Ch. 53 Care of Patients with Oral Cavity Problems

fungal infection that is very painful

candidas

The nurse is instructing a client on measures to maintain effective oral health. Which measures does the nurse include in the client's teaching plan? Select all that apply. a. Regular dental checkups b. Use of mouthwashes containing alcohol c. Ensuring that dentures are slightly loose-fitting d. Managing stress as much as possible e. Eating a balanced diet

a, d, and e

A client completing radiation treatment has developed dysphagia and stomatitis. What teaching will the nurse provide? (Select all that apply.) a. Brush teeth twice daily with chemobrush. b. Thin liquids will make it easier to swallow. c. Limit alcohol consumption to three drinks per day. d. Rinse mouth with mild saline and water mix before and after eating. e. Refrain from using liquid dietary supplements, as these will irritate mucous membranes. f. Plan to eat soft foods like cheese, well-cooked legumes, peanut butter, and pudding.

a, d, and f

The nurse admits an immunocompromised client who has contracted herpes simplex stomatitis. The nurse anticipates that the health care provider will request which medication? a. Acyclovir (Zovirax) b. Diphenhydramine (Benadryl) c. Nystatin (Mycostatin) d. Tetracycline syrup (Sumycin syrup)

a. Acyclovir (Zovirax)

noninfectious

apathous

Treatment of stomatitis

oral hygiene with soft tooth brush and sodium bicarbonate rinse avoid mouthwash, toothpaste with SIS, citrus fruits, tabacco, alcohol, pototoes, nuts, cheese take antifungal to treat candidas

A client who has undergone surgery and completed radiation therapy to treat oral cancer reports persistent dry mouth. What will the nurse teach this client about managing this symptom? a. Use saliva substitutes, especially when eating dry foods. b. This condition is common but is temporary. c. Use lozenges and hard candies to prevent dry mouth. d. This indicates a complication of therapy.

a. Use saliva substitutes, especially when eating dry foods.

As a result of being treated with radiation for oral cancer, a client is experiencing xerostomia. What collaborative resource does the nurse suggest for this client's care? a. Dentist b. Occupational therapist c. Psychiatrist d. Speech therapist

a. Dentist

The nurse is caring for four clients. Which is at the highest risk for development of oral cancer? a. 32-year-old client with ankle fracture b. 41-year-old with human papilloma virus (HPV) infection c. 60-year old who quit smoking twenty years ago d. 83-year old that lives in a warm climate during the winter

b. 41-year-old with human papilloma virus (HPV) infection

A client has recently developed acute sialadenitis. Which intervention does the nurse include in this client's care? a. Applying cold compresses b. Avoiding the use of fruit or citrus-flavored candy c. Massaging the salivary gland d. Restrict fluids

c. Massaging the salivary gland

The nurse is caring for a postoperative client who had an extensive oral and neck surgery. The client is now describing throbbing pain in the head. The nurse anticipates that the health care provider will request which medication for this client? a. Diphenhydramine (Benadryl) b. Midazolam (Versed) intravenously c. Morphine sulfate intravenously d. Oxycodone plus acetaminophen (Percocet, Tylox)

c. Morphine sulfate intravenously

The nurse is providing instructions to a client who has a history of stomatitis. Which instructions does the nurse include in the client's teaching plan? a. Encourage the client to eat acidic foods to decrease bacteria. b. Mouth care should be performed twice daily. c. Rinse the mouth with warm saline or sodium bicarbonate. d. Use a medium-bristled toothbrush for oral care.

c. Rinse the mouth with warm saline or sodium bicarbonate.

Which food does the nurse instruct a client undergoing chemotherapy for oral cancer with secondary stomatitis to avoid? a. Broiled fish b. Ice cream c. Salted pretzels d. Scrambled eggs

c. Salted pretzels

common type of secondary stomatitis is caused by

candida albicans

stomatitis can result from

infection, allergy, certain foods, vitamin deficiency, systemic disease, & irritants, such as tobacco & alcohol.

certain foods that can cause stomatitis

potatoes, coffee, cheese, nuts, citrus fruits, and gluten may trigger allergic responses that cause apathous

stomatitis, apathous, herpes simplex stomatitis, and traumatic ulcers

primary stomatitis

generally rustles from infection by opportunistic viruses, fungi, or bacteria in patients who are immunocompromised

secondary stomatitis

coughing, choking, sensation of food sticking to pharynx, difficulty intitaing the swallowing process

signs of dysphasia

a broad term that refers to inflammation within the oral cavity

stomatitis

Which practice does the nurse include when teaching a client about proper oral care? a Perform self-examination of the mouth every week, and report any unusual findings. b. Brush the teeth daily and floss as needed. c. Use drugs that reduce the flow of saliva unless lesions are present. d. Regularly rinse mouth with alcohol-based agent.

a Perform self-examination of the mouth every week, and report any unusual findings.

Which facial assessment finding in a client with a salivary gland tumor prompts the nurse to notify the health care provider? a. Loss of sensation in tongue b. Alternates smiling and grimacing c. Wrinkles brows on command d. Holds eyes shut as the nurse pulls gently upon the eyebrows

a. Loss of sensation in tongue

When caring for a client with oral cancer who has developed stomatitis as a complication of radiation and chemotherapy, which action does the nurse delegate to the unlicensed assistive personnel (UAP)? a. Provide oral care using disposable foam swabs. b. Inspect the oral mucosa for evidence of oral candidiasis. c. Instruct the client on how to use nystatin (Mycostatin) oral rinses. d. Teach the client how to make appropriate dietary choices.

a. Provide oral care using disposable foam swabs.

A client has undergone a partial glossectomy for cancer. What community resource does the nurse refer the client to when dressing supplies will be needed at home? a. Oral Cancer Foundation b. American Cancer Society (ACS) c. Client Advocate Foundation d. American Medical Supply Foundation

b. American Cancer Society (ACS)

The nurse is caring for a client diagnosed with aphthous ulcers. The nurse instructs the client to avoid which foods? Select all that apply. a. Apples b. Bananas c. Cheese d. Nuts e. Potatoes

c, d, and e

Which client statement requires immediate nursing intervention? a. "I used to chew tobacco but quit 5 years ago." b. "I use sunscreen to cover my face and body when I'm at the beach." c. "I do not have dental insurance, so I cannot get dental check-ups." d. "I only drink alcohol on special occasions like my birthday and anniversary."

c. "I do not have dental insurance, so I cannot get dental check-ups."

Adequate nutrition is required for healing after treatment for recurrent aphthous ulcers (RAU). Which client response indicates that nursing teaching has been effective? a. "I have ordered a snack of milk and pretzels." b. "I will try to drink orange juice twice per day." c. "I ordered my sandwich on a crusty roll." d. "I would like scrambled eggs and a banana for breakfast"

d. "I would like scrambled eggs and a banana for breakfast"

A client with oral carcinoma has a priority problem of risk for airway blockage related to obstruction by the tumor. At the beginning of the shift, which action will the nurse take first? a. Suction the client's oral secretions to clear the airway. b. Place the client on humidified oxygen per nasal cannula. c. Assist the client to an upright position to facilitate breathing. d. Assess the respiratory effort and quantities and types of oral secretions.

d. Assess the respiratory effort and quantities and types of oral secretions.

A client with oral cancer is depressed over the diagnosis and tells the nurse of plans to have a radical neck dissection. What is the nurse's best reaction? a. Listen to the client and then explain that it is normal to feel depressed about the diagnosis. b. Explain the grieving process and listen to what the client has to say. c. Suggest that the client talk with friends and family and seek their support. d. Listen to the client's concerns and feelings and then suggest that the client join a community group of cancer survivors.

d. Listen to the client's concerns and feelings and then suggest that the client join a community group of cancer survivors.