S8 · Likely to inhale food or fluid
Risk Safety and protection
Definition
Weak swallowing or reduced alertness raise the chance of food or fluid entering the lungs.- Stroke
- low consciousness
- weak cough
- tube feeding
- dementia
- Coughing at meals
- wet voice
- chest infection
- fever
📋 Scenario
An older woman with dementia eats very quickly and has a weak cough.
Subjective (S): Daughter: "She eats very fast and does not chew well."
Objective (O): Dementia; weak cough; eats quickly, half propped in bed; swallow screen shows delayed swallow; temperature 36.9 C; chest clear.
Assessment tools for this scenario: CP-SAFE Safety & Falls Score
Validated scales to consider: Morse Fall Scale
**CarePath diagnosis:** Likely to inhale food or fluid related to dementia and weak cough (risk factors); no signs of the problem are present yet.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Sit fully upright to eat. | Sitting fully upright lets food travel down by gravity and keeps the airway protected, lowering the chance of inhaling food. |
| Supervise meals. | Watching meals allows the nurse to slow the pace, give prompts and respond at once to coughing or choking. |
| Follow swallow advice. | Swallow advice from specialists, such as food texture and pace, matches the safest way to eat for her delayed swallow. |
| Give mouth care. | Mouth care lowers the germs in the mouth, so if a little saliva or food is inhaled it is less likely to cause a lung infection. |
| Check chest and temperature. | Checking the chest and temperature can reveal early signs of aspiration, such as crackles or fever, so treatment is not delayed. |
**Expected outcomes**
- No signs of aspiration.
- Temperature normal.
- Eats safely upright with supervision.
- Swallow review completed.
**Linking the data to the diagnosis**
The older woman with dementia eats quickly, has a weak cough, and was half propped in bed while eating. Her daughter says she eats very fast and does not chew well, and a swallow screen showed a delayed swallow. Her temperature is 36.9 C and her chest is clear, so no food has been inhaled yet. This is a risk diagnosis resting on dementia and a weak cough, not an actual chest infection. The plan aims for no signs of aspiration, a normal temperature, safe eating upright with supervision, and completion of the swallow review.
CarePath diagnosis
Likely to inhale food or fluid related to dementia and weak cough (risk factors); no signs of the problem are present yet.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Sit fully upright to eat. | Sitting fully upright lets food travel down by gravity and keeps the airway protected, lowering the chance of inhaling food. |
| 2. Supervise meals. | Watching meals allows the nurse to slow the pace, give prompts and respond at once to coughing or choking. |
| 3. Follow swallow advice. | Swallow advice from specialists, such as food texture and pace, matches the safest way to eat for her delayed swallow. |
| 4. Give mouth care. | Mouth care lowers the germs in the mouth, so if a little saliva or food is inhaled it is less likely to cause a lung infection. |
| 5. Check chest and temperature. | Checking the chest and temperature can reveal early signs of aspiration, such as crackles or fever, so treatment is not delayed. |
Expected outcomes
- No signs of aspiration.
- Temperature normal.
- Eats safely upright with supervision.
- Swallow review completed.
Linking the data to the diagnosis
The older woman with dementia eats quickly, has a weak cough, and was half propped in bed while eating. Her daughter says she eats very fast and does not chew well, and a swallow screen showed a delayed swallow. Her temperature is 36.9 C and her chest is clear, so no food has been inhaled yet. This is a risk diagnosis resting on dementia and a weak cough, not an actual chest infection. The plan aims for no signs of aspiration, a normal temperature, safe eating upright with supervision, and completion of the swallow review.