護理師照顧一位中風後嚴重吞嚥困難的病人。為預防進餐時吸入性肺炎，應採取哪些措施？（選所有適合的）
A nurse is caring for a client with severe dysphagia following a stroke. Which interventions should the nurse implement to prevent aspiration during meals? (Select all that apply.)
- AKeep the client in an upright position (90 degrees) during meals.✓ 正解進餐時讓病人保持直立姿勢（90 度）
- BOffer thin liquids to wash down solid food more easily.提供清流質以便更輕鬆地送服固體食物
- CEncourage the client to tuck their chin toward the chest when swallowing.✓ 正解鼓勵病人在吞嚥時將下巴收向胸部
- DProvide mouth care before and after meals.✓ 正解餐前和餐後提供口腔護理
- EMinimize distractions in the room during mealtime.✓ 正解進餐期間盡量減少房間內的干擾
吞嚥困難護理的核心在於保護呼吸道（Airway Protection）。首先，維持 90 度坐姿（A）利用重力協助食物下行，並在餐後維持 30 分鐘。縮下巴動作（C）能關閉氣道口並打開食道門，是預防吸入的關鍵技術。口腔護理（D）不僅能刺激唾液分泌協助吞嚥，餐後清潔更可避免殘留食物引起吸入。減少環境干擾（E）能讓病人專注於吞嚥動作，減少因分心導致的協調錯誤。選項 B 是絕對錯誤的，清流質（thin liquids）在口腔內流動速度過快，最容易在會厭軟骨蓋住前進入氣管，應使用增稠劑。整體策略是「環境調整+姿勢控制+質地改良」。
Preventing aspiration in clients with dysphagia involves maintaining an upright position to use gravity, encouraging a chin-tuck maneuver to protect the airway, and minimizing distractions to improve swallowing coordination. Additionally, providing thorough oral hygiene reduces bacterial load and prevents complications if aspiration occurs.
美國 NCLEX 強調護理師必須熟悉 Chin-tuck 技術與增稠劑分級（IDDSI 框架）。台灣臨床常過度依賴鼻胃管，對於嘗試由口進食的漸進式吞嚥訓練，護理與語言治療師的跨團隊合作在近年才逐漸普及。