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Hygiene 4.3

Terms in this set (22)

The skin
The serves several functions
-protects the body

-regulates temperature

-senses stimuli- skin contains sensory organs for touch, pain, heat, cold, and pressure

-excretion and secretion - excretion of sweat and secretion of sebum

maintains fluid and electrolytes
-produces and absorbs vitamin D
Factors influencing Skin Condition
Developmental
1.An infant's skin and mucous membranes are easily injured and subject to infection.
2.A child's skin becomes increasingly resistant to injury and infection.
3.An adolescent's skin ordinarily has enlarged oil glands caused by hormonal changes in the body.
4.Secretions from the skin glands are at their maximum during adolescence and up to about 50 years old.
5.Changes that occur in the skin with aging are irreversible. The skin becomes thinner & less elastic & less supple with aging
Basic Principles that guide practices to skin care
Knowledge of the functions of the skin and of factors affecting it includes an understanding of certain basic principles that become important in the care of the skin:
1.Unbroken, healthy skin and mucous membranes serve as the first line of defense against harmful agents.
2.Resistance of the skin and mucous membranes to injury varies among people.

Factors influencing resistance include:
1.Age
2.Amount of underlying tissues
3.Illness conditions
4.Adequately nourished and hydrated body cells are resistant to injury.
5.The better nourished the cell, the better its ability to resist injury and disease
6.Adequate circulation is necessary to maintain cell life.

The cells are inadequately nourished and wastes are poorly removed when circulation is impaired for any reason
asses the integumentary system and adequacy of self-care hygiene
Each each patient needs to be assessed for adequacy of self hygiene and self-care ability to determine if a patient can adequately perform self hygiene given the current state of health or mental health.
Factors of Personal hygiene practices
Personal hygiene can be affected by cultural differences the state of a person's health or personal preferences
Hygiene scheduling in Hospital setting
...1.Early Morning Care is provided shortly after waking and includes assisting with toileting and measures to get the patient ready for breakfast. The patient's hands and faced are washed and mouth care is provided.
2.Morning Care is provided after breakfast is finished. Morning care may be self-care for a patient capable of managing hygiene independently, partial-care for a patient who is only capable of managing parts of the bath, or complete-care for the patient who requires nuring assistance with all aspects of hygiene care.
3.Afternoon Care (PM care) allows the patient to be refreshed after lunch. Provide opportunity for toileting, hand washing, oral care, straightening the linens, and a clean gown if necessary.
4.Hour of Sleep Care is provided as preparation for sleep. Again, provide the opportunity for toileting, washing hands and face, oral care, and backrub. Make sure that the call light and other objects such as a urinal are close at hand.
5.PRN care is providing whatever is necessary when the need occurs.
Describe priorities of scheduled hygienic care
A patient's condition influences your priorities for hygienic care.

For example a seriously ill patient usually needs a daily bath because body secretions accumulate.

Hygiene is based on the need of the individual patient
Distinguish between the different classifications of hygiene assistance required
A. Self care - can safely and effectively perform own self hygiene

B. Partial care - Can safely perform portions of some self hygiene but require some assistance for other aspect

C. Complete care - cannot perform any aspects of hygiene care due to condition or illness etc.
Purposes of bathing
Purposes of Bathing

Bathing serves a variety of purposes including:
1.Bathing cleanses the skin and decreases the number of micro-organisms on the skin. This is especially important for the hospitalized, ill person who is often sweaty and may have severe breaks in their skin due to invasive procedures or surgical incisions.
2.Bathing acts as a skin conditioner.
3.Bathing helps to relax a restless person.
4.Bathing promotes circulation.
5.Bathing serves as musculo-skeletal exercise
6.Bathing stimulates the rate & depth of respiration.
7.Bathing promotes comfort.
8.Bathing provides the person with sensory input.
9.Bathing improves self-image.
10.Bathing gives the nurse an excellent opportunity to get to know the Patient. It's a good time for social interaction and to establish rapport.
11.Bathing provides a convenient time to assess the skin, joint mobility, etc.
12.During a bath is an excellent opportunity to teach health care practices..



Untoward effects of bathing
1.Giving a bath takes about 30 minutes per patient.
2.Daily baths can dry out the skin. Moist skin is less prone to breakdown & heals faster
Shower & tub baths
Using a shower or a tub is the preferred method of bathing ambulatory patients. Even though patients can do this on their own, the nurse still has some responsibilities, which include:
1.Check that the bathroom is available, clean and safe.
2.Make sure the patient has the necessary supplies
3.Provide a place for a weak person to sit in the shower.
4.Check bath water for a safe temperature.
5.Provide assistance getting in & out of the tub as needed.
6.Ensure privacy but be sure the call light is easily assessible.
7.Keep the bathroom door unlocked.
Bed Bath
Some patients must remain in bed as part of their treatment, but they are able to bathe themselves. Others depend on the nursing staff to provide all of their hygiene care.

The nurse can help the patient who is able to bathe by:
1.Providing the articles necessary.
2.Providing privacy.
3.Providing a mirror.
4.Assist with any hard to reach spots.

Towel Baths or lotion baths use a quick-drying solution containing a cleaning agent, disinfectant, and a softening agent mixed with water. When using these commercial products, be sure to follow the hospital procedures and manufacturer's directions.
Oral hygiene care
A. Conscious - the patient is able to perform mouth care the nurse needs to be sure to provide the necessary equipment

B. Unconscious - it is important to wear gloves enroll the patient to prevent aspiration use a minimum amount of liquid to prevent choking
Denture care
Dentures should be worn for as long as possible. When Dentures are removed they should be place in a clearly marked denture cup and placed in the patient's bedside drawer. Do not wrap the dentures in tissue or a napkin because they can be easily discarded Dentures should be stored in water to prevent drying and warping.

Pictures of very costly and break easily they must be handled carefully. Wash dishes with warm water over the sink
Cleaning the eye
Use water no soap in a clean washcloth to clean the eyes. Position the patient so that water runs away from the eye. Wipe from inner to Outer. Use a clean section of cloth with each wipe
Hair care
Writing sample in the hospital requires a doctor's order shampoo as often as necessary to maintain cleanliness

Cutting of hair requires a doctor's order and patient needs to sign a permit.

An electric shaver is recommended when a patient is on anticoagulant therapy or has a bleeding disorder
Perineal care
If the patient's condition allows it encourage patient to perform self perineal care.

Perineal care from a healthcare provider should be in a matter-of-fact manner and should be done from least contaminated area to the most contaminated area.
TED stockings
Ted stockings must be removed every day during morning care in the skin must be assessed. The legs are to be washed and then the stockings are to be reapplied prior to the patient getting out of bed do not massage your legs if a clot is present this may cause it to break away
Back rub
A backrub generally follows the band stimulates relaxation circulation and give the nurse a chance to check the back for skin breakdown. Use lotion for massaging unless contraindicated. Back rub should take about 4 to 6 minutes.
Hospital bed safety
Locks on the wheels
Side rails
Removable head for cpr and access to patients head.
Water repellent mattresses
Bed making
See Pages 851 and 852
Bedside unit
The bedside unit at the furniture and equipment in the space surrounding the patient's bed.

The bed
Over bed table
Bedside stand
Chairs
Safe bedside unit
1. Call light functioning and always easy in reach
2. Bed in lowest position
3. At least one side rail up so that the patient can reach bed controls
4. Uncluttered walk space
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