* Patients with acute stroke are at great risk of aspiration. All patients should remain NPO until a swallowing assessment is performed.

* Because of dysphagia, a temporary feeding tube may be required.

* If the patient remains at a significant aspiration risk for the foreseeable future, a percutaneous endoscopic gastrostomy (PEG) feeding tube may be required.

* A dietitian can help identify a diet that not only addresses the aspiration risk but also ensures adequate caloric intake to help prevent poststroke malnutrition.

* The dietitian also must consider special dietary needs of patients with hypertension, diabetes mellitus, and hyperlipidemia.

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