Hygiene and Care in Dementia Nursing

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Questions and Answers

What is the maximum safe bathing temperature for patients aged 12 years and younger?

40 degrees

38 degrees (correct)

43 degrees

37 degrees

How often is preferred bathing recommended for patients in continuing care homes?

Three times a week

Twice a week (correct)

Daily

Once a week

When measuring bathing water temperature, what is the first step staff must take?

Monitor the temperature with a tent thermometer

Ask the patient if the temperature feels right

Adjust the water until it feels comfortable

Use a thermometer provided in the environment (correct)

Which of the following is a key reason for the safe bathing temperature policy?

To prevent harm to patients Signup and view all the answers

Which practice ensures patient comfort and dignity during bathing?

Using a bath blanket to cover exposed areas Signup and view all the answers

What skin condition commonly affects older adults, necessitating the use of moisturizers?

Xerosis Signup and view all the answers

What might trigger more frequent bathing for a patient?

Frequent incontinence Signup and view all the answers

What is the appropriate method for cleansing during a bath?

From clean to dirty areas Signup and view all the answers

When should gloves be used during patient bathing?

When cleansing the perineal and bottom area Signup and view all the answers

What type of care product might be used for perineal care?

Spray cleansers Signup and view all the answers

Why is it important to anticipate a patient's needs before bathing?

To avoid leaving the patient partially covered Signup and view all the answers

How do moisturizers benefit the skin of older adults?

They repair the skin barrier and increase hydration Signup and view all the answers

What technique should be used when washing limbs to promote circulation?

Long strokes from distal to proximal Signup and view all the answers

What should be done if the washcloth or water becomes cold or dirty?

Change the washcloth and water immediately Signup and view all the answers

What is a key benefit of using pre-moistened washcloths in patient bathing?

They require no drying of the patient Signup and view all the answers

How should communication be handled during the bathing process?

Communicating preemptively about each action Signup and view all the answers

What is the primary function of emollients?

To replenish oils in the skin surface Signup and view all the answers

How do humectants function in skin care?

They draw water from deeper skin layers Signup and view all the answers

Which factor is crucial for nurses to consider when monitoring urinary elimination in older adults?

Patient's age and developmental stage Signup and view all the answers

What could decreased muscle tone in the perineal floor indicate?

Increased risk of falls Signup and view all the answers

What color should normal urine ideally be?

Light yellow Signup and view all the answers

What abnormal characteristic of urine could indicate a potential health issue?

Heavy or noxious odor Signup and view all the answers

What role does the reduction in lumbar filtration rate have in urinary elimination for older adults?

It can increase urine concentration Signup and view all the answers

Which of the following findings might be considered unexpected in older adults regarding urinary elimination?

Increased thirst sensation Signup and view all the answers

What is typically included in early morning care?

Changing into clean clothes or gowns Signup and view all the answers

Which of the following hygiene care routines is emphasized in the afternoon?

Providing oral care and hand washing Signup and view all the answers

What is the primary goal of HS care?

Preparing the patient for sleep Signup and view all the answers

When might a partial bed bath be particularly necessary?

Following surgery Signup and view all the answers

What is one reason for providing hygiene care to patients, besides cleanliness?

To enhance patient appetite Signup and view all the answers

In routine care settings, how often might morning care occur?

Several times a week Signup and view all the answers

What is one principle related to hygiene care that should be applied?

Assessing skin integrity during care Signup and view all the answers

What might be included in HS care besides washing and oral care?

Changing into bedclothes Signup and view all the answers

What is the best approach if a patient feels cold during a bath?

Remove the patient from the bath and cover them with a warm blanket Signup and view all the answers

Which area is specifically advised against using soap during a bed bath?

Eye area Signup and view all the answers

What should be particularly assessed for a patient wearing an incontinence brief?

Skin condition in dependent areas Signup and view all the answers

What is one reason why the patient may not be able to mobilize effectively?

He is not drinking enough fluids. Signup and view all the answers

What is an important consideration when treating a patient with arthritis in terms of bath temperature?

Monitor temperature to avoid risks of scalding Signup and view all the answers

When collaborating with physiotherapy for an arthritis patient, what could be a beneficial treatment option?

Alternative therapies supervised by a physiotherapist Signup and view all the answers

Why is it important for the patient to have privacy during bowel movements?

To prevent embarrassing situations. Signup and view all the answers

During a bath, what approach ensures patient privacy and comfort?

Using curtains or screens around the bath area Signup and view all the answers

What dietary consideration might affect the patient's mobility?

Avoiding solid foods due to poor dentures. Signup and view all the answers

If a patient's bath water has cooled off significantly, what is the appropriate action?

Check the patient's condition and adjust care accordingly Signup and view all the answers

What action should the nurse take if the patient is suffering from constipation?

Administer a stool softener or laxative if ordered. Signup and view all the answers

How can the nurse assist the patient in achieving a proper squat position?

Ensure the patient has adequate abdominal muscle function. Signup and view all the answers

What would be an inappropriate method for warming a patient still in the bath?

Increasing the water temperature significantly Signup and view all the answers

What is one possible effect of not managing the patient's pain adequately?

Continued reluctance to mobilize. Signup and view all the answers

Which of the following strategies may help reduce the patient's risk of constipation?

Promoting regular bowel movement patterns. Signup and view all the answers

When Mrs. Hicks requests hotter water during her tub bath, what is the nurse's appropriate response?

Explain the need to adhere to temperature guidelines. Signup and view all the answers

Study Notes

Promotions and Integrity, Hygiene Care and Elimination and Continence Care

Patient Exemplar: Case study of 82-year-old female (Mrs. Hicks) resident in a long-term care facility with advancing dementia and osteoarthritis. She experiences urinary incontinence and dry, flaky skin.
Hygiene: Hygiene refers to practices of cleanliness conducive to health and well-being. It's fundamental to care and comfort, and nurses usually manage this. It involves bathing, feeding, toileting, and dressing independently.
Self-Care: A person's ability to perform personal care functions without assistance. Factors affecting self-care include illness, age, culture, mental health, and cognition.
Factors Affecting Elimination: Skin integrity, elimination, both urinary and bowel, and bathing practices are affected by functional ability and expected/unexpected findings in relation to personal hygiene.
Hygiene Practice Deficit: Mrs. Hicks has a hygiene deficit due to the impact of her urinary incontinence.
Additional Information Needed: Understanding of Mrs. Hicks' bathing preferences, factors related to her ability to perform hygiene tasks, access to resources, cultural practices, and any specific needs related to her advancing dementia, osteoarthritis, and incontinence. Relevant health assessments, including skin integrity, hydration and nutrition are required.
Bath Practices: Importance of regular bathing practices for healthy skin and its intimate nature. Considerations for personal preferences, independence, comfort, and safety. Different bathing environments, such as showers and bathtubs, may require adaptations due to health conditions. Patients' preferences for types of baths, such as sponge baths, or the use of particular equipment may also need to be considered.
Hygiene Care in Healthcare: A routine for hygiene care (early morning care, morning care, afternoon care, and nighttime care). This typically includes oral care, handwashing, elimination needs, and linen changes and may be adjusted as needed.
Patient Safety: Maintaining safety procedures during hygiene care, including maintaining warmth, providing privacy, and appropriately using gloves. Assessments and application of standard precautions are necessary.
Hygiene for Different Patients Specific needs for those with, for example, medical conditions, wounds, or religious or cultural guidelines for practices need to be taken into account.
Assessing Skin Integrity: Importance of skin integrity assessments before, during, and after bathing or other care procedures to detect any potential issues.
Correct Water Temperature: Care settings must adhere to safe water temperatures (38–43 degrees Celcius for adults and not exceeding 38 degrees for those 12 or younger). Thermomters should be used to ensure compliance.
Incontinence Products and Care: Using appropriate incontinence products to prevent or address hygiene issues may need to be part of a care plan, such as condom catheters or incontinence briefs.
Factors Affecting Urinary and Bowel Elimination: Factors such as age, medical conditions, medications, cultural/religious beliefs, and other issues.
Diagnostic Tests: Diagnostic tests when there are specific problems related to urination or bowels may include urinalysis, urine cultures, blood tests, x-rays, CT scans, and others. Keeping a bladder and bowel diary can help identify patterns.
Bristol Stool Chart: Categorising stool consistency and frequency, which can further aid in diagnosis of and monitoring issues related to bowels in patients such as Mrs. Hicks.
Safe Bathing Techniques: Providing correct techniques for different bathing situations including hand washing, body washing and perineal care for both males, females, and those with special needs. Ensuring proper cleansing techniques and rinsing to prevent the spread of infection.
Skin Repair The importance of moisture and cream, the types of creams, and how they help in skin repair (especially in older adults).

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Description

This quiz explores essential concepts in hygiene care and elimination practices, focusing on Mrs. Hicks, an 82-year-old female with dementia. It discusses the importance of self-care, skin integrity, and hygiene management in a long-term care setting. Test your knowledge on how these factors impact patient care and comfort.