Assessment Diagnosis Planning Intervention Rationale Evaluation

Objective Impaired oral mucous Short term Independent Short term

Dry lips and cracked membrane related to (Goal met)
Red strawberry inflamed oral mucosa After 24hrs of nursing Assess for changes in Typical changes of
tongue evidence by dry lips intervention he the lips and oral the mucous After 24hrs of nursing
Mouth sores and cracked mouth, patient will report cavity membrane include intervention he patient
Oral mucosa is deep red strawberry less discomfort in his redness of the will able to report
red in color tongue, oral mucosa is mouth while eating or mouth, strawberry less discomfort in his
deep red in color, drinking within in 24 tongue, and red, dry mouth while eating or
mouth sores hours. fissured lips. drinking within in 24
hours.
Provide soft, Soft food requires less
Long term nonirritating foods chewing and provides Long term
such as gelatin. less irritation to the (Goal met)
After 2 days of oral mucosa
nursing intervention After 2 days of
the patient will Maintains hydration nursing intervention
Maintains intact, Provide cool liquids and decreases mouth the patient will able to
moist oral mucous such as ice chips. tenderness. maintained intact,
membranes that are moist oral mucous
free of ulceration Soft-bristle brush membranes that are
Instruct the use a soft- limits mucosal free of ulceration
bristle brush or a irritation.
padded tongue blade
during mouth care.
Limits the bacterial
Provide regular oral accumulation that can
care with alcohol-free cause infection.
mouthwash.

Dependent

Administer Gelclair This is a

bioadherent oral
gel that covers the
oral cavity and
 forms a protective
barrier to relieve
pain

Collaborative

Refer the patient

to the dietitian for Nutritional
instructions on the expertise may be
maintenance of a necessary to
well-balanced diet. optimize the
therapeutic diet
needed to facilitate
healing.