Dysphagia Nursing Diagnosis & Care Plan

Jump to Sections

• What is Dysphagia?
• Signs & Symptoms
• Assessment
• Dysphagia Nursing Diagnosis
• Expected Outcomes & Goals
• Dysphagia Nursing Interventions
• Dysphagia Care Plan Examples
• Additional Resources

Swallowing shouldn’t feel like a high-stakes challenge. 

But for patients with dysphagia, every bite and sip can carry risks. A strong dysphagia nursing care plan helps nurses step in before those risks turn into serious complications. 

When swallowing becomes unsafe, a dysphagia nursing care plan becomes the frontline defense — protecting the airway, supporting nutrition, and restoring confidence at mealtime.

What is Dysphagia?

Patients with dysphagia have difficulty swallowing, which can range from mild discomfort to severe impairment. 

It may result from:

• Neurological conditions
• Structural abnormalities
• Muscular dysfunction

Dysphagia increases the risk of aspiration, malnutrition, and dehydration.

Signs and Symptoms of Dysphagia

Recognizing the signs early can prevent complications. 

Symptoms may include:

• Coughing or choking while eating or drinking
• Sensation of food sticking in the throat
• Drooling or spilling food from the mouth
• Unintentional weight loss
• Hoarseness or changes in voice after eating
• Frequent respiratory infections (aspiration pneumonia)
• Gurgling sounds after swallowing
• Difficulty initiating swallowing

Nursing Process for Dysphagia

The nursing process for managing dysphagia involves:

• A thorough assessment
• Accurate diagnosis
• Planning appropriate interventions
• Implementing care strategies
• Evaluating patient outcomes

Dysphagia Nursing Assessment

A focused assessment guides safe and effective interventions. 

Use the checklist below to spot signs of aspiration, evaluate nutrition, and check hydration status. Tailor dysphagia nursing interventions accordingly.

• Assess the patient’s ability to swallow safely using a swallow screen.
• Evaluate the consistency of food or liquids that the patient can tolerate.
• Monitor for signs of aspiration (coughing, choking, or wet voice).
• Assess respiratory status and oxygen saturation.
• Evaluate nutritional intake and body weight.
• Monitor for dehydration signs (dry mucous membranes and poor skin turgor).
• Conduct a detailed history, including medical conditions and medication use.

Dysphagia Nursing Diagnosis

Examples of nursing diagnoses to include in a dysphagia nursing care plan include:

• Risk for aspiration related to impaired swallowing
• Impaired swallowing related to neuromuscular dysfunction or structural abnormality
• Imbalanced nutrition: Less than body requirements related to inadequate oral intake

Dysphagia Nursing Interventions

Effective dysphagia nursing interventions reduce aspiration risk and support nutritional needs.

• Perform a comprehensive swallow evaluation and consult with a speech-language pathologist (SLP).

• Provide a safe feeding environment (upright position and supervised feeding).

• Teach swallowing techniques (chin-tuck and double-swallow).

• Modify diet consistency as recommended (pureed and thickened liquids).

• Educate on proper oral care to reduce the risk of aspiration pneumonia.

• Monitor respiratory status for early signs of aspiration.

• Educate caregivers on safe feeding techniques and aspiration precautions.

For more on prioritizing airway and nutritional needs, check out our ABCs of Nursing Prioritization.

Nursing Goals and Expected Outcomes for Dysphagia

Setting realistic goals is essential when managing patients with dysphagia. 

These outcomes help guide care and evaluate the effectiveness of dysphagia nursing interventions.

• Patient will swallow safely without signs of aspiration
• Patient will maintain adequate nutritional intake and body weight
• Patient will demonstrate correct swallowing techniques
• Caregivers will verbalize understanding of safe feeding practices

Nursing Care Plans for Dysphagia

Tailor each dysphagia nursing care plan to the patient’s:

• Cause of dysphagia
• Level of impairment
• Risk factors 

Below are examples of individualized plans addressing common nursing diagnoses associated with swallowing difficulties.

Care Plan #1 – Risk for Aspiration

Diagnostic Statement

Risk for aspiration related to impaired swallowing secondary to neurological impairment

Expected Outcomes

• Patient will remain free from signs of aspiration (coughing, choking)
• Patient will use proper swallowing techniques consistently
• Patient will tolerate recommended diet consistency without difficulty

Assessment

• Monitor for signs of aspiration during and after meals
• Assess respiratory rate, oxygen saturation, and lung sounds
• Observe for coughing, choking, or drooling during swallowing

Interventions

• Position the patient upright (90 degrees) during meals and for at least 30 minutes afterward.

• Educate the patient on the chin-tuck method to protect the airway.

• Offer small bites and sips; encourage slow, deliberate swallowing.

• Monitor for signs of distress and discontinue feeding if there’s suspected aspiration.

• Perform oral hygiene after meals to reduce bacterial colonization.

Care Plan #2 – Impaired Swallowing

Diagnostic Statement

Impaired swallowing related to decreased neuromuscular coordination, as evidenced by coughing and difficulty swallowing liquids

Expected Outcomes

• Patient will demonstrate effective swallowing without coughing or choking
• Patient will consume prescribed diet consistently without distress
• Patient will exhibit improved muscle strength and coordination for swallowing

Assessment

• Assess gag reflex and ability to control saliva.
• Monitor for signs of muscle weakness or incoordination.
• Evaluate the patient’s ability to follow swallowing instructions.

Interventions

• Conduct a bedside swallow screen before oral intake.
• Refer to an SLP for a detailed swallowing assessment.
• Educate the patient on compensatory strategies (alternate solid and liquid intake).
• Implement exercises to strengthen oropharyngeal muscles (as prescribed).
• Modify food and liquid textures based on SLP recommendations.

Care Plan #3 – Imbalanced Nutrition: Less than Body Requirements

Diagnostic Statement

Imbalanced nutrition: Less than body requirements related to reduced oral intake due to swallowing difficulty, as evidenced by weight loss and decreased muscle mass

Expected Outcomes

• Patient will maintain or achieve target body weight
• Patient will consume meals with appropriate nutritional value
• Patient will report fewer difficulties with eating and swallowing

Assessment

• Monitor weight weekly and assess BMI.
• Evaluate dietary intake, including calories and protein.
• Assess for signs of malnutrition (fatigue or muscle wasting).

Interventions

• Provide nutrient-dense, easily swallowable foods.
• Collaborate with dietitians to develop a meal plan that meets nutritional needs.
• Encourage small, frequent meals.
• Offer oral supplements as recommended.
• Educate the patient on the importance of maintaining adequate nutrition despite swallowing challenges.

Patient Education and Discharge Planning

Effective education and discharge planning set patients up for success beyond the clinical setting. 

Reinforcing what’s learned during hospitalization — and involving caregivers in the process — can help prevent complications while supporting long-term management of dysphagia at home.

• Teach patients and caregivers safe swallowing practices.
• Provide written instructions on dietary modifications and safe food consistencies.
• Demonstrate proper positioning during meals.
• Instruct on the importance of consistent oral hygiene.
• Schedule follow-ups with speech therapy and dietary support.
• Encourage hydration with thickened liquids if needed.

Recommended Resources on Dysphagia

Looking to expand your understanding of dysphagia nursing interventions and care? 

The information found on these organizations’ websites can support your clinical practice:

• American Speech-Language-Hearing Association (ASHA)
• National Foundation of Swallowing Disorders
• Dysphagia Research Society

Nursing Care Plan Resources

• Nursing Diagnosis
• Nursing Interventions
• Nursing Care Plan Template
• Nursing Process
• ADPIE

Help Patients Swallow Safely

Supporting a patient with dysphagia means more than adjusting diet textures. 

With the right dysphagia nursing care plan, nurses can teach patients how to eat safely, avoid complications, and stay nourished. Stay alert to changes, collaborate with specialists, and use evidence-based dysphagia nursing interventions to improve outcomes and confidence at mealtime.

References and Sources

American Speech-Language-Hearing Association. (n.d.). Dysphagia. Retrieved April 5, 2025.

Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2025). Nursing care plans: Guidelines for individualizing client care across the life span (11th ed.). F.A. Davis Company.

Mayo Clinic. (n.d.). Dysphagia: Symptoms and causes. Retrieved April 6, 2025. 

National Foundation of Swallowing Disorders. (n.d.). Dysphagia assessment. Retrieved April 6, 2025.

Patel, D. A., Krishnaswami, S., & Steger, E. (2019). Dysphagia. In StatPearls [Internet]. StatPearls Publishing. Retrieved April 7, 2025. 

Wilkinson, J. M., Codipilly, D. C., & Wilfahrt, R. P. (2021). Dysphagia: Evaluation and Collaborative Management. American Family Physician, 103(2), 97–106.