護理師照護一位中風後有吞嚥困難病史的病人。進食期間護理師應執行哪些介入措施？（選所有適合的）
A nurse is caring for a client with a history of dysphagia following a stroke. Which interventions should the nurse implement during meals? (Select all that apply.)
- AProvide thin liquids to facilitate easier swallowing.提供稀釋液體以促進較容易吞嚥
- BInstruct the client to tuck their chin toward the chest when swallowing.✓ 正解指示病人在吞嚥時將下巴收向胸部
- CEncourage the client to sit upright at a 90-degree angle.✓ 正解鼓勵病人以 90 度角坐直
- DAllow the client to rest for 30 minutes before mealtime.✓ 正解允許病人在用餐前休息 30 分鐘
- ECheck the mouth for pocketing of food after each swallow.✓ 正解每次吞嚥後檢查口腔是否有食物殘留
中風後吞嚥困難的護理重點在於預防吸入性肺炎。核心策略包含：姿勢維持、食物質地調整與進食耐力評估。收下巴動作（Chin-tuck）能擴大會厭下間隙並保護氣道，是經典的防嗆咳技巧。維持 90 度坐姿是重力輔助進食的最佳角度。進食前的休息能確保病人有足夠體力完成整個進食過程，避免疲倦導致的吞嚥協調不良。清查頰部餘食（Pocketing）是防止誤吸的最後關卡。澄清液體（Thin liquids）對吞嚥困難者極其危險，因為流速過快，會厭常來不及關閉，應改為稠化液體（Thickened liquids）。臨床上安全永遠優先於營養攝取的量。
The nurse should instruct the client to tuck their chin toward the chest to help close the airway and open the esophagus, encourage sitting upright at 90 degrees to use gravity for swallowing, and check the mouth for food pocketing to prevent later aspiration. Additionally, allowing rest before meals prevents fatigue, which can impair swallowing coordination and increase aspiration risk.
美國醫院有專門的語言治療師（SLP）進行吞嚥評估並決定飲食等級，護理師需嚴格執行 SLP 的建議；台灣雖也有語言治療師，但在人力不足的醫院，吞嚥篩檢常由護理師先進行初步評估，且對於食物稠度的標準化操作（如 IDDSI 標準）在基層普及度仍有差異。