The nurse is reviewing the care of an 89-year-old client who is dying of a brain tumor from metastatic cancer. The client is lethargic, has slurred speech, but seems to be aware of people and surroundings
The nurse provides instruction to the nurse aide to provide oral care. What would the nurse include in the instruction to the nurse aide? 1. Use alcohol-based mouthwash to keep secretions down
2. Keep the client's dentures in at all times
3. Rinse the mouth with water and ask the patient to swish and swallow
4. Provide mouth care several times a day with a non-alcohol-based solution or water
4. Provide mouth care several times a day with a non-alcohol-based solution or water
Rationale:
Oral hygiene is crucial in the dying patient. Care is best provided with non-alcohol-based solutions that are soothing and nonirritating to an already dry mucosa. Clients may not be able to have dentures in because of mouth breathing, which causes dry and painful mucosa. Clients with speech deficits often have swallowing problems. Therefore, the risk for aspiration is present in this client.
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