A home health nurse is caring for an older adult client who reports. "I keep coughing when I try to swallow my food, but not at other times." Which of the following actions should the nurse take?

Rationale: A. Instruct the client that this is due to increased salivary flow that occurs with aging: While aging can affect swallowing, persistent coughing specifically during meals suggests dysphagia or aspiration risk, not just increased saliva. Dismissing it as normal aging could delay necessary evaluation and intervention. B. Encourage the client to increase fluid intake when the cough is present: Increasing fluids without assessing swallowing ability could worsen aspiration risk. Proper evaluation of swallowing mechanics is necessary before recommending fluid intake adjustments. C. Recommend an antitussive 30 min prior to each meal: Suppressing the cough reflex can be dangerous in clients with swallowing difficulties, as the cough helps prevent aspiration. Using antitussives in this situation may increase the risk of choking or pneumonia. D. Initiate a consultation with a speech-language pathologist: A speech-language pathologist can perform a swallowing assessment, identify aspiration risk, and recommend safe feeding strategies. Referral ensures proper evaluation and helps prevent complications such as aspiration pneumonia.