Stomatitis

Question 1

What is it?

Answer 1

Inflammatory condition affecting the oral mucosa, dentition, and periosteum

Question 2

Primary Stomatitis

Answer 2

• Canker sores
• Painful, small oral ulcers, herpes simplex, and traumatic ulcers

Question 3

Secondary Stomatitis

Answer 3

• Result of viral, bacterial, or fungal infections in patients with suppressed immune systems
• Secondary to radiation & chemotherapy

Question 4

Risk Factors

Answer 4

• Viral, bacterial, & fungal infections
• Irritants (alcohol, tobacco, & mouthwash)
• Radiation therapy (7-14 days after starting treatment)
• Allergic reactions
• Vitamin deficiency (Vitamin B, Folate, Zinc, & Iron)
• Systemic disease (CKD & IBD)
• Dry mouth

Question 5

Manifestations

Answer 5

• painful inflammation and ulceration of the lining of mouth or other oral mucosa

Question 6

Management

Answer 6

• Prompt Diagnosis
• Frequent assessment in onc. patients
• Prevent dry mouth
• Topical analgesics and anesthetics for pain
• Antibiotics, Antifungals, & Antivirals

Question 7

Major Complications

Answer 7

• Swallowing and speaking become painful
• Dysphagia (difficulty swallowing)
• Odynophagia (painful swallowing)
• Lead to local or systemic infections
• Increased risk of pain
• Severe cases = open lesions & edema can obstruct airway

Question 8

Common Assessment Findings

Answer 8

• Dry, red, swollen, and cracked oral mucosa
• Mouth ulcers
• Recurrent canker sores
• Open, bleeding mouth sores
• Pain
• Presence in inflammation or irritation in other mucosal areas

Question 9

Nursing Diagnoses Examples

Answer 9

• Acute pain related to swollen, cracked, ulcerated oral mucosa
• Risk for infection related to impaired nutritional status and impaired integrity of oral mucosa

Question 10

Monitor/Assess

Answer 10

• Vitals (temp. elevation = infection, elevated HR and decreased BP = fluid volume deficit)
• Oral mucosa (bleeding or ulceration)
• Nutritional intake, weight, and I&) (painful oral lesions people avoid eating and drinking and experience dysphagia)

Question 11

Nursing Actions

Answer 11

• Implement Aspiration precautions
• Administer medications
• Administer water-soluble lubricants for lips and mouth

Question 12

Medications

Answer 12

• Antibiotics
• Antimicrobials (tetracycline syrup & minocycline swish and swallow)
• Antiviral (Acyclovir IV and PO/topical)
• Anti-fungal (nystatin swish and swallow)
• Viscous lidocaine (oral rinse pain relief)

Question 13

Patient education Ex.

Answer 13

• Mouth care after each meal
• Discourage alcohol-contain mouthwash
• Encourage regular dental checkups
• Encourage saline mouth rinses every 4 hours
• High protein and vitamin C diet (promotes healing)
• Avoid spicy, salty, hot, hard, and acidic foods