Assessing Mouth, Throat, Nose and Sinuses

Student: Date:___________________

Client: __________________________________

Nursing Interview Guide to Collect

Subjective Data From the Client
Questions Findings
Current Symptoms
1. Mouth problems (tongue or mouth
sores or lesions, gum or mouth
redness, swelling, bleeding, or pain)?
2. Sinus problems (pain over sinuses,
postnasal drip)?
3. Nose problems (nosebleeds, stuffy
nose, cannot breath through one or
both nostrils, change in ability to
smell or taste)?
Past History
1. Previous problems with mouth,
throat, nose, or sinuses (surgeries or
treatment; how much and how
often)?
2. Use of nasal sprays?
3. History of tooth grinding?
4. Last dental exam? Fit of dentures?
Family History
1. Family history of oral, nasal, or sinus
cancer or chronic problems?
Lifestyle and Health Practices
1. Daily practice of oral care, tooth
care, or denture care?
2. Usual diet?
3. History of smoking, use of, how
much, and how often?
4. Use of alcohol (how much and how
often)?