DysphagiaSurviving a serious stroke often leads to a new problem. Nearly half of patients affected by a severe stroke develop difficulty swallowing, called dysphagia. People in this condition have difficulty keeping food and liquids in their mouth or swallowing. As food passes from the mouth through the oropharynx and laryngopharynx, it enters the esophagus and muscular contraction propels it towards the stomach, but when the process goes wrong, food and liquids re-enter the esophagus, what we call reflux (Nozarka, 2010). are factors that disrupt normal swallowing. These include stroke, age-related changes, medications, and neurological diseases (Nozarko, 2010). Signs of dysphagia include coughing during meals, a change in tone or quality of voice after swallowing, abnormal movements of the mouth, tongue or lips, and slow, weak, precise or uncoordinated speech. . Other signs of the disease are abnormal nausea, delayed swallowing, incomplete oral clearance or puffiness, regurgitation, pharyngeal accumulation, delayed or absent initiation of swallowing, and inability to speak coherently (Potter and Perry, 2009). Dysphagia can lead to aspiration pneumonia. During aspiration, food or liquid passes through the vocal cords and enters the airway. It can be caused by impaired laryngeal closure or overflow of food or liquids retained in the pharynx. This increases the risk of choking and aspiration pneumonia. By coughing, the body tries to release suction which helps remove food and fluid from the lungs. However, silent suctioning is very dangerous because food and liquids enter the airways and penetrate deep into the lungs, causing major breathing problems. Dysphagia also results from malnutrition and dehydration. This increases the risk of pressure ulcers (Nozarko, 2010). Evaluation of the data collected leads to a nursing diagnosis. A client who is a stroke survivor complains of difficulty swallowing associated with a deficit in oral, pharyngeal, or esophageal structure or function. In this case, the nursing diagnosis is swallowing difficulty linked to a neurological problem (Ackley and Ladwig, 2011). As a caregiver to a client with this condition, it is necessary to set goals and outcomes. The goal and outcome for a client with dysphagia is: the client can swallow effectively without choking within seven days, and the client will be free of signs of aspiration by a clear lung sound within five days (Ackley and Ladwig , 2011). To achieve goals and outcomes for this patient, first determine the severity of the dysphagia. . “If a person has mild dysphagia, simply providing appropriate guidance to eat slowly and sit up straight while eating can keep the person well nourished [sic] and problem-free” ( Nozarka, 2010, para..