Aspiration
Aspiration is the entry of food, liquid, saliva, or other foreign material into the airway and lungs instead of the esophagus. Aspiration can cause choking, aspiration pneumonia, and in severe cases, death, making prevention a critical nursing assistant responsibility.
Exam Tip
Aspiration = food/liquid entering the airway. Prevent by elevating HOB 30-45 degrees, keeping patient upright 30+ min after eating, using thickened liquids if ordered, and feeding slowly. Report coughing, choking, or wet voice to the nurse immediately.
What Is Aspiration?
Aspiration occurs when substances that should go into the stomach (food, liquid, saliva, vomit) accidentally enter the trachea (windpipe) and lungs. This is a serious and potentially life-threatening complication, especially in elderly, neurologically impaired, or sedated patients.
Risk Factors for Aspiration
| Risk Factor | Why It Increases Risk |
|---|---|
| Dysphagia (difficulty swallowing) | Impaired swallow reflex |
| Stroke | Affects swallowing muscles/coordination |
| Decreased consciousness | Reduced cough/gag reflex |
| Dementia | Forgets to chew/swallow properly |
| Tube feeding | Reflux of formula into airway |
| Poor oral hygiene | Bacteria-laden secretions enter lungs |
| Lying flat during/after eating | Gravity does not help keep food down |
Signs of Aspiration
- Coughing or choking during or after eating/drinking
- Wet or gurgling voice quality after swallowing
- Difficulty breathing or wheezing
- Watery eyes during meals
- Food or liquid coming from the nose
- Recurrent pneumonia (aspiration pneumonia)
Prevention Strategies (CNA Responsibilities)
- Position upright: Elevate head of bed (HOB) to at least 30-45 degrees during meals
- Keep upright after eating: Maintain elevated position for 30-60 minutes after meals
- Provide thickened liquids if ordered (for patients with dysphagia)
- Feed slowly: Allow adequate time to chew and swallow
- Check for food pocketing: Ensure patient swallows before offering more food
- Chin-tuck position: Have patient tuck chin toward chest when swallowing
- Monitor during meals: Never rush or leave a high-risk patient unattended while eating
Exam Alert
Aspiration prevention is heavily tested on the CNA exam. Key points: always elevate HOB to 30-45 degrees during meals, keep the patient upright for at least 30 minutes after eating, use thickened liquids if ordered, and report any signs of difficulty swallowing to the nurse immediately.
Study This Term In
Related Terms
Aspiration Precautions
Aspiration precautions are nursing interventions designed to prevent food, liquid, or gastric contents from entering the airway and lungs. Key measures include elevating the head of bed to 30-45 degrees, thickening liquids, and monitoring swallowing ability.
Dysphagia
Dysphagia is difficulty swallowing food, liquids, or saliva, which increases the risk of aspiration (food or liquid entering the airway), choking, malnutrition, and dehydration. Dysphagia is common in elderly patients and those with stroke, dementia, or neurological conditions.
Thickened Liquids
Thickened liquids are beverages and liquid foods that have been modified to a thicker consistency using commercial thickening agents to make them safer to swallow for patients with dysphagia (difficulty swallowing). Thickening liquids slows the flow, giving the patient more time to control the swallow and reducing the risk of aspiration.
Fowler's Position
Fowler's position is a standard patient positioning in which the head of the bed is elevated to a 45-90 degree angle while the patient sits semi-upright or upright. Variations include low Fowler's (15-30 degrees), semi-Fowler's (30-45 degrees), standard Fowler's (45-60 degrees), and high Fowler's (60-90 degrees).
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