During the assessment of a client’s mouth, the nurse notes the absence of saliva. The client is also complaining of pain near the area of the ear. The client has been NPO for several days because of the insertion of a NG tube. Based on these findings, the nurse suspects that the client is developing which of the following mouth conditions?
A. Stomatitis
B. Oral candidiasis
C. Parotitis
D. Gingivitis
Correct Answer: C. Parotitis
The lack of saliva, pain near the area of the ear, and the prolonged NPO status of the client should lead the nurse to suspect the development of parotitis, or inflammation of the parotid gland. Parotitis usually develops in cases of dehydration combined with poor oral hygiene or when clients have been NPO for an extended period. Preventative measures include the use of sugarless hard candy or gum to stimulate saliva production, adequate hydration, and frequent mouth care.
Option A: Stomatitis (inflammation of the mouth) produces excessive salivation and a sore mouth. Stomatitis may involve swelling and redness of the oral mucosa or discrete, painful ulcers (single or multiple). Less commonly, whitish lesions form, and, rarely, the mouth appears normal despite significant symptoms. Symptoms hinder eating, sometimes leading to dehydration and malnutrition. Secondary infection occasionally occurs, especially in immunocompromised patients.
Option B: Oral candidiasis or thrush is an infection of the oral cavity by Candida albicans. Oral candidiasis is generally obtained secondary to immune suppression, whether a patient’s oral cavity has decreased immune function or if it is systemic. This immunosuppression is dose-dependent.
Option D: Gingivitis is an inflammatory condition of the gingival tissue, most commonly caused by bacterial infection. Unlike periodontitis, there is no attachment loss and therefore no migration of the junctional epithelium. The condition is restricted to the soft-tissue area of the gingival epithelium and connective tissue.
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