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Discussion

oral care..

Hello to all!

I just want to ask a little help from you guys (If you don't mind at all).Anyway, last night I was reading my reviewer for NLE, when I come up with this question which really confused me a lot. Here is the question I got:

An elderly client, 84 years old is unconscious. Assessment of the mouth reveals excessive dryness and presence of sores. Which of the following is best to sue for oral care?

a. Lemon Glycerin

b. Hydrogen peroxide

c. Mineral oil

d. Normal Saline Solution

I've selected letter D. my rationale is that lemon glycerin might irritate more the oral mucosa considering the patient already has a sore and dryness of the mouth. So for me to make it safer use NSS, even when I checked on my fundamentals of nursing book NSS is highly recommended for oral care but when I checked for the right answer the book said the correct answer is a. why do you think is that so? help! thanks. god bless.:saint:

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I think lemon glycerine might be chosen as first choice because it moistens and soothes (the glycerine part), while NS only moistens. I see your reasoning that the lemon in it might irritate. Maybe the lemon isn't real lemon, only lemon flavoring?

  • Guides

I think it's just flavoring too. I've never seen anyone use natural saline for a sore dry mouth. They always go for the lemon swabs.

However, I seem to recall from somewhere, someone saying something negative about the swabs. Can't recall what it was nor what the source was.

But, then, I ask myself, why IS the flavoring lemon? I like lemons, but I'd think a light mint would be more refreshing... but that's just me.

You need to address the dryness. NS is great for cleansing but will dry out the oral mucosa. The glycerine will keep it moist. I'd say the lemon is just flavoring too...

I think it's just flavoring too. I've never seen anyone use natural saline for a sore dry mouth. They always go for the lemon swabs.

However, I seem to recall from somewhere, someone saying something negative about the swabs. Can't recall what it was nor what the source was.

But, then, I ask myself, why IS the flavoring lemon? I like lemons, but I'd think a light mint would be more refreshing... but that's just me.

Because lemon is the flavoring of clean? :D

I'm dusting off my thinking cap LOL; but if I'm remembering correctly we were taught that the glycerine is good in the short term -like in PACU but in the long term glycerine itself is very drying. I prefer a toothette with either nonalcohol mouthwash or mouth moistuiser.:twocents:

Because lemon is the flavoring of clean? :D

Bahaha... yeah like cleaning your mouth out with lemon scented Lysol... Ummm...smells fresh in here, too funny!:clown:

  • Guides
Bahaha... yeah like cleaning your mouth out with lemon scented Lysol... Ummm...smells fresh in here, too funny!:clown:

There have been some pts where I wish I COULD use lemon Lysol!!

Our prepackaged mouth swabs have a touch of peroxide in them (Peroxamint?), and they are gentle. There is a little packet of "mouth moisturizer" too.

Glycerin swabs work fine too.

NS stings on open sores, ouch!

Mineral oil is not for oral use.

  • Expert

The S in NS stands for saline which is salt. You wouldn't want to put something salty on a sore dry mouth.

It is my understanding that the lemon flavor will also stir up the saliva glands to aide in moisturizing.

We were told in nursing school that the lemon glycerin is no longer recommended. It's an old school of thought.

We were told in nursing school that the lemon glycerin is no longer recommended. It's an old school of thought.

Yep, lemon glycerine swabs have been removed from our hospital. They smelled nice and were wet, but did nothing for cleaning or treatment of sore mouths. Some brands have alcohol in them which is drying.

Here is a quote from an article on oral care in the American Journal of Critical Care:

"Lemon and glycerine swabs stimulate production of saliva initially, but are acidic, causing irritation and decalcification of the teeth and rebound xerostomia." American Journal of Critical Care. 2004;13: 25-34

I think your text may be out of date on this issue. The normal saline solution sounds like the best answer to me, (it's isotonic, and won't sting like a salt water solution you would make in your own kitchen).

( p.s. After rinsing this patient's mouth, you better do a thorough oral assessment and notify the doc. Patient may need an antifunglal!)

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