The nurse is teaching a nursing assistant methods to assist an older client with dementia in performing mouth care. Which instruction should the nurse provide to the assistant?
1. Place a hand over the client's hand and guide the client to perform mouth care.
2. Use sponge swabs to cleanse the gums around the teeth in the front.
3. Brush the teeth quickly for the agitated or irritable client and finish with a mouth rinse.
4. Carefully place two fingers of a gloved hand in the client's mouth to access the back teeth.
1. Place a hand over the client's hand and guide the client to perform mouth care.
Explanation: 1. The hand-over-hand method involves the caregiver placing a hand over the client's hand and guiding the client in performing the activity.
2. Sponge swabs are not as effective as a toothbrush for mouth care. This is not an acceptable replacement.
3. Effective tooth brushing requires the cooperation of the client and requires two minutes of brush time.
4. Caregivers should never place their hands inside the mouth of any cognitively impaired client who is apt to bite or clamp down.
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