5.3 Basic Care, Dysphagia, Nutrition & Post-Procedure Care
Implement stroke aspiration precautions, enteral feeding protocols, CAUTI prevention, pressure injury staging, and post-cardiac cath recovery.
🎯 Key NCLEX-RN® Clinical Takeaways
- Post-stroke dysphagia precautions: Sit 90 degrees upright, chin-tuck swallow, food on unaffected side, remain upright 30-45 min post-meal.
- CAUTI prevention: Keep drainage collection bag continuously below bladder level, closed system, and tubing secured to thigh.
- Post-femoral cardiac catheterization: Keep affected leg immobilized straight for 4-6 hours, check distal pedal pulses, inspect groin for hematoma.
- Post-lumbar puncture: Lie flat supine for 4-6 hours to prevent CSF leakage and post-dural puncture headache; push fluids.
Basic care and comfort forms the foundation of post-operative and chronic care nursing. Dysphagia following stroke requires meticulous positioning (high-Fowler 90 degrees, chin-tuck maneuver) to prevent silent aspiration pneumonia.
Invasive lines and catheters are major portals of nosocomial infection. CAUTI prevention guidelines mandate keeping collection bags below bladder level to prevent retrograde reflux.
Post-procedural nursing focuses on detecting arterial bleeding and nerve injury. Following femoral cardiac catheterization, strict leg immobilization prevents clot disruption, while serial distal pedal pulse checks verify limb perfusion.
⚠️ Common Pearson VUE / NCLEX Traps
- Allowing a client to sit upright immediately after lumbar puncture, provoking excruciating spinal headache.
- Flexing the knee or ambulating early after femoral artery cardiac catheterization, causing massive arterial hemorrhage.
Knowledge Checkpoint
A client recovering from an acute ischemic left hemispheric stroke is evaluated by speech-language pathology and cleared for a pureed diet with nectar-thick liquids. Which nursing action effectively minimizes the risk of pulmonary aspiration during mealtime?