Exam (elaborations)
Gerontological Nursing, 4e (Tabloski) Chapter 13 The Mouth and Oral Cavity
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Gerontological Nursing, 4e (Tabloski) Chapter 13 The Mouth and Oral Cavity
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Gerontological Nursing, 4e (Tabloski)Chapter 13 The Mouth and Oral Cavity
1) Thernurserisrcompletingranrassessmentrofranrolderrclient'sroralrcavity.rWhichrfindingrmostrcon
cernsrthernurse?
1. Leukoplakia
2. Gumrredness
3. Excessrsaliva
4. Multiplercavitiesr
Answer:r 1
Explanation:r 1.rLeukoplakia,rarwhiterpatchyrcoatingrthatroccursronrtheroralrmucosa,risrnotrnor
malrandrrequiresrfurtherrevaluationrandrpossiblyrbiopsyrorranti-infectiverprescription.
2. Withrage,rgumsrtendrtorrecederleavingrthernewlyrexposedrarearofrtherteethrbelowrtherpreviousrgum
rlinervulnerablertortoothrdecay.rGingivitisrinvolvesrred,rswollenrgums.rThisrdoesrneedrattentionrfro
mrardentist,rbutritrisrnotrthermostrconcerningrfinding.
3. Therproductionrofrsalivarusuallyrdecreasesrwithrage;rhowever,rtherappearancerofrextrarsalivarisrnotr
concerning.
4. Enamelronrteethrisrwornrawayrandrabradedrwithraging.rCavitiesrneedrattentionrbutrarernotranrim
mediatercauserofrconcern.
PagerRef:r309-
317rCognitiverLevel:r Analy
zing
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:rReductionrofrRiskrPotentialrNur
s/IntegrConc.:r NursingrProcess:rAssessment
LearningrOutcome:r 1.rExplainrnormalrchangesrofragingrinrthermouthrandroralrcavity.
1
Copyrightr©r2019rPearsonrEducation,rInc.
,2) Anrolderrclientrhasrseveralrsmallrvesiclesrwithrerodedrcentersronrtherlips.rWhatrisrtherfirstracti
onrforrthernursertorperform?
1. Notifyrtherhealthcarerproviderrofrtherliprvesicles.
2. Documentrtherassessmentrfindingsrinrthermedicalrrecord.
3. Teachrtherclientrtorperformrcarefulrhandrwashing.
4. Reviewrtherclient'srtemperaturesrandrwhiterbloodrcellrcount.rA
nswer:r 1
Explanation:r1.rThernurserneedsrtorobtainrarprescriptionrtortreatrwhatrappearsrtorberherpesrsimplex
,rotherwiserknownrasrarfeverrblister.rClustersrofrvesiclesrwithrerodedrcenters,rulcersronrtherlips,randr
mucosarcanrindicatertherpresencerofrherpesrsimplexrorrzoster.
2. Thernurserwillrdocumentrtherassessmentrfindingsrlast.
3. Therclientrwillrneedrtorbertaughtrtorwashrtheirrhandsrtoravoidrspreadingrthervirusrandrtoravoidrarsec
ondaryrinfection.rHowever,rtherriskrofrspreadrandrinfectionrisrnotrgreatrandrthisrisrnotrtherpriorityract
ion.
4. Therclientrlikelyrshowsrlittlertornorsignsrofrinfection.rHerpesrsimplexrtendsrtorberlocalizedrandrnotr
causersystemicrsymptomsrofrclinicalrsignificance.
PagerRef:r312
CognitiverLevel:r Analyzing
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:rReductionrofrRiskrPotentialrNur
s/IntegrConc.:r NursingrProcess:rAssessment
LearningrOutcome:r 2.rIdentifyrcommonrdiseasesrofrthermouthrandroralrcavityrinrolderradults.
3) Anrolderrclientrisrexperiencingrmouthrpainrratedr4ronrar10-
pointrpainrscale.rWhatractionrshouldrthernursertake?
1. Medicatertherclientrwithrarprescribedrnarcoticranalgesic.
2. Carefullyrinspectrtherclient'srmouth,rteeth,randrtongue.
3. Askrtherclientrifrtheyrhavereverrhadrmouthrpainrforranyrreason.
4. Instructrtherclientrtorbeginrrinsingrthermouthrwithranrisotonicrsolution.rAn
swer:r 2
Explanation:r1.rThernursershouldrnotrmedicatertherclientrforrcomplaintsrofrmouthrpainruntilrthersourcer
ofrtherpainrcanrberdetermined.rArnarcoticrmayrnotrberneededrforrthermouthrpain.
2. Therfirstrsteprthernursershouldrtakerinrresponsertorarclientrcomplainingrofrmouthrpainrisrtorcareful
lyrconductrarthoroughrassessmentrofrtheroralrcavityrandrvisualizeranyrobviousrsourcerforrtherpain.
3. Priorrhistoryrofrmouthrpainrcanrbertherresultrofrmanyrdifferentrissuesrandrdoesrnotrnecessarilyrhav
eranyrbearingronrthercurrentrsituation.
4. Thernursermayrsuggestrtherclientrrinsertheroralrcavityrwithranrisotonicrsolutionrifrapplicable,rafte
rrtherclient'sroralrcavityrhasrbeenrthoroughlyrassessed.rThisrmayrnotraddressrtherclient'srproblemrsi
ncer"mouthrpain"risrarvaguersymptom.
PagerRef:r312
CognitiverLevel:r Applying
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:rReductionrofrRiskrPotentialrNur
s/IntegrConc.:r NursingrProcess:rAssessment
LearningrOutcome:r 4.rRecognizernursingrinterventionsrthatrcanrberimplementedrtorassistrtheragi
ngrclientrwithroralrproblems.
2
Copyrightr©r2019rPearsonrEducation,rInc.
, 4) Whatrshouldrthernurseruserforrmouthrcarerinranrolderrclientrwhorisrunablertorperformrteethrbrus
hingrindependently?
1. Nystatin
2. Chlorhexidiner(Peridex)
3. Lemonrandrglycerinrswabs
4. Undilutedrhydrogenrperoxider
Answer:r 2
Explanation:r 1.rNystatinrisranrantifungalragent,rwhichrisrusedrtortreatroralrcandidiasis.
2. Chlorhexidiner(Peridex)risrusedrwithrclientsrinrwhomrmechanicalrplaquerremovalrisrdifficultrtora
chieve.rThisrmouthrrinserisrusedrtortreatrgingivalrandrperiodontalrdiseaserandroralrinfections.
3. Theruserofrlemonrandrglycerinrswabsrisrnotrrecommendedrandrhasrbeenrfoundrtorberharmfulrtorthero
ralrtissues.
4. Theruserofrhydrogenrperoxiderhasrbeenrquestionedrbecauserthererisrevidencersuggestingrthatritrisrh
armfulrtortheroralrmucosa.
PagerRef:r322
CognitiverLevel:r Applying
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:rReductionrofrRiskrPotentialrN
urs/IntegrConc.:r NursingrProcess:rPlanning
LearningrOutcome:r 4.rRecognizernursingrinterventionsrthatrcanrberimplementedrtorassistrtheragi
ngrclientrwithroralrproblems.
5) Anrolderrclientrtellsrthernurserthatrtoothrbrushingrisrseldomrdone.rWhatrshouldrthernurserasse
ssrasrreasonsrwhyrtherclientrhasrstoppedrperformingroralrhygiene?rSelectrallrthatrapply.
1. Visionrchanges
2. Malocclusionrofrteeth
3. Decreaserinrtasteracuity
4. Lackrofrdentalrinsurance
5. Lossrofrmanualrdexterityr
Answer:r 1,r5
Explanation:r 1.rAmongrtherreasonsrwhyrolderrclientsrstoprparticipatingrinroralrhygienerpractices,rsuc
hrasrbrushingrtherteeth,rmayrberpoorrvision.
2. Malocclusionrofrteethrwouldrdecreasertherclient'srabilityrtorchew.
3. Ardecreaserinrthersenserofrtastermayraddrtorarlackrofrappetite.
4. Arlackrofrdentalrinsurancermayrberarfactorrasrtorwhyrarclientrdoesrnotrseerardentistrforrchec
kupsrbutrwouldrnotrberarreasonrforromittingroralrhygieneraltogether.
5. Amongrtherreasonsrwhyrolderrclientsrstoprparticipatingrinroralrhygienerpractices,rsuchrasrbrush
ingrtherteeth,rmayrincludertherinabilityrtorphysicallyrperformrtheractionrcausedrbyrlossrinrmanualrd
exterity.
PagerRef:r307-321
CognitiverLevel:r Applying
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:rReductionrofrRiskrPotentialrNur
s/IntegrConc.:r NursingrProcess:rAssessment
LearningrOutcome:r 4.rRecognizernursingrinterventionsrthatrcanrberimplementedrtorassistrtheragi
ngrclientrwithroralrproblems.
3
Copyrightr©r2019rPearsonrEducation,rInc.
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