護理師照顧一位有吞嚥困難病史的病人。為預防誤吸，進食時哪項措施最合適？
A nurse is caring for a client with a history of dysphagia. Which action is most appropriate during mealtime to prevent aspiration?
- AProvide thin liquids like water and apple juice提供清水和蘋果汁等稀薄液體
- BPlace food on the unaffected side of the mouth✓ 正解將食物放在口腔未受影響的一側
- CEncourage the client to use a straw for all liquids鼓勵病人使用吸管飲用所有液體
- DInstruct the client to tilt the head back while swallowing指示病人在吞嚥時將頭向後仰
吞嚥困難病人的照護核心在於控制食物路徑與流速。將食物放置在口腔的『健側』（Unaffected side）能讓病人利用尚存的感覺與運動功能來控制食團，確保食物能被正確推送至食道而非氣管。選項 C 錯誤，使用吸管會使液體快速沖向後咽，增加誤吸風險；選項 D 錯誤，抬頭會打開氣道，正確應為『縮下巴』（Chin-tuck）以關閉氣道；選項 A 錯誤，清稀液體流速太快，對於吞嚥反應慢的病人極危險，通常需要加入增稠劑。護理師應評估病人的吞嚥代償技巧，並在進食全程監測其是否有嗆咳跡象。
To prevent aspiration in clients with dysphagia, food should be placed on the unaffected side of the mouth to utilize intact motor and sensory functions. This allows the client to control the bolus effectively and direct it toward the esophagus. Thickened liquids and chin-tuck maneuvers are preferred over thin liquids or head extension to minimize aspiration risk.
美國 NCLEX 考試中，Speech-Language Pathologist (SLP) 是吞嚥評估的權威，護理師必須嚴格執行 SLP 的增稠指示；台灣則多由護理師或語言治療師共同衛教，但增稠劑的選用有時由家屬決定，需注意一致性。