallowing anatomy and physiology
- identify signs of possible/potential disorders in oral and pharyngeal stages of
swallowing
- make decisions about management
- develop treatment plan
- provide treatment, document progress, and determine appropriate dismissal criteria
- teach/counsel patients and family
- educate other professionals
- serve as part of a team
- advocate for services for individuals
- advance the knowledge based through research activities (EBP)
Who is a part of the dysphagia team - Answer-- SLP
- parents/caregivers/family
,- physicians/medical specialists (neurologist, pulmonologist, ENT, radiologist,
pediatrician, gastroenterologist, maxillofacial prosthodontist)
- nursing
- OT/PT or respiratory therapist
- nutritionist/dentition
- social work and psychology
Level of care may differ depending on - Answer-the setting where the patient is seen
(the role of each professional may be different)
The access to some medical specialties may not be available across - Answer-different
settings
Name the medical care settings - Answer-- acute
- subacute (short-term care and long term care)
- home health
Acute care setting often refers to - Answer-the hospital
What is the prevalence of swallowing-related disorders in the acute care setting -
Answer-13% (often in neurology and neurosurgery unites)
Due to short stay (2-4 days), swallowing issue must be addressed - Answer-rapidly
Frequently there is not sufficient time or pt cooperation because - Answer-of
mental/physical status
If pt is able to tolerate testing, future care may be facilitated with the results of - Answer-
swallowing testing using from instrumental assessments
In the subacute setting patients may require - Answer-additional medical monitoring
Patients ma stay in the subacute unit for - Answer-5 to 28 days
Subacute Setting: If patients are not ready for strenuous rehabilitation program -
Answer-- do 1-2 hours of therapy per day
- action plan from hospital is implemented
Subacute Setting: When pts have the physical stamina for a full day of tasks oriented
toward restoring lost function: - Answer-- they receive PT, OT, SLP as needed and are
medically managed by specially trained physicians
- min 3 hours per day/discipline, up to 6 days a week
After admission to subacute care setting, patients may be discharged to - Answer--
home
- an outpatient rehab facility
, - or a skilled nursing facility
Is outpatient rehab setting a common setting for dysphagia therapy - Answer-no
In outpatient rehab setting patient may be living at home and - Answer-visit the clinic for
therapy
Outpatient rehab team develops individual plans to - Answer-- maximize safety
- improve communication skills
- assist with self-care independence
How often do pts in outpatient rehab setting receive therapy - Answer-2-3 days a week
are there nursing services in outpatient rehab setting - Answer-no
- and own transportation is required
Long term care often refers to - Answer-a skilled nursing facility
What patients go to long-term care? - Answer-- pts who have not responded to attempts
are rehab
- pts who are not candidates for rehab
- pts who are too ill to be home
- pts who have chronic medical conditions that require monitoring in structured
environment
The prevalence of swallowing disorders in long term care setting has been reported to
be - Answer-as high as 60% or higher
Some facilities provide - Answer-- subacute care, inpatient rehab and long-term care
Evaluation in Long term care setting may rely on a combination of - Answer-- medical
history
- detailed observations of each meal
SLPs in long term care setting work closely with - Answer-- the physician
- nursing
- dietician
- other rehab disciplines
In long term care setting initiating an advance directive is usually required to - Answer-
state the ways to sustain nutrition
T/F: some pts may elect to not be red by a feeding tube despite the risk of aspiration
and life threatening pneumonia - Answer-T
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