1. How to Care For an Unconscious Patient's Mouth
It's important to keep patient's mouths clean when they cannot do so themselves. Good oral hygiene
clears debris out of the mouth and keeps the teeth, gum and tongue healthy. It also discourages the
growth of bacteria. Poor oral hygiene can lead to a dry mouth and may become fertile ground for the
growth of bacteria. Providing oral care for clients who are unconscious requires certain nursing
interventions.
Before Providing an Unconscious Patient with Mouth care
Wash your hands and put on clean gloves. This reduces the risk of transmitting disease causing
organisms. Then do the following:
Check to see what health problems the unconscious patient may have as a result of poor oral
hygiene. Check for issues like thrush, mouth sores or inflammation of the gums. This information
helps you determine how to provide oral care.
Assess your patient to determine if he is at risk for aspiration. Do this by placing a tongue blade at
the back half of the patient's tongue. If the patient gags, then his gag reflex is intact; if not, then he
is at risk for aspiration, which means that fluids may travel into his lungs instead of his stomach.
Proceed with oral care if this test is positive or negative, but institute aspiration precautions if the
patients gag reflexes are absent, such as placing the patient on his side.
Take off your gloves and wash your hands again. Put on a new pair of gloves and explain what you
are about to do - perform oral hygiene - to the patient. Prepare your supplies of swabs and brush on
a table near your patient and pull the curtains around him for privacy.
Position your patient on his side to prevent aspiration and place his bed at a height that is
comfortable for you. Place a towel and basin under the patients chin. Since the patient is
unconscious, place an oral airway in his mouth to maintain a patent airway.
The Process For Providing Mouth Care
2. Moisten a toothbrush with cleaning solution and brush the chewing and inner surfaces of your
patient's mouth. Then moisten the brush with water and rinse your patients mouth with it. Use a
swab to wipe your patients inner cheeks, gum and the roof of his mouth. Moisten the swab with
water and use it to rinse out your patients mouth. Wipe your patients tongue with the swab as well.
Suction your patients mouth with a bulb syringe as oral secretions accumulate. Wipe the patient's
mouth and apply water soluble jelly to his lips to prevent dry , cracked lips.
Once the mouth care process is completed, let your client know that the procedure is over,
reposition him into a comfortable position and clear away your supplies. Keeping your patient's
mouth clean reduces risks of acquiring mouth diseases.
References:
"Lippincott Manual of Nursing Practice"; Sandra M. Nettina ANP-BC; 2009.
"Fundamentals of Nursing"; Patricia A. Potter, Ph.D., and Anne Griffin Perry, Ed.D.; 2009
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