General
What Factors Influence Hygiene Practices?
Personal Preferences
Culture and Religion or Spirituality
Economic Status or Living Environment
Developmental Level
When should you not help a patient with foot / nail hygiene
Diabetes patient
Benefits to bathing a patient
Ability to assess: skin, hair, nails, ROM, mobility, cognitive ability, pain
Opportunity for therapeutic communication
Strengthen patient nurse relationship
Helps circulation
Promote comfort
After you have cleaned a prosthetic eye, should you dry it before reinserting it, or leave it wet?
Leave it wet so it will slide in more easily.
The donts of bed making
Don’t shake linens
Don’t place soiled linens on floor
Don’t hold soiled linens close to body
How Does Health Status Affect Self-Care Ability?
Limited Mobility
Sensory Deficits
Pain
Cognitive Impairment
Emotional or Other Mental Health Disturbances
Changes in skin as we age
both layers of the skin become thinner and more fragile.
collagen and elastin fibers in the dermis deteriorate
Sebaceous and sweat gland activity decreases,causing the skin to become dry, scaly, and itchy,and temperature regulation in hot weather becomes more difficult.
number and activity of hair follicles and pigment cells (melanocytes)diminish, hair becomes thin, turns gray or white,and grows more slowly.
Nails thicken and growth decreases.
Types of baths
Shower or tub
Bed bath
Disposable bag or packaged bath (8-10 cloths, different cloth for each spot)
Help (assist) bath - hard to reach areas
Partial bath - "bird bath" only spots that are absolutely necessary and perineum
Complete bath - totally done by nurse
What direction should eyes be cleaned in
From the outer to the inner canthus.
Steps for making an unoccupied bed
Place blue linen bag near bed
Gloves
Remove dirty sheets/pillow cases
Place dirty linen in appropriate place
Discard dirty gloves and wash hands
Place clean linen on bed, make one side completely, then move to other side.
Miter corners
What are the routine types/ times of scheduled care
Early morning care soon after the patient awakens to prepare the patient for breakfast or other activities, such as diagnostic tests. As needed, assist with toileting, washing the face and hands, giving mouth care, and providing comfort measures.
AM care after breakfast. Depending on the patient’s self-care ability, assist with toileting, bathing, oral hygiene, skin care, hair care (including shaving if needed), dressing, and positioning or helping the patient transfer to a chair. Change or straighten bed linens, according to agency policy, and tidy the room.
PM care preparing patients for afternoon rest or to receive visitors. As needed, assist non-ambulatory patients with toileting, hand washing, and oral care; straighten bed linens; reposition the patient; and offer other comfort measures (e.g., pain medications)
HS care (promote relaxation before bed)ame care as given in the afternoon, adding a back massage to help relax the patient. Also place within easy reach the call light, water glass, urinal, or anything else the patient may need during the night. Turn off lights and TV and close the door before leaving the room
Anti-embolism stockings, what are they and what do they do
Elastic stockings that may extend foot to knee or knee to thigh
Compress the veins of the legs to increase venous return to the heart
MD order
Prebath assessment
Ability to perform self care
Position restrictions
Number of people needed to bathe patient
Personal and cultural issues regarding bathing
What are the two most common problems affecting the teeth?
Dental caries and periodontal disease
Protecting patient privacy for perineal care
• Drape the patient with a bath blanket, exposingonly the area needed.
• Pull privacy curtains around the bed.
• Close the door.
•Hang a sign on the door signaling visitors to avoidentering the room (e.g., Do Not Disturb)
What are we talking about with "Beds & Activities of daily living?"
Bed making
Promoting self care
Activities involved in personal grooming and cleanliness
What are Sequential Compression Devices and their purpose
Cuffs that surround lower legs : alternate inflating and deflating, worn only in bed
Promotes venous return
For perineum care which direction do you clean?
front to back
How often should dentures be cleaned?
Same amount as natural teeth (2x daily)
When will a patient need an electric razor
Condition that predisposes him to bleeding or infection
Nurses role in ADLS
Assessing self care ability
Providing assistance
Promoting self care - for independence
Delegating appropriate parts of hygiene care
Risks for impaired skin
Poor nutrition
Skin dampness
DehydrationInsufficient circulation
Skin disease
Immobility
Systemic diseases
AgeWhat are the advantages of a towel or bag bath?
Rinsing and drying are unnecessary, so it is quick,making efficient use of the nurse’s time.
• It is a preferred method for patients who have mildto moderate Impaired Skin Integrity or Activity Intolerance and for persons who have dementia.
• Cleanliness is satisfactorily achieved with thistechnique.
• A bag bath with no-rinse cleanser may be less dry-ing to the skin than a traditional bath with soapand water
Describe oral care for unconscious patient
Place patient on side to prevent aspiration
May use a special type of applicator that has suction device attached
Do not put your finger in patient mouth
What should you do before removing patients hearing aide
Turn it off