The nurse notes that a client consistently coughs while eating and drinking. Which nursing diagnosis best applies?

• A. Impaired gas exchange
• B. Risk for aspiration
• C. Ineffective airway clearance
• D. Activity intolerance

Answer: (B)

Coughing while eating or drinking signals a swallowing problem that can allow food or liquid to enter the airway, creating a real risk of aspiration. The best nursing diagnosis here is risk for aspiration because the key issue is the potential for material to enter the lungs, which can lead to pneumonia or airway obstruction if not addressed. This is not describing an ongoing problem with gas exchange right now, which would require actual impaired gas exchange; nor does it describe an inability to clear airway secretions that the person currently has. It isn’t about being unable to sustain activity, which would pertain to fatigue with activity rather than swallowing safety. Interventions focus on swallowing safety and prevention, such as elevating the head during meals, offering small bites and appropriate textures, and consulting speech therapy for evaluation and strategies.