I'd like to add mor to clinical skills while I still can! I'm in the UCS library at the minute and I've had, like, a whole day of lectures which as some of you may know can be very tiring even though you are sitting down the whole day!! ^ ^
Someone in this library has KFC... I can smell it... It smells sooo good!!!!! -_-;
Anyway, here is mouth care! Enjoy!
Mouth Care
What you need:
* Towel and/or disposable soft cloths, disposable bowl, waste bag, mouthwash, toothbrush and toothpaste, jug and glass, drinking straw, gloves, goggles and apron, small, free-standing mirror, tongue depressor, pen torch.
* Fill a jug with water, bring it and other equipment to the patients bedside.
Wash hands thoroughly, put on gloves and an apron (you may wish to wear goggles to prevent splashing into your eyes.
Supervising mouth care
* If the patient is bed-ridden but capable of self-care, encourage him to perform his own mouth care
* If allowed, assist the patient into an upright position, place the over-bed table in front of him with the mirror angled to allow the patient to view his face; arrange the rest of equipment on the table, ensuring everything is within reach.
* Drape the towel over the patient’s chest to protect clothing.
* Mix mouthwash in a glass, place a straw in it if needed and position the disposable bowl nearby.
* Instruct him to brush his teeth and gums while looking into the mirror. Encourage him to rise frequently during brushing, and provide facial tissues or soft cloths for him to wipe his mouth.
* Ensure all areas of the mouth are cleaned – teeth, palate, buccal surfaces, gums and tongue.
Performing mouth care
* Perform mouth care on the patient if they are comatose or unable to do it themselves.
* If they wear dentures, clean them thoroughly.
* Raise the bed to a comfortable working height to prevent back strain.
* If a patient is unconscious then lower the head of the bed and position the patient on his side, with his face extended over the edge of the pillow to facilitate drainage and prevent fluid aspiration.
* The conscious patient should be assisted to an upright position.
* Arrange the equipment on the over-bed table or bed locker.
* Place a soft disposable cloth under the patients chin and a disposable kidney bowl near his cheek to absorb and catch drainage.
* Lubricate the patients lips with water or petroleum-free balm to prevent dryness and cracking. Reapply lubricant as needed, during oral care
* If necessary use a tongue depressor to hold the patients tongue flat during the procedure.
* Wet the toothbrush with water. If needed, use hot water to soften the bristles.
* Apply toothpaste and brush the patients lower teeth from the gum line up; the upper teeth, from the gum line down.
* Place the brush at a 45 degree angle to the gum line and press the bristles gently into the gingival sulcus. Using short gentle stroke to prevent gum damage, brush the buccal surfaces (toward the cheek) and the lingual surfaces (toward the tongue) of the bottom teeth. Using the same technique, brush the buccal and lingual surfaces of the top teeth. Brush the biting surfaces of the bottom and top teeth, using a back and forth motion.
* Hold the disposable kidney bowl steady under the patients cheek and wipe his mouth and cheecks with tissues/soft cloth as needed. Use suction as required.
* Follow up with a swab.
* After brushing the patients teeth, dip a cotton-tipped mouth swab into the mouthwash solution or warm water. Press the swab against the side of the glass to remove excess moisture. Gently stroke the gums, buccal surfaces, palate and tongue to clean the mucosa and stimulate circulation.
After mouth care
* Assess the patients mouth for cleanliness and tooth and tissue condition
* Rinse the toothbrush and glass, dispose of the kidney bowl
* Empty and clean the suction bottle, if used, and place a clean yanker suction catheter on the tubing
* Remove your gloves and apron, return reusable equipment to the appropriate storage location, and discard disposable equipment in the clinical waste or household waste as per local policy. Wash your hands.
Documenting mouth care
* In your nursing care plan document the time and date of mouth care and sign. Document the condition such as bleeding, dry, oedema, mouth odour, excessive secretions or plaque on the tongue.
* Document the care that your administered.
And that's it!!
Hope you enjoyed it!! (:
Emily
