Self Directed Learning Package - University of Queensland

More documents

Recommendations

Info

146 • The Palliative Approach ToolkitSayReport your assessmentReport to the nurse if you see any of the problems listedpreviously.Residents get the best outcomes when you provide clearinformation about the resident.Thinking PointWhich of the following do you think will get the bestresponse?Careworker to nurse:‘Alfred appears to have a very dry mouth. Swallowinganything more than water is difficult. His tongue isdry and has white spots and there are some cracksin the corners of his lips. He says it got much worsewhen the strong pain medications began’.Is much better than:‘Alfred has problems with his mouth. You better takea look’.DoManage the problemThe best clinical outcomes will be achieved if care plans aredeveloped after careful assessment of the resident’s oral cavity.Thinking PointAlfred’s medications cause a dry mouth, heoccasionally uses oxygen and often sleeps with hismouth open. He has a ‘sore’ spot on his gum and histongue is coated. What could you do to help Alfredwith his dry mouth?Dry mouth (xerostomia)• moisten oral cavity with frequent rinsing and sipping of water• apply water-based moisturiser to lips• discourage strong cordials, juices or sugary drinks• reduce caffeine intake• stimulate saliva with tooth friendly lollies• encourage resident to drink water after meals, medicationsand other drinks and snacks• use saliva substitutes such as a water spray or an oral balancegel or liquid. 10Pain or ulceration• help the resident to rinse or swab their mouth with warmsaline three to four times a day until resolved• check the fitment of dentures• avoid spicy or acidic foods or food with sharp edges• offer cold, soft food• local or systemic analgesics may be required• medical review if not resolved within seven days. 10Coated tongue, mucosa or teeth• remove debris with a soft toothbrush or mouth swab• help the resident to rinse or swab their mouth with warmsaline three to four times a day until resolved• brush tongue gently with soft toothbrush. 10
147 • Self Directed Learning Package - CareworkerOral care in the final days of lifeIn the final scenes of the “All on the same page” DVD, Alfred hasonly hours or days left to live. He cannot swallow food or fluids,is very drowsy, and breathes through his mouth. His tongue andlips are dry.Thinking pointThink about when you have a dry mouth. When youmoisten it with water, how long does it take untilthe dryness returns? Not very long? Perhaps fiveminutes?Imagine you are Alfred who relies on you to providethis comfort measure for him.As a resident approaches death they lose the ability to feedthemselves or have a drink. Eventually swallowing becomesdifficult and unsafe. Functionally they cannot clean their teethor oral cavity by themselves. Often this is when a ‘mouth care’trolley or tray is seen in the resident’s room.Key PointEvery time you attend to a resident:Apply dry mouth products: e.g. water spray, oral balance gel orliquid via mouth swabs.Apply water based lip moisturisers: Do not use petroleum basedproducts (e.g. vaseline) as they canincrease the risk of inflammationand aspiration pneumonia; alsocontraindicated during oxygentherapy. 10Key PointSome preparations may damage oral tissues orincrease the risk of infection.Do not use mouthwashes and swabs containing:• lemon and glycerine• sodium bicarbonate (high strength)• preparations containing alcohol (Listerinemouthwash) or hydrogen peroxide• pineapple or other acidic fruit juices. 10
Page 5 and 6:
3 • Self Directed Learning Packag
Page 7 and 8:
Page 11 and 12:
Page 13 and 14:
11 • Self Directed Learning Packa
Page 16 and 17:
14 • The Palliative Approach Tool
Page 18 and 19:
Page 21 and 22:
Page 24 and 25:
Page 26 and 27:
Page 28 and 29:
Page 30 and 31:
Page 32 and 33:
Page 34 and 35:
Page 36 and 37:
Page 38 and 39:
Page 40 and 41:
Page 42 and 43:
Page 44 and 45:
Page 46 and 47:
Page 48 and 49:
Page 50 and 51:
Page 52 and 53:
Page 54:
Page 57 and 58:
Page 59 and 60:
Page 61 and 62:
Page 63 and 64:
Page 66:
Page 69:
Page 72 and 73:
Page 74 and 75:
Page 76 and 77:
Page 78 and 79:
Page 80 and 81:
Page 82 and 83:
Page 84 and 85:
Page 86 and 87:
Page 88 and 89:
Page 91 and 92:
Page 93 and 94:
Page 95 and 96:
Page 97: 95 • Self Directed Learning Packa
Page 101 and 102: 99 • Self Directed Learning Packa
Page 103 and 104: 101 • Self Directed Learning Pack
Page 106 and 107: 104 • The Palliative Approach Too
Page 108 and 109: 106 • The Palliative Approach Too
Page 147: 145 • Self Directed Learning Pack
show all

Self Directed Learning Package - University of Queensland

Create successful ePaper yourself

Delete template?

Save as template?