00039 Risk for aspiration

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00039 Risk for aspiration

Definition of the NANDA label

Situation in which the individual runs the risk of oropharyngeal or gastrointestinal secretions, solid or liquid foods, entering the tracheobronchial tract, due to a dysfunction or an absence of normal protection mechanisms.

Susceptible to entry of gastrointestinal secretions, oropharyngeal secretions, solids, or fluids to the tracheobronchial passages, which may compromise health.

Risk factors

• Decreased level of consciousness.
• Swallowing disorders.
• Depression of the cough center.
• Depression of the vomiting center.
• Incompetence of the esophageal sphincter.
• Tracheostomy or endotracheal intubation.
• Inadequate inflation of the safety balloon of the tracheostomy tube or endotracheal tube.
• Use of gastrointestinal tubes.
• Feeding or administration of medications by nasogastric tube.
• Situations that affect mobility and prevent the incorporation of the upper body.
• Increased endogastric pressure.
• Increase in residual gastric volume.
• Decrease in gastrointestinal peristalsis.
• Surgery or trauma to the face, mouth or neck.
• Mandibular fixation.

Associated condition

• Decrease in level of consciousness
• Delayed gastric emptying
• Depressed gag reflex
• Enteral feedings
• Facial surgery
• Facial trauma
• Impaired ability to swallow
• Incompetent lower esophageal sphincter
• Increase in gastric residual
• Increase in intragastric pressure
• Neck surgery
• Neck trauma
• Oral surgery
• Oral trauma
• Presence of oral/nasal tube
• Treatment regimen
• Wired jaw

NOC

• Prevention of aspiration.
• Suction control.
• State of swallowing.
• Ventilation.

NIC

• Precautions to avoid aspiration.
• Management of vomiting.
• Swallowing therapy.
• Individual teaching.
• Aspiration of the airways.
• Surveillance.
• Change of position.
• Airway management.
• Nutritional management.
• Teaching therapeutic regimen.

This diagnosis will retire from the NANDA-I Taxonomy in the 2021-2023 edition unless additional work is completed to bring it up to a level of evidence 2.1 or higher.

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