Chapter 26: Hygiene

Chapter 26: Hygiene

Copyright © 2003, Mosby, Inc. All rights reserved.

1

Scientific Knowledge Base • Good physical hygiene is necessary for comfort, safety, and well being. • Ill clients require assistance with personal hygiene. • Several factors influence a client’s hygiene practices.

Copyright © 2003, Mosby, Inc. All rights reserved.

2

The Skin • Functions of the skin: protection, secretion, excretion, temperature regulation, and sensation • Three layers – Epidermis: shields underlying tissue – Dermis: contains nerves, vessels, and glands – Subcutaneous tissue: insulates and cushions skin Copyright © 2003, Mosby, Inc. All rights reserved.

3

Feet and Nails • The feet and nails require special attention. • Discomfort causes stress and pain. • The normal nail is transparent, smooth, and convex with a pink nail bed and white tip. • Changes in shape, thickness, and curvature can occur.

Copyright © 2003, Mosby, Inc. All rights reserved.

4

Oral Cavity and Teeth • Mucous membranes • Oral mucosa is light pink and moist

Copyright © 2003, Mosby, Inc. All rights reserved.

5

Nursing Knowledge Base • Personal preferences for hygiene • Hygiene care is never routine • During hygiene – – – –

Assess physical status and limitations Assess client’s readiness to learn Provide privacy Foster physical well being

Copyright © 2003, Mosby, Inc. All rights reserved.

6

Factors Influencing Hygiene • Body image – A person’s subjective concept of their appearance

• Social practices – Social groups and family practices

• Socioeconomics • Cultural variables Copyright © 2003, Mosby, Inc. All rights reserved.

• Personal preferences – Frequency – Preferred products

• Physical condition – Lack of physical energy – Loss of dexterity

• Knowledge about importance of hygiene 7

8

9

10

11

• How about scabies?

12

• Is a contagious skin infestation by the itch mite • Burrow by female mite- penetrates into the upper layer of skin • Burrow are shory wavy brown or black, threadlike lesions • Find between fingers, in the creases of the wrists and elbow, beneath the breast tissue and in the groin area • Intense itching, worse at night- secondary lesions • Scabicide lotion, linens and clothing should be washed in very hot or boiling water

13

Hygiene • • • •

Bathing Oral hygiene Dressing/ grooming Toileting

14

15

Bathing and Skin Care • Tub or shower – More thorough than bed bath

• Complete bed bath – For clients who are dependent and require total hygienic care

• Partial bed bath – Involves bathing only those parts that would cause discomfort or odor if left unbathed Copyright © 2003, Mosby, Inc. All rights reserved.

16

Bathing • Therapeutic bath – Physical effect – E.g. skin or perineum

17

18

19

20

21

Perineal Care • Part of the bed bath • Clients most in need are those with secretions or Foley catheters and following rectal surgery or childbirth • Be alert to discharge, skin irritation, and odors • Good perineal care prevents skin irritation and breakdown Copyright © 2003, Mosby, Inc. All rights reserved.

22

Feet • Corn- avoid pressure • Planter warts – Virus papovavirus hominis – Currettage, freeze with solid carbon dioxide, apply salicylic acid

• Fissures – Good foot hygiene – Application of an antiseptic to prevent infection

• Tinea pedis – Antifungal ointment

• Ingrown toe nail – Proper nail trimming 23

Foot and Nail Care • Soak and soften cuticles. • Cleanse and dry the feet thoroughly. • Trim nails straight across (check agency policy regarding trimming of nails). • Inspect for lesions, dryness, and signs of infection. • Clients with DM (Diabetes Mellitus)or PVD (Peripheral Vascular Disease) are at risk for impaired circulation.

Copyright © 2003, Mosby, Inc. All rights reserved.

24

Nails • Avoid trimming or digging into nails at lateral corners

25

Oral Hygiene • Involves cleanliness, comfort, and moisturizing the mouth • Unconscious client • Flossing and brushing • Denture care

Copyright © 2003, Mosby, Inc. All rights reserved.

26

Hair • • • •

Dandruff Hair loss Ticks, lice, scabies Hirsutism

27

Hair Care • Brushing and combing • Brushing/combing hair from scalp to end • Shampooing

Copyright © 2003, Mosby, Inc. All rights reserved.

28

Shaving • • • •

Facial hair Electric razor Refer to the client’s normal routine Never shave off a mustache or beard without the client’s consent

Copyright © 2003, Mosby, Inc. All rights reserved.

29

Eyes • Contact lens – Refer to book for removing of the contact lens – Soft lens- use the pads of the thumb and index finger

• General eye care • Eyes care for the comatose client – – – –

cleaning Moist compress Protective shield Continuous monitoring 30

Ears • • • •

Avoid bobby pins and cotton- tip applicator Retracting the auricle up and back Irrigating Proper usage and care of hearing aids – – – – –

Behind- the- ear (BTE) In- the- ear (ITE) In- the- canal (ITC) Eyeglasses Aid Body hearing aid 31