An unresponsive client requires morning oral hygiene. How should the nurse sequence the following interventions? (Arrange the steps from first to last.)
- 1Turn the client onto their side.
- 2Arrange a towel under the client's chin and a basin near the cheek.
- 3Swab the teeth, tongue, and gums with a moistened sponge.
- 4Coat the client's lips with a water-soluble moisturizer.
Answer
The correct sequence is to first turn the client onto their side, then arrange the towel and basin, proceed to swab the oral cavity, and finally apply moisturizer to the lips.
The absolute priority when providing oral care to an unresponsive client is airway management. Positioning the client on their side must always occur first to allow fluids to drain out of the mouth, thereby preventing aspiration. After the airway is secure, preparation of the physical environment with a towel and basin ensures cleanliness. The actual mechanical cleaning of the oral cavity follows. Finally, applying a water-soluble moisturizer provides comfort and preserves skin integrity.
Step-by-Step Solution
Key Concept
Oral Hygiene for the Unresponsive Client