Nursing Study Guide for Asthma. 3. The prevalence of malnutrition has been extensively reported, but there is little empirical data on the prevalence of the underlying causes of reduced oral intake and the extent of nursing interventions that address malnutrition. Citation: Wilson A (2011) How to provide effective oral care. There is a concern that the incidence is increasing, particularly in younger patients and in women. Maximizing what the patient can do for themselves will facilitate their care plan and you spend a lot of time every shift doing this! Imm… Decreased platelets 9. The nurse administers the oral medication to the patient as ordered. This article reviews nursing interventions to increase adherence to oral cancer therapies, such as patient and care-partner education, side-effect and medication management, and safety issues. Maintain privacy as required. 7, (2), pp. Rationale: provides data for planning care. An oral airway can be a problem because it keeps the mouth open, which predisposes the patient to xerostomia. Nurses should undertake oral care for patients who cannot maintain a clean mouth for themselves. The prevalence of malnutrition has been extensively reported, but there is little empirical data on the prevalence of the underlying causes of reduced oral intake and the extent of nursing interventions that address malnutrition. There are a variety of tools, use the one selected by your trust. To identify any new problems (Dougherty and Lister, 2008). Each nursing intervention is carefully planned using knowledge, critical thinking and Nursing interventions and supportive care for the prevention and treatment of oral mucositis associated with cancer treatment. While nurses should educate patients about their oral care needs, in some cases patients would benefit from the special advice that the dental hygienist can provide. After using a chlorhexidine based gel or mouth rinse the patient should be instructed as follows; a patient should spit out excess gel or mouthrinse (do not swallow the gel or mouth rinse), a patient should not rinse out their mouth or eat and drink for 30 minutes post using the gel or mouth rinse (rinsing after using the chlorhexidine gel may remove it from the mouth and teeth and decrease effectiveness), Chlorhexidine based gels and mouth rinses need to be prescribed, If chlorhexidine 0.5% gel is unavailable, chlorhexidine 0.2% mouth rinse may be used; moisten the toothbrush with the chlorhexidine 0.2% mouth rinse and clean teeth as normal (a foam brush or super soft toothbrush may be used as a temporary alternative if the patient has significant mucositis, bleeding or pain in the oral cavity), Rinsing the mouth with chlorhexidine 0.2% mouth rinse should not be used as a substitute for tooth brushing, Flossing should be encouraged once daily if the child is older than 12 years of age, is used to regular flossing and it can be managed atraumatically, Interdental brushes may be used as an alternative, Flossing or the use of interdental brushes should be discontinued if mucositis is present, Non adherence to mouth care by the paediatric oncology or HSCT patient may be related to oral mucosa pain, Indications of pain associated with mucositis may include; difficulty swallowing, refusal to swallow, difficulty/refusal to talk, difficulty/refusal in opening mouth, drooling saliva, difficulty/refusal to attend to mouthcare and epigastric chest pain as examples, A regular pain assessment is required using a validated tool as per the, Effective analgesia should be provided prior to performing mouth care where there is evidence of mucositis. Immunocompromised 13. Extreme intake of fluorides 10. Reduced nutritional intake in care-dependent patients is a risk factor for malnutrition. London: NMC. Integrating oral care interventions into nursing practice can be feasibly implemented to serve different community groups across a multitude of locations ranging from primary care and maternal child health centers, hospital-based clinics to home settings. The procedure should be undertaken with the patient’s head turned to the side, and suction equipment should be to hand); Wet the toothbrush head and apply a small amount of toothpaste only. Keeping the mouth and teeth clean will protect a patient’s oral health and allow quicker recovery by preventing infections. 2. Nursing care plan for Impaired Oral Mucous Membrane Impaired Oral Mucous Membrane. Methods. Oral hygiene assessment and oral care are important nursing interventions after a stroke. Pathophysiology The epiglottis is the flap of cartilage that covers the trachea when swallowing that blocks airflow and prevents food from entering the lungs. @article{Wrdh2009NursingSU, title={Nursing staff's understanding of oral health care for patients with cancer diagnoses: an intervention study. Barriers to professional care 3. The financial and human costs associated with these conditions, including mortality, indicate the need for interventions that promote oral health and prevent disease for all persons, regardless of … Background. Dentures may be soaked occasionally – use specific soaking solution and follow manufacturer’s instructions. Assemble equipment – gloves and apron, a denture brush or toothbrush, and denture cleaner or toothpaste denture products are preferable if available as they preserve the condition of the dentures compared with toothpaste (Major, 2005); Remove dentures and partial dentures from the oral cavity; Pat dry and rinse with cold water before repositioning in patient’s mouth (Hickson, 2008). / Eilers, June. Oral care is a nursing intervention that may help prevent ventilator-associated pneumonia. The signs and symptom that a care plan should anticipate include: Oral… Older patients in hospital may be unable to maintain hydration by drinking, leading to intravenous fluid replacement, complications and a longer length of stay. Department of Health (2010) Essence of Care 2010: Benchmarks for Fundamental Aspects of Care. Contextual factors, supportive and restraining mechanisms influence the intervention’s success. Renton S (2007) Mouth Care In: Jamieson EM et al (eds) Clinical Nursing Practices. Each Chlorhexidine based gels and mouth rinses can also inhibit plaque formation on the teeth and decrease the risk of dental caries and long term dental complications. Excessive use of tobacco 8. Care of the mouth is considered to be one of the most basic nursing activities, yet nurses’ knowledge of oral health problems is often limited 1 and in clinical practice is not always regarded as a priority. Contextual factors, supportive and restraining mechanisms influence the intervention's success. Chemotherapy alters the integrity of the mucosa, the normal microbial flora of the oral cavity, salivary quantity and composition, as well as epithelial maturation. Evidence-Based Approach for Oral Care If the nursing care is based on evidence, some important facts like improvement of care … It is best gargled and spat out rather than swallowed, or may be applied with a swab directly to painful areas. Nursing Care Plans Diagnosis: Impaired Oral mucous membrane Definition: Disruptions of the lips and soft tissues of the oral cavity Defining Characteristics: Purulent drainage or exudates; gingival recession, pockets deeper than 4 mm; enlarged tonsils beyond what is developmentally appropriate; smooth atrophic, sensitive tongue; geographic tongue; mucosal denudation; presence of … Depression 11. Author: Ann Wilson is a senior lecturer at Coventry University. The Oral Assessment Guide (OAG) can assist in determining the patient’s oral health and function. You may need a tongue depressor and a torch to carry out the assessment efficiently. Fawzy suggested that psychosocial interventions provide an overall positive effect on quality of life, although some interventions have failed to achieve the desired results. There are several distinct categories of interventions that have been employed for patients with cancer, namely, education, emotional support, and psychotherapy. Oral Health Care Education Sessions for Nursing Home Caregivers: Adults: All: Worksite: Provider Education, Environment & Policy: An Oral Health Counseling Intervention Targeted at Parents of Young Children: Infants/Toddlers, Children, Adults: All: Health care facility: Individual Education, Supportive Relationships, Environment & Policy In: Richardson R (ed) Clinical Skills for Student Nurses. planning Establish the care plan goals, incorporating the resident’s wishes and preferences. Consult the, Systemic analgesics (as examples paracetamol or opioids) may be required, and should be administered according to the degree of pain (as stated by the child), the presence of drooling, and/or difficulty in swallowing, talking, eating or opening the mouth. It is the responsibility of the nurse managing the patient’s care to assess the oral mucosa and decide on subsequent methods of oral hygiene in consultation with the medical team. 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