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.

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Exam Tip

Always elevate HOB 30-45 degrees during meals and for 30-60 minutes after. Assess swallowing ability BEFORE giving oral food/fluids/meds. Chin-tuck position protects the airway. Report coughing, choking, or wet voice quality to the RN immediately.

What Are Aspiration Precautions?

Aspiration precautions are a set of nursing interventions aimed at preventing aspiration, which occurs when food, liquid, saliva, or gastric contents are inhaled into the trachea and lungs. Aspiration can cause pneumonia, airway obstruction, and even death, making prevention a critical nursing priority.

Risk Factors for Aspiration

CategoryExamples
NeurologicalStroke, dementia, Parkinson's disease, decreased level of consciousness
MechanicalEndotracheal/tracheostomy tubes, NG tubes, facial trauma
GastrointestinalGERD, delayed gastric emptying, vomiting
Medication-relatedSedatives, opioids, anesthesia
Age-relatedElderly patients with weakened swallow reflex
PositionalSupine positioning during or after meals

Key Aspiration Precautions

InterventionRationale
Elevate HOB 30-45 degreesGravity prevents reflux and promotes swallowing
Keep HOB elevated 30-60 min after eatingPrevents post-meal aspiration
Assess swallow ability before oral intakeIdentifies dysphagia before feeding
Thicken liquids as orderedSlows liquid flow, easier to control in the mouth
Provide small, frequent mealsReduces fatigue and aspiration risk
Encourage chin-tuck positionProtects the airway during swallowing
Monitor for coughing/choking during mealsSigns of aspiration
Provide oral care before and after mealsReduces bacteria that could cause aspiration pneumonia
Check tube feeding residualsHigh residuals indicate delayed gastric emptying

Signs of Aspiration

  • Coughing or choking during or after eating/drinking
  • Wet or gurgling voice quality after swallowing
  • Fever (may indicate aspiration pneumonia)
  • Dyspnea or tachypnea
  • Oxygen desaturation
  • Crackles or rhonchi on lung auscultation

Exam Alert

Aspiration precautions appear in the Safety and Infection Control and Basic Care & Comfort categories on the NCLEX-PN. Always elevate the HOB to at least 30 degrees during and after feeding. Assess swallowing before giving oral medications or food. Report signs of aspiration to the RN immediately.

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