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