Recognizing oral candidiasis
Creamy white plaques that scrape off and leave a red base are the typical appearance of oral candidiasis (thrush). Clients receiving chemotherapy and radiation to the head and neck are at high risk because of immunosuppression, mucosal damage, and reduced saliva, and a denture provides a surface where the fungus can grow. Nystatin oral suspension is a topical antifungal that acts only where it touches the infected tissue.
How to take nystatin suspension
Because nystatin acts on contact, the denture is removed first, and the suspension is swished for at least 1 to 2 minutes so it stays in contact with the plaques, then swallowed. The client removes the denture so the drug can reach the palate, which the denture covers, and so the denture does not reinfect the mouth. The denture is cleaned and disinfected, for example soaked according to instructions, and kept out of the mouth while the drug is in contact. The client avoids eating or drinking for a short time after the dose to prolong contact.
| Option | Denture | Swish time | Verdict |
|---|
| 1 | Kept in: blocks the palate | 1–2 minutes | Wrong |
| 2 | Removed | A few seconds: too short | Wrong |
| 3 | Kept in | A few seconds | Wrong |
| 4 | Removed | 1–2 minutes, then swallow | Correct |
Why both details matter
Each wrong option fails on one or both details. Keeping the denture in prevents the drug from touching the palate, where the plaques are, and leaves a reservoir of fungus on the denture surface. A brief swish of a few seconds does not give enough contact time for a drug that is barely absorbed and works only locally. Swallowing after swishing lets the drug also treat any infection in the throat and esophagus.
Watch out! Options 1 and 4 share the correct swish time; options 2 and 4 share denture removal. Only option 4 combines both, so check every part of a two-part answer.
Exam takeaway
The nurse also reinforces mouth care for mucositis, teaches the client to clean the denture daily, and checks that the plaques are resolving. Key point! For nystatin suspension, remove and disinfect the denture, swish for at least 1 to 2 minutes, then swallow.