A nurse taking care of a patient with throat cancer is assessing the patient's ability to swallow food without aspiration or choking. The patient had a laryngectomy and has started oral intake. Which of the following diets, if taken without difficulty swallowing, indicates that the patient has tolerated the first stage of dietary advancement?
• After a laryngectomy, oral intake is started with a pureed or soft diet. Pudding and yogurt are examples of food that have a pureed consistency. Once the patient can tolerate this type of food, liquids may be introduced. Thin liquids are not given until the risk of aspiration is negligible.
• Laryngectomy is the surgical removal of all or part of the larynx. Risks involved with this surgery are problems with swallowing or eating. The patient is often started on tube feeds until edema has subsided and the patient is able to swallow secretions.
• Broth, apple juice, water and gelatin are examples of a clear liquid diet. A patient with a swallowing difficulty due to the effects of laryngectomy will be unable to manage liquids initially and should be started on pureed or soft foods.
• Cereal and dry toast are examples of regular or general diet, which are not appropriate for patients after a laryngectomy.