Question

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Explanation:

Analyze the clinical scenario

The question describes a nurse caring for a client following a cerebrovascular accident (CVA, or stroke). The visible portion of the prompt mentions that the nurse observes the client, and asks which nutritional therapy will likely be prescribed. Although the exact observation is partially cut off, the options clearly focus on dysphagia (difficulty swallowing), which is a highly common and critical complication following a CVA.

Evaluate the clinical options

• Supplements via nasogastric tube: This is an invasive intervention used if the client cannot meet nutritional needs orally over a longer period, but it is not the immediate first-line safety measure for suspected dysphagia.
• NPO until dysphagia subsides: "NPO" stands for nil per os (nothing by mouth). Following a CVA, clients are at a very high risk for dysphagia and subsequent aspiration pneumonia. Keeping the client NPO until a formal swallow study is performed and dysphagia is evaluated/subsides is the standard safety intervention to prevent aspiration.
• Initiation of total parenteral nutrition (TPN): TPN is an intravenous feeding method used when the gastrointestinal tract is non-functional. It is not indicated for standard post-stroke dysphagia.
• Soft residue diet: Offering oral intake like a soft residue diet before a comprehensive swallowing evaluation is unsafe due to the risk of silent aspiration.

Determine the safest intervention

The primary nursing priority for a post-CVA client showing signs of swallowing difficulty or awaiting evaluation is to prevent aspiration. Keeping the client NPO (nothing by mouth) is the standard, safest initial prescription until dysphagia is fully assessed and managed.

Answer:

• Supplements via nasogastric tube
• NPO until dysphagia subsides (Correct answer)
• Initiation of total parenteral nutrition
• Soft residue diet