Central Mindanao University

College of Nursing
FUNDAMENTALS OF NURSING PRACTICE, RLE
Procedure Checklist

Name of Student:
Clinical Instructor:

Brushing and Flossing the Teeth of Conscious and Unconscious Client

A. Direction: Write your answers on the space provided.

Assessment:
Assess the patient’s oral hygiene preferences: frequency, time of day and type of hygiene products. Assess for any
physical activity limitations. Assess patient’s oral cavity and dentition. thrush. Assess for signs of dehydration (dry
mucosa) and dental decay. Look at the lips for dryness or cracking. Assess patient’s ability to perform own care.

Possible Nursing
Diagnoses:
1. Impaired Oral Mucous
Membrane
2. Ineffective Health Maintenance

Materials:

Toothbrush, Toothpaste, Emesis basin, Glass with water, Disposable gloves, Towel, Mouthwash (optional), Washcloth
or paper towel, Lip lubricant, Dental floss

B. Directions: Provide your assessment findings/rationale on the box. You are rated based on the
performance rubrics.

PROCEDURE RATIONALE
CONCSCIOUS CLIENT
Preparatory Phase: To encourage participation and allows for individualized
1. Assess the client’s ability to brush the nursing care.
teeth and rinse the mouth.

2. Explain procedure to client and inquire Explaining procedure facilitates cooperation.

3. Wash Hands Hand hygiene prevents the spreading of microorganism.

4. Gather equipment and place overbed Avoids interrupting procedure or leaving patient unattended
table. to retrieve missing equipment.

5. Pull curtain or close room door Cleaning another person’s mouth is invasive and may be
embarrassing (Holman, et al., 2005). Closing the door or
curtains provides privacy.
6. Raise bed to a comfortable working Proper bed height helps reduce back strain while performing
position. Raise head of bed to position the procedure. The sitting or side-lying position prevents
in which client move to a position near aspiration of fluids into the lungs.
you.
7. Lower side rail and place towel on client The towel protects the patient from dampness.

8. Position overbed table within easy Organization facilitates performance of task. To prevent
reach and adjust height as needed. unnecessary movement and saves time.

9. Apply toothpaste to toothbrush and To be prepare and to begin the oral care.
hold toothbrush over emesis basin.

HYGIENE 1
 PROCEDURE RATIONALE
Performance Phase: Brushing action removes food particles between the teeth and
10. Brush inner and outer surfaces of along chewing surfaces and removes crusts and secretions
upper and lower teeth, always from mucosa.
brushing from gum onto crown of
each tooth. Brush one tooth at a time.
Clean biting surfaces of teeth also by
moving
bristles back and forth.
11. Hold brush at 45°angle and lightly The 45-degree angle of brushing permits cleansing of all
brush over surface and sides of surface areas of the tooth.
tongue. Avoid initiating gag reflex.

12. Allow client to rinse his mouth The vigorous swishing motion helps to remove debris.
thoroughly by taking several sips of Suction is appropriate if patient is unable to expectorate well.
water, swishing it across all tooth
surfaces, and spitting it into emesis
basin.
13. Allow client to gargle or rinse his Mouthwash leaves a pleasant taste in the mouth.
mouth with mouthwash.

14. Assist client in a comfortable position, To promote client comfort and safety.
remove bedside table, raise the side
rail, and lower bed to its original
position.
15. Wipe off overbed table, discard soiled Proper disposal of soiled equipment prevents spread of
linen and towels in appropriate infection and microorganisms.
container, and return equipment to
proper place.

16. Wash your hands. Hand hygiene prevents the spread of microorganisms.

17. Record and report procedure in Nurse’s Timely documentation helps ensure patient safety.
notes, mentioning specifically
condition or oral cavity.

UNCONCSCIOUS CLIENT
18. Explain procedure to client Even debilitated or intubated patients are usually able to hear.
Explanation can reduce anxiety.
19. Wash your hand Hand hygiene prevents the spreading of microorganisms.

20. Place towels on overbed table and Prevents soiling of tabletop. Equipment prepared in advance
arrange equipment. insures smooth and safe procedure. Supplies with reach create
organized workspace.
21. Pull curtain around bed or close. Cleaning another person’s mouth is invasive and may be
embarrassing (Holman, et al., 2005). Closing the door or
curtains provides privacy.
22. Raise bed to its highest horizontal level. Proper bed height helps reduce back strain while performing
Lower side rail. the procedure.

23. Position client on side near you. Make The side-lying position with head forward prevents aspiration
sure his head is turned toward the of fluid into lungs.
mattress.

24. Place towel under client’s face and Towel and emesis basin protects patient from dampness.
emesis basin under his chin.

25. Carefully separate client’s upper and Toothbrush provides friction necessary to clean areas were
lower teeth with padded tongue plaque and tartar accumulate.
blade.
 PROCEDURE RATIONALE
26. Clean client’s mouth using toothettes Repeated rinsing removes all debris and aids in moistening
or tongue blade moistened with mucosa. Suction removes secretions and fluids that collect in
mouthwash or water. Suction as posterior pharynx, thus reducing aspiration risk.
needed cleansing. Clean chewing and
inner surfaces first. Swab roof of
mouth and inside cheek and lips.
Swab
mouth to rinse. Repeat as needed.
27. Apply petroleum jelly to clients lip. Petroleum jelly lubricates lips to prevent drying and cracking.

28. Explain to client that you have Provides meaningful stimulation to unconscious or less-
completed the procedure. responsive patient.

29. Reposition client comfortably, raise It reduces the risk of falls from the bed.
side rail and return bed to its original
position.

30. Clean equipment and return it to Proper disposal of soiled equipment and cleaning the
proper place. Dispose soiled linen in equipment prevents the spread of infection.
“dirty” utility room.
31. Wash your hands Hand hygiene prevents the spread of microorganisms.

32. Record procedure in Nurse’s notes Timely documentation helps ensure patient safety.
mentioning pertinent observations.

FLOSS THE TEETH

References: (Kozier, Erb, Berman, & Snyder, 2014); (Nettina, 2006)

C. Write medical terms and abbreviations related to this procedure. Provide meaning for each.

Hygiene – conditions or practices conducive to maintaining health and preventing disease, especially through cleanliness.
Toothpaste - used to promote oral hygiene: it is an abrasive that aids in removing dental plaque and food from the teeth
Toothbrush - is an oral hygiene instrument used to clean the teeth, gums, and tongue. It consists of a head of tightly clustered bristles
emesis basin - shallow basin with a kidney-shaped base and sloping walls used in medical and surgical wards to receive soiled dressings and
other medical waste.
gag reflex - is a contraction of the throat that happens when something touches the roof of your mouth, the back of your tongue or throat, or
the area around your tonsils.
toothettes - are disposable, single-use oral care sponge swabs attached to a stick
suction- is almost always necessary to remove excess saliva and fluids during a dental procedure.
petroleum jelly - is a mixture of mineral oils and waxes, which form a semisolid jelly-like substance.
Floss - is a cord of thin filaments used to remove food and dental plaque from between teeth in areas a toothbrush is unable to reach.