護理師照護一名有吞嚥困難病史的病人。為了預防用餐時發生吸入性肺炎，應採取哪些措施？（選所有適合的）
A nurse is caring for a client with a history of dysphagia. Which interventions should the nurse implement to prevent aspiration during meals? (Select all that apply.)
- AAdd a thickening agent to thin liquids.✓ 正解在稀薄液體中添加增稠劑
- BPosition the client in a high-Fowler's position during meals.✓ 正解進餐時將病人置於高福勒氏臥位
- CEncourage the client to use a straw for drinking.鼓勵病人使用吸管飲水
- DInstruct the client to tuck the chin when swallowing.✓ 正解指示病人在吞嚥時收下巴
- EProvide small, frequent bites of food.✓ 正解提供少量多次的食物
預防吞嚥困難病人吸入的核心在於控制食物流速與利用重力。增稠劑（A）可減慢液體在咽喉的流動速度，給予會厭軟骨更多反應時間來封閉氣道。高坐臥位（B）能利用重力防止食物逆流並優化吞嚥機制。縮下巴動作（D）可使會厭後移並縮小氣道開口，是預防嗆咳的關鍵技巧。小口餵食（E）可避免口腔內食物積聚過多導致失控。選項 C（使用吸管）是常見錯誤，吸管會使液體快速且難以控制地進入咽喉後部，顯著增加吸入風險。護理師應在餐後維持病人坐姿至少 30 分鐘，並持續檢查口腔是否有殘留食物（口袋化現象）。這類病人的安全管理需要多專業團隊協作，包括語言治療師的評估與營養師的質地調整。護理師的觀察力，如注意進食時的咳嗽、流淚或聲音改變（溼性嗓音），對於早期發現隱性吸入至關重要。
The core of preventing aspiration in patients with dysphagia is to control the rate of food flow and to use gravity. Thickening agents (A) slow the flow of liquids in the pharynx, giving the epiglottis more time to close off the airway. A high-Fowler's position (B) uses gravity to prevent reflux and optimize swallowing mechanics. The chin-tuck maneuver (D) moves the epiglottis backward and narrows the airway opening, making it a key technique for preventing aspiration. Small bites (E) prevent food from accumulating in the mouth and becoming uncontrolled. Option C (using a straw) is a common error, because a straw delivers liquid rapidly and uncontrollably to the back of the pharynx, significantly increasing the risk of aspiration. The nurse should keep the patient seated upright for at least 30 minutes after meals and continually check the mouth for retained food (pocketing). Care for these patients requires interdisciplinary collaboration, including evaluation by a speech therapist and texture modification by a dietitian. The nurse's observational skills, including watching for coughing, tearing, or voice changes (wet voice) during eating, are crucial for early identification of silent aspiration.
美國醫院高度依賴語言治療師（SLP）進行 bedside swallow screen 與飲食分級（IDDSI標準）；台灣則多由護理師初步篩檢，再由復健科醫師或語言治療師介入。此外，美國較常使用商業化預拌增稠液，台灣則多由護理師或家屬在餐點中自行添加增稠粉。