The nurse caring for a chronic renal failure client notes that the client's oral mucosa is dry and cracked. The nurse would: Select all that apply
1. Provide frequent oral care.
2. Offer hard candy.
3. Document the finding.
4. Encourage fluids.
5. Administer a fluid bolus.
1. Provide frequent oral care.
2. Offer hard candy.
3. Document the finding.
Rationale: Provide frequent oral care. Provide frequent oral care to decrease the dryness of the oral mucosa, remove debris, and add comfort. Offer hard candy. Hard candy should be offered because this will stimulate salivation, adding to the comfort of the client. Document the finding. The nurse should document this finding to alert other staff of the condition of the oral mucosa and measures implemented to increase client comfort. Encourage fluids. Chronic renal failure clients are fluid restricted. Administer a fluid bolus. Administering a fluid bolus would not be indicated because of the fluid restriction of chronic renal failure clients.
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