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Altered Oral Mucous Membranes: Stomatitis

Published on Saturday March 10th , 2007

Altered Oral Mucous Membranes: Stomatitis

(_)Actual (_) Potential

**Related To:**
*[Check those that apply]*
(_) Immunosupression from chemotherapy (_) Nutritional depletion (_) Radiation to head and neck (_) Improper fitting dentures (_) Excessive dry mouth (_) Other:_____________________________ ____________________________________ ____________________________________

**As evidenced by:**
*[Check those that apply]*
Major: (Must be present)	(_) Disruption of mucous membrane tissue. (_) Lesion
Minor: (May be present)	(_) Coated tongue (_) Dry mucous membranes (_) Edema (_)Erythema (_) Leukoplakia

Date &
Sign.

Plan and Outcome
[Check those that apply]

Target
Date:

Nursing Interventions
[Check those that apply]

Date
Achieved:

The patient will:

(_) Be free of oral mucosa irritation.

(_) Exhibit signs of healing with decrease inflammation.

(_) Other:

(_) Obtain history of radiation or chemotherapy regimen.

(_) Check for oral burning, pain, or change in tolerance to temperature.

(_) Do oral exam noting evidence of lesions within the mouth and tongue q____.

(_) Oral hygiene q____ hours using:
________________________

(_) Teach patient to:

avoid commercial mouth washes, citrus fruit juices, spicy foods, extremes in food temperature, crusty or rough foods
use straw to facilitate fluids bypassing inflammed lesions (if indicated)
use soft tooth brush or toothettes for oral care
check for proper fit of dentures

(_) Other:________________
________________________
________________________
________________________

__________________________
Patient/Significant other signature

__________________________
RN signature

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