The home health nurse teaches an elderly client with dysphagia some strategies to help limit repeated hospitalizations for aspiration pneumonia. Which statement indicates that the client needs further teaching?

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Dysphagia increases the risk for aspiration of oropharyngeal secretions, gastric content, food, and/or fluid into the lungs. Aspiration of foreign material into the lungs increases the risk for developing aspiration pneumonia. Interventions to help decrease aspiration and resulting aspiration pneumonia in susceptible clients (eg, elderly, neurologic dysfunction, decreased cough or gag reflexes, decreased immunity, chronic disease), include the following: Swallowing 2 times before taking another bite of food. This clears food from the pharynx. Thickening liquids to assist swallowing Avoiding over-the-counter cold medications. Antihistamine cold preparation medications also have some anticholinergic properties, such as causing drowsiness, decreasing saliva (xerostomia) production, and making the mouth dry. Saliva is a lubricant, and it helps bind food together to facilitate swallowing. Sitting upright for at least 30-40 minutes after meals. This uses gravity to move food or fluid through the alimentary tract, decreases gastroesophageal reflux, and helps decrease risk for aspiration. Brushing teeth and using antiseptic mouthwash before and after meals. This reduces the bacterial count before eating because bacteria as well as food can be aspirated. After-meal use removes particles of food that can be aspirated later. Smoking cessation. Smoking decreases mucociliary clearance and increases bacterial count in the mouth. (Option A) Positioning the chin slightly downward toward the neck (chin-tuck) when swallowing can be effective in some clients with dysphagia due to its facilitating closure of the epiglottis to help prevent tracheal aspiration. Educational objective: Teaching clients who are susceptible to aspiration about swallowing techniques, positioning, avoidance of over-the-counter cold preparation medications (cause drowsiness and dry mouth), oral care, and smoking cessation can decrease the risk for aspiration pneumonia

The Home Health Nurse Teaches an Elderly Client with Dysphagia