Altered Oral Mucous Membranes

 

Instructions: Fill out this form, print it, and hand it in with your assessment to your instructor. When you click on Next at the bottom of the page, you see the data you submitted. Please follow the instructions on how to save the data on the next page.

AOL users: Read this instruction.

Definition: disruptions of lips and soft tissue of the oral cavity

1. Your initials (required): 

2. Defining Characteristics- check those that apply to your client:

None- high risk diagnosis  oral pain or discomfort  dry, cracked lips dry mouth bleeding  white patches  coated tongue  oral lesions  difficulty eating or swallowing changes in tongue (fissures, edema)
3. Related Factors- check those that apply to your client:

NPO for more than 24 hours radiation therapy NG tube ET tube trauma to mouth oral surgery dehydration mouth breathing inadequate oral hygiene infection


4. Goal (ultimate, long term) 

5. Outcome Criteria (short term) 

6. Evaluation: Was the outcome criteria met? 

Yes- Give Evidence: 

No- Explain how you would change the plan: 

7A. Interventions 

1. 

2.

3. 

4. 

5.

6. 

7B. Rationale for each intervention
1. 

2. 

3. 

4. 

5. 

6. 
 
 

 
 
Back to top
Return to Care Plan Homepage