Oral hygiene assessment and oral care are important nursing interventions after a stroke. The nurse administers the oral medication to the patient as ordered. The patient should be referred to a dental hygienist if specialist advice is needed, but in the meantime it is important to proceed with oral care. 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. Nursing interventions and supportive care for the prevention and treatment of oral mucositis associated with cancer treatment. It is best gargled and spat out rather than swallowed, or may be applied with a swab directly to painful areas. As a result, the child receiving chemotherapy may experience pain, dysphagia, alteration in nutritional status, and risk of infection. Results from the pilot study suggest that this workshop is a feasible intervention for a service-wide trial. Updated December 2018. Point of Care Resources; Node Name Weight Weight Selector ; Oral care infection prevention and control: Algorithm for Oral Care: Oral Health History — Sample Questions: Risk Factors for Oral Disease and Poor Oral Health: Oral Hygiene Care Plan for Long-Term Care: Sample Oral Health Care Plan: Toothbrushing Techniques: Denture Care After using toothpaste the patient should be instructed as follows; a patient should spit out excess toothpaste (infants may swallow very small amounts of toothpaste), a patient should not rinse out their mouth or eat and drink for 30 minutes post using toothpaste (rinsing or eating and drinking after using toothpaste may remove it from the mouth and teeth and decrease effectiveness), Normal saline or water should be used in babies who have no teeth instead of a toothpaste. 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. Barriers to self-care 3. For example, patients who are unable to go to the bathroom should be given water and a bowl. Fawzy suggested that psychosocial interventions provide an overall positive effect on quality of life, although some interventions have failed to achieve the desired results. evidence table for the Mouth Care – Oral Care of the paediatric oncology patient and haematopoieitic stem cell transplant patient can be found here. Nursing interventions and supportive care for the prevention and treatment of oral mucositis associated with cancer treatment. Swelling can occur quickly and requires immediate intervention. intensive care patients’ oral care frequency. All children diagnosed with cancer or receiving a haemopoietic stem cell transplant should be reviewed by a paediatric dentist at least every 3-4 months during active treatment and then every 6-12 months after completion of treatment. Conclusion. Avoid petroleum based lubricants such as vaseline that can increase dryness of the tissues, preferably use water, lanolin or aloe based products. The more you look into nursing careers, the more you realize that a day in the life of a nurse is rarely boring. Nursing Writing Services offers the best Impaired Oral Mucous Membrane Care Plan Writing Help Online Nursing interventions and supportive care for the prevention and treatment of oral mucositis associated with cancer treatment Oncol Nurs Forum . Nursing Study Guide for Asthma. Here are some factors that may be related to the nursing diagnosis Impaired Dentition: 1. Continuous vomiting 4. The development of this nursing guideline was coordinated by  Lisa Barrow, Clinical Nurse Educator, Children's Cancer Centre and approved by the Nursing Clinical Effectiveness Committee. As often as necessary. Journal of Advanced Nursing Practice. Rationale: provides data for planning care. Sign in or Register a new account to join the discussion. Dougherty L, Lister S (2008) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. 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 Dental caries, oral cancers, and sports-related craniofacial injuries are potentially preventable conditions. Nursing Interventions and Supportive Care for the Prevention and Treatment of Oral Mucositis Associated with Cancer Treatment August 2004 Oncology Nursing Forum 31(4 Suppl):13-23 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. London: NMC. Home Care Interventions 1. Assess the oral cavity using an appropriate assessment tool. Symptoms usually start 14 days after radiotherapy; the duration of radiotherapy associated mucositis may last for several weeks, Encourage patients to rinse the mouth after vomiting with water (this will remove any stomach acid in the mouth; left in contact with the teeth, stomach acid can contribute to tooth decay and irritate the mouth), Sodium bicarbonate mouth rinses may be useful and effective in dissolving mucus and loosening debris, raising pH and preventing overgrowth of aciduric bacteria, Rantidine or a proton pump inhibitor such as omeprazole or pantoprazole may be useful for the prevention of epigastric pain after treatment with cyclophosphamide, methotrexate and 5-FU, The use of hydrogen peroxide is not recommended as it increases dryness, contributes to the breakdown of newly formed tissue, disrupts normal oral flora and may increase the risk of aspiration and foaming, Chewing sugarless gum or lozenges has been shown to increase saliva flow and thus reduce discomfort. An azole antifungal agent, such as fluconazole, may be prescribed, Prophylaxis for fungal infections will be based on sensitivities of the proven or suspected organism, consideration of medication toxicity and consideration of the patient's clinical status, comorbidities and concomitant medications, Antifungal agents that are not absorbed by the GI tract, such as nystatin, are NO longer recommended for the treatment of oral candida in the immunocompromised patient, Oral anti-fungal agents (intravenous if not tolerated) should be used for the treatment of visible oral candidia. Oxford: Wiley Blackwell. Time analgesia administration to have maximum efficacy during mouth care procedures, Xylocaine 2% Viscous applied topically may be of use prior to mouth care. 2.3 Oral health related nursing interventions Oral hygiene is an essential aspect of nursing care and is methodically planned using nursing interventions. Diminished hormone levels (women) 12. You may also gently brush the surface of the tongue and the gums; If the patient cannot tolerate the use of a toothbrush (for example due to mouth tenderness) foam sticks and mouthwash can be used instead (Dougherty and Lister, 2008); Allow the patient to take mouthfuls of water, rinse the mouth and spit into the receiver. 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. In: Oncology nursing forum, Vol. Edinburgh: Churchill Livingstone. Severe mucositis can delay treatment and so limit the effectiveness of the child's cancer therapy. Older patients in hospital may be unable to maintain hydration by drinking, leading to intravenous fluid replacement, complications and a longer length of stay. Extreme intake of fluorides 10. The management plan should be clearly documented in the Electronic Medical Record. The Shared Oral Care intervention supports an individual and multidisciplinary assessment of nursing home residents’ ability to self‐care concerning oral care. 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. 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