Teaching Sheets Two
Difficult Swallowing
Difficult Breathing
Dizziness
Feeding Tubes
Fever

Problems – Dysphagia can cause:

• A sore mouth, drooling, excessive or no saliva
• Pain in the throat or chest when swallowing
• Oral monilia (white patches or coating on the tongue or mouth)
• Gagging or coughing

• Infection in the mouth or esophagus
• Side effects of chemotherapy or radiation
• The heart may not be pumping properly
• Cancer of the head and neck
• Weakness due to the disease process

• Eat small meals of soft foods such as puddings, yogurt, ice cream (high in calories)
• Keep the head of the bed elevated for 1 – 2 hours after eating
• Puree foods such as fruits, meats and cereals
• Popsicles and crushed ice made from juices are soothing
• Cold compresses to the throat 30 minutes before meals may be helpful

Difficulty Breathing

Problems – Dyspnea can cause:

• Decrease in oxygen intake
• Weakness
• Fatigue
• Fear
• Anxiety

• Anemia
• Infections (such as pneumonia)
• Other lung conditions such as COPD, Pleural effusion, Lung cancer
• Cardiac conditions such as CHF
• Ascites (accumulation of fluids in the peritoneal cavity) causing pressure on the diaphragm under the lungs

• Oxygen
• Relaxation and reassurance
• Breathing exercises
• Nebulizer treatments
• Medications as ordered by your physician

Dizziness

Problems – Dizziness can cause:

• Difficulty with balance
• Light – headaches
• Falls
• Nausea

• Low blood pressure
• Weakness
• Anemia
• Infections

• Use corrective devices, such as a cane or walker to prevent falls
• Avoid stooping to pick something up from the floor
• Move from a lying position to an upright position slowly (in stages)
• Medications as prescribed by your doctor

Feeding Tubes

Feeding tubes can either be inserted in the nose, stomach or intestines.

• NG tube is a nasal gastric tube inserted into the nose down into the stomach.
• A G – tube is one that is inserted through the skin into the stomach.
• A J – tube is inserted through the skin into the intestines.

• Wash your hands before handling the feedings and/or equipment.

• The feeding tube should be flushed with ½ cup of water before and after a feeding. Ask your nurse for a large syringe for flushing.

• Give the feedings at room temperature (not just out of the refrigerator).

• If the tube is blocked, Do Not Force the food or medicine into the tube. Instead try flushing with water. If this does not work, call the hospice nurse.

• Store the feedings as instructed by the pharmacy. Usually they should be stored in a climate controlled environment. After opening, the supplement should be refrigerated and used within 48 hours. Discard the feeding if they have expired.

• Do not let a feeding hang for more than 8 hours unless it is in a closed system. Those in a closed system are allowed to hang up to 24 hours.

• Change the feeding bag and tubing every 24 hours.

• The patient should be in a sitting position. If the patient is in bed, raise the head of the bed to a comfortable sitting position.

• If the patient vomits or complains of fullness, stop the feeding and call the hospice nurse.

• In the event the feeding tube falls out or is accidentally pulled out, stay calm; call hospice and we will send a nurse to evaluate the situation.

Fever

Problems – Fever can cause:

• Chills
• Weakness
• Fatigue
• Sweating
• Dehydration

• Infection
• Tumors
• Compromised Immune System
• Hypersensitivity to drugs
• Blood Transfusion

• Increase fluids
• Maintain stable room temperature
• Tepid sponge baths
• Antipyretic drugs such as aspirin and Tylenol as directed by your doctor

 

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