An older adult client is brought to the emergency department by an adult child with a preliminary diagnosis of dehydration

The client is agitated and when asked by the nurse to open the mouth the client yells, "You don't need to look in my mouth to see what is wrong with me!" Which rationale for conducting a mouth assessment is the most accurate?
1. That a complete physical exam must be performed.
2. To assess for poorly fitting dentures.
3. To assess for oral lesions.
4. To assess mucous membranes.


Correct Answer: 4
Assessment of mucous membranes for moistness and color is part of an assessment when considering dehydration. Poor dental health may contribute to malnutrition. If a client has oral ulcerations in the mouth, poorly fitting dentures, decaying or loose teeth, it may be painful to eat or drink. This could cause a client to have a limited oral intake of food and fluids.

Nursing

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