A nurse is contributing to the plan of care for a client who has dysphagia. Which of the following interventions should the nurse include?

Dysphagia is a condition that increases the risk of aspiration, malnutrition, and choking due to impaired coordination of swallowing mechanisms. Nursing care focuses on promoting safe swallowing techniques, reducing aspiration risk, and ensuring adequate nutritional intake. Positioning and swallowing strategies are key components of the care plan. Proper technique helps protect the airway during oral intake. Rationale: A. Tilting the client’s head forward (chin-tuck position) during meals helps protect the airway by narrowing the opening to the trachea and facilitating safer passage of food into the esophagus. This position reduces the risk of aspiration by improving control of the swallowing process. It is a recommended intervention for many clients with dysphagia. B. Encouraging socialization during mealtimes is beneficial for psychological well-being but does not directly address swallowing safety. In clients with dysphagia, distractions during meals may actually increase the risk of choking or aspiration. Focus during feeding should remain on safe swallowing techniques. C. Providing three large meals per day is not appropriate for clients with dysphagia because large volumes of food increase fatigue and aspiration risk. Smaller, more frequent meals with appropriate texture modifications are preferred to ensure safe and adequate intake. D. Elevating the head of the bed to 30° is insufficient for safe feeding in clients with dysphagia. A higher elevation, typically 45° to 90° during meals, is recommended to reduce aspiration risk. A 30° elevation is more appropriate for general positioning but not for active swallowing safety during meals.