Chapter 24: Hygiene

1. Chapter 24: Hygiene

2. General Concepts Related to Hygiene • Activities involved in personal grooming and cleanliness • Activities of daily living (ADLs) • Bathing • Showering • Combing hair

3. General Concepts Related to Hygiene (cont’d) • Maintenance of personal hygiene • Promotes comfort • Improves self-image • Decreases infection and disease

4. Nursing Role • Assess self-care abilities • Provide assistance with ADLs • Promote self-care in ADLs • Delegate appropriate parts of hygiene care

5. Factors That Influence Hygiene and Self-Care Practices • Psychosocial factors • Personal preferences • When to bathe, what products to use • Culture and religion • Beliefs about hygiene and cleanliness

6. Factors That Influence Hygiene and Self-Care Practices (cont’d) • Economic status • Availability of facilities • Monetary constraints • Developmental level • Parents, media, peers, age • Knowledge level

7. Factors That Influence Hygiene and Self-Care Practices (cont’d) • Physical factors: health status • Pain: limits mobility and energy • Limited mobility: decreased range of motion, weakness, bedrest • Sensory deficits: decreased independence and increased safety concerns

8. Factors That Influence Hygiene and Self-Care Practices (cont’d) • Physical factors: health status (cont’d) • Cognitive impairments • Cannot determine need for hygiene • Cannot problem-solve ADL processes • Forgets when last performed hygiene and ADLs • Emotional disturbances • Profound lack of energy for ADLs • Altered reality does not include hygiene

9. ClickerCheck Which factor would be most likely to influence the hygiene practice of the homeless client? A. The client’s degree of mental illness B. The client’s cultural beliefs C. The client’s living environment D. The client’s knowledge level

10. Correct answer: C The homeless client may have no access to facilities in which to perform routine hygiene measures.

11. Types of Scheduled Hygiene Care Routine hygiene care in the in-client facility • Early morning care: on awakening – wash face and hands, mouth care • A.M. care: after breakfast – bathing, toileting, hair, skin, bedmaking

12. Types of Scheduled Hygiene Care (cont’d) • P.M. care: afternoon – toileting, hand washing, oral care, readying for visitors • H.S. care: prior to sleep – relaxation activities, readying environment to facilitate sleep

13. Delegating Hygiene Care • Assess prior to delegating • Instruct NAP regarding • Client’s limitations • Amount of assistance needed • Use of assistive devices • Presence and care of tubes • Observations to make during hygiene care

14. Major Areas of Hygiene Care: Bathing Bathing a client facilitates • Assessment of the integumentary system • Color: pallor, erythema, jaundice • Conditions that affect the skin: maceration, pruritus, acne • Alterations in skin integrity: abrasions, pressure ulcers

15. Major Areas of Hygiene Care: Bathing (cont’d) Bathing a client facilitates (cont’d) • RN assessment of client’s functional abilities and status

16. Common Types of Baths • Assist bath • Bathe areas hard to reach • Partial bath • Bathe only those areas absolutely necessary, including perineum • Bed bath • Complete • Partial • Help bath

17. Other Types of Baths • Towel bath • Bag or packaged bath • Shower • Tub bath • Therapeutic bath

18. ClickerCheck The confused client becomes distressed and agitated when the NAP attempts to give the morning bath. The nurse instructs the NAP to complete a A. Partial bath B. Help bath C. Bed bath D. Complete bath

19. Correct answer: A The intent of the partial bath is to cleanse only the areas in most need of hygienic care. The nurse would continue to monitor the client’s emotional/cognitive status and alter the type of bath accordingly.

20. Major Areas of Hygiene Care: Oral Care Oral care facilitates • Removal of food particles and secretions • Improved appetite • Assessment of client’s oral status • Care of dentures

21. Major Areas of Hygiene Care: Oral Care (cont’d) Oral care facilitates (cont’d) • Assessment of the oral cavity • Condition of the teeth, cavities, gingivitis • Conditions affecting the mouth: stomatitis, glossitis, oral lesions/malignancies

22. ClickerCheck When providing oral care for the unconscious patient, the nurse should A. Place the patient on his side with the head of the bed in a lowered positionB. Skip brushing the teeth as the patient could aspirateC. Swab the patient's lips and oral cavity with lemon glycerin swabs at least hourlyD. Place the patient in an upright position and brush his teeth with a sponge brush

23. Correct answer: A To facilitate oral hygiene and protect the patient's airway, the nurse should keep the patient on his side with his head lower than his stomach.

24. Other Hygiene Care Areas • Care of the feet • Special considerations for care of the diabetic client • Care of the nails • Hair care • Special considerations for cultural variations in hair • Care for mustaches and beards

25. Hair Care

26. Other Hygiene Care Areas (cont’d) • Care of theeyes • Special considerations for clients with contact lenses • Care of an artificial eye • Care of theears • Care of a hearing aid

27. Think Like a Nurse Suppose you have been providing towel baths to a patientwho hasmild dementia. One day a visiting family member says, “My father tells me that he has not had a bath all week. What’s going on here?” What would you do? How could you help to prevent this misunderstanding in the future?