Mr. Campion, 73, recently diagnosed with CVA. When the nurse feeds him, he coughs after every swallow. What is the nurse's best course of action?

• A. Request a swallowing assessment from a person who is certified to do it
• B. Stop feeding briefly
• C. Continue feeding
• D. Administer cough suppressant

Answer: (A)

Coughing after swallowing in a person who recently had a stroke points to possible dysphagia and a real risk of aspiration. The appropriate next step is to arrange a swallowing assessment by a certified professional, typically a speech-language pathologist, to determine if he can safely swallow and what modifications are needed. This evaluation will guide whether it’s safe to continue oral feeding, what consistencies or textures to use, and whether alternative feeding methods are required.

Continuing to feed without assessment risks further aspiration and pneumonia, while a cough suppressant would not address the swallowing safety itself and could mask ongoing airway problems. A formal swallow assessment provides the necessary evaluation to protect the patient and tailor safe feeding.