What is in this woman's mouth?

[not now]

I work LTC and we have a resident who is a GT feeder and completely NPO (we have two GT residents who have managed to rehab back to oral feedings but have a bolus if the don't eat much). This resident suffered a massive stroke, doesn't move much, can follow you with her eyes, moans off and on throughout the day and is a mouth breather. She is on continuous feeding with a pump that runs 20 hours a day. There is little to no residual when checked.

We started noticing she would moan and it would sound like she was gargling. Got an order to suction PRN and when we did we would get this thick, beige stuff comming out the back of her throat. Suspecting it was maybe the lemon flaverd swabs leaving a film we only clean her mouth with a toothbrush and water. Thing is she still gets thick, beige mucously stuff in her mouth. It usually comes out in a big chunk when suctioned.

Any ideas on what is causing it? Or what we can do to avoid it?

[LauraF, RN, ASN, CNA, LPN, RN]

We had a woman in our LTC that got something similar. But it would cake her tongue and her cheeks. And she always had mucous, though her chest x-rays were always clear. She was pretty much non-responsive but had a really good gag reflex. We found that really good oral care improved this situation. I assigned a CNA that I could trust not to forget to do it each time she was in there, I did it when I was in there, and it got better. I hope you get it figured out.

[kat911]

Even with precautions, true there may be some occasional GERD involved, however my thought is that it may be mucus from the sinuses/nose. Post nasal drip left to dry with mouth breathing can become very thick and sticky quickly and if mouth care isnt consistent and the patient is boardering mild dehydration it would get dried and stuck near the back of the throat. If tissues in the throat/nose are irritated from dryness there could be some slight oozing of blood from capillaries causing the tinge that appears like it could be tube feeding being regurged. Just a thought but another avenue to explore.

I think you hit the nail on the head. I've seen big clumps of dried mucous stuck to the roof of the nmouth because no one did mouth care for days. Looked like tissue sloughing off the mouth, yeech. Good mouth care of all surfaces of the mouth should help.

[Bipley]

Mucous plug. Get it out and don't let her choke on it. Congrats to you for looking!

[RosesrReder, BSN, MSN, RN]

At first I was scared to open this thread because of the title, LOL

Now, I have found it interesting.

[MadisonsMomRN, BSN, RN]

It does sound like tube feeding. I dont know why its doing that though!