An adult client is admitted with AIDS and oral candidiasis manifested by several painful mouth ulcers. The nurse delegates oral care to the unlicensed assistive personnel (UAP) and discusses how to assist the client. Which instruction should the nurse provide the UAP?

Choice A reason: Offering mouthwash may irritate painful candidiasis ulcers in AIDS, as alcohol-based solutions exacerbate discomfort. While cleansing is important, a soft-bristled toothbrush is gentler, effectively cleaning without worsening mucosal damage, making this choice less appropriate for oral care.

Choice B reason: Providing a soft-bristled toothbrush is correct, as it gently cleans the mouth without irritating painful candidiasis ulcers in AIDS. Soft bristles minimize trauma to inflamed mucosa, promoting hygiene and comfort, making this the best instruction for safe and effective oral care by the UAP.

Choice C reason: Leaving oral care to the nurse is unnecessary, as UAPs can perform oral hygiene with proper instruction. Delegating soft-bristled toothbrush use ensures safe care for candidiasis, and reserving this task for nurses limits efficiency without clinical justification, making this choice incorrect.

Choice D reason: Wearing sterile gloves is excessive, as candidiasis is opportunistic, not requiring sterile technique. Standard precautions with clean gloves suffice for oral care in AIDS, as sterile gloves are reserved for invasive procedures, making this instruction inappropriate for routine mucosal cleansing.

Choice A reason: Avoiding gluten is specific to celiac disease, not Crohn’s, which involves inflammatory bowel disease without gluten sensitivity. Gluten restriction does not address Crohn’s mucosal inflammation, and this instruction misguides the client, as dietary triggers vary, requiring individualized management.

Choice B reason: Restricting fluids is incorrect, as Crohn’s patients need adequate hydration to manage diarrhea and prevent dehydration. Fluid restriction exacerbates electrolyte imbalances, worsening symptoms, making this an inappropriate recommendation for Crohn’s dietary management, which focuses on symptom-specific adjustments.

Choice C reason: Limiting calcium and iron is not standard for Crohn’s, as these nutrients support bone health and anemia prevention, common concerns in inflammatory bowel disease. This restriction could worsen deficiencies without addressing inflammation, making it an incorrect dietary focus for Crohn’s.

Choice D reason: Recommending a personalized diet plan with a dietitian is correct, as Crohn’s dietary triggers vary, requiring tailored plans to avoid exacerbating inflammation. Dietitians identify specific irritants, like high-fiber foods, ensuring nutritional balance while minimizing symptoms, making this the best approach for effective management.