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.
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I think your text may be out of date on this issue.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!)
Specializes in Pedi,Tele,ICU,ER,Ortho,MedSurg;prison.
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.
That is what was taught in my nursing program as well. Over time ( more than 3 days ), with repeated use, the glycerin causes further drying of the mucosa. We were taught to use a toothette with nonalcohol mouthwash.
I love these kind of questions - typical distractor - the client is unconscious:banghead: :banghead:
a is the best answer given the choices, however impractical in real life
Oh well, I just got it from my reviewer.. anywayz thanks for all of the answers. Just want to clarify, what should I select for oral care if ever i'll gonna encounter this question again? NSS or Lemon glycerin?
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.
Oh well, I just got it from my reviewer.. anywayz thanks for all of the answers. Just want to clarify, what should I select for oral care if ever i'll gonna encounter this question again? NSS or Lemon glycerin?
Specializes in Oral care, diabetes, caries management.
Of the choices given you're right NSS would be the best option. The next most logical is H2O3. Any topical application of anything acidic is contraindicated. If this is an end of life situation, and the glycerine would be ok, I suppose.
From an oral perspective the options suck, no pun intended.
I'm going to try to lurk around here and offer some assistance to those oral health questions. I suppose I'll fill out my personnel file too so you know who the heck I am. Not one of the Olsen Twins.
:banghead: 
boggle, ASN, RN
393 Posts
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!)