رجل عمره ٨٠ سنة بعد سكتة دماغية قبل أسبوع، عنده ضعف في الوجه الأيمن، ويسعل أثناء الأكل والشرب. اليوم صار عنده حرارة ٣٨٫٤، وتنفس ٢٦، وتشبع ٩٠٪، وخراخر في قاعدة الرئة اليمنى. بعد علاج الالتهاب، أي إجراء يمنع تكرار المشكلة؟

An 80-year-old man a week after a stroke has right facial weakness and coughs when eating and drinking. Today he has T 38.4 °C, RR 26, SpO2 90% and right basal crackles. After treating the infection, which measure prevents recurrence?

1. Swallow assessment and sitting upright for meals
2. Feeding him lying down to reduce effort
3. Feeding him quickly so he does not tire
4. Giving thin liquids because they are easier to swallow

Answer: A) Swallow assessment and sitting upright for meals. This suggests aspiration pneumonia from dysphagia; the right lung is more affected because the right bronchus is wider and straighter. Swallowing is assessed, he eats upright, and fluids may be thickened per assessment.