Chapter 17 Personal Hygiene PDF

# Chapter 17 Personal Hygiene ## Personal Hygiene (1 of 5) - Promotes comfort, safety, and health - Includes activities to clean the skin, mouth, genital area and anus - Intact skin and mucous membranes: - Are the body's first line of defense against disease - Prevent microbes from entering...

# Chapter 17 Personal Hygiene ## Personal Hygiene (1 of 5) - Promotes comfort, safety, and health - Includes activities to clean the skin, mouth, genital area and anus - Intact skin and mucous membranes: - Are the body's first line of defense against disease - Prevent microbes from entering the body and causing an infection ## Personal Hygiene (2 of 5) - Good hygiene: - Cleanses the body - Prevents body and breath odours - Is relaxing - Increases circulation ## Personal Hygiene (3 of 5) - Support workers help clients with personal hygiene - Some clients require minimal help - Others may need all hygiene are done for them - Illness, disability, and changes associated with aging may affect the client's ability to practice hygiene independently. - Culture and personal choice also effect hygiene. ## Personal Hygiene (4 of 5) - Factors affecting hygiene and skin care: - Perspiration, elimination, vomiting, drainage from wounds or body openings, bed rest, and activity - Client's care plan identifies the personal hygiene measures for your client - Follow the nurse's directions and the care plan - See textbook box: Respecting Diversity: Personal Hygiene Practices of Different Cultures ## Personal Hygiene (5 of 5) - Daily care: - Most people have hygiene routines and habits - Routine care is given during the day and evening - AM care: early morning care (before breakfast); morning care (after breakfast) - Afternoon care: after lunch, before evening meal - HS care (PM care or evening care) before sleep - You assist with hygiene whenever it is needed. - Your client may feel frustrated, angry, or embarrassed because of needing help with personal care-always promote DIPPS. ## Oral Hygiene (1 of 2) Oral hygiene (mouth care) does the following: - Keeps the mouth and teeth clean - Prevents mouth odours, infections, cavities (dental caries) - Increases comfort - Makes food taste better - Prevents periodontal disease (gum disease, pyorrhea)-inflammation of tissues around the teeth - Oral care is given on awakening, after each meal, and at bedtime. ## Oral Hygiene (2 of 2) - Dry mouth is common as a result of: - Oxygen administration - Smoking - Decreased fluid intake - Mouth breathing - Anxiety - Medications - The mouth contains many microbes-always wear gloves and follow Standard Practices when providing mouth care to clients. ## Equipment - Oral hygiene: - Toothbrush - Toothpaste - Dental floss - Mouthwash - For clients with dentures: - Denture cleaner - Denture cup - Denture brush/toothbrush ## Observations for Oral Hygiene After giving oral hygiene, report and record: - Dry, cracked, swollen, or blistered lips - Bleeding, redness or swelling of the gums, irritation, sores, or white patches in the mouth or on the tongue - Missing or loose teeth - Rough, sharp, or chipped areas on dentures - Complaints of pain or discomfort - Difficulty swallowing or speaking - Foul breath - Presence of food or foreign objects ## Brushing Teeth (1 of 2) - Many clients perform oral hygiene themselves. - Some clients need help gathering and setting up equipment. - Encourage the client to be as independent as possible. - You may have to brush the teeth of clients who: - Are very weak - Cannot use or move their arms - Are too confused to brush their teeth ## Brushing Teeth (2 of 2) - Brushing a child's teeth - Children should start brushing teeth at the age of 3 years. - Children 3-6 years should be given toothpaste containing fluoride (size no bigger than a pea) with each brushing. - Older children can do a thorough job, but may need to be reminded to brush. ## Flossing - Flossing: - Removes plaque and tartar from the teeth - Removes food from between the teeth - Is preventative-do at least once per day - See textbook boxes: - Focus on Children: Flossing - Focus on Older Persons Flossing - See textbook procedure: Flossing a Client's Teeth ## Mouth Care for an Unconscious Client (1 of 4) - Unconscious clients may have mouth dryness and crusting on the tongue and mucous membranes - The care plan tells you what cleaning agent to use - Use sponge swabs to apply the cleaning agent. - Applying a lubricant to the lips after cleaning prevents cracking of the lips. - Check the care plan. - Follow agency policy and your scope of practice to be sure you are can provide this type of care. ## Mouth Care for an Unconscious Client (2 of 4) - Protect unconscious clients from choking and aspiration (breathing fluid, food, vomitus, or an object into the lungs): - Position the client on one side with the head turned well to the side. - Use only a small amount of fluid to clean the mouth. - Do not insert dentures. - Keep the client's mouth open with a padded tongue blade. - Always assume that unconscious clients can hear. - Mouth care is given at least every 2 hours - Follow the nurse's directions and the care plan. ## Mouth Care for an Unconscious Client (3 of 4) - A graphic showing a caregiver providing mouth care to an unconscious client ## Mouth Care for an Unconscious Client (4 of 4) - Two graphics showing the process of applying cleaning agents to a swab. ## Denture Care (1 of 2) - Dentures are a set of artificial teeth - Complete and partial dentures are common. - Mouth care is given and dentures are cleaned as often as natural teeth. - Dentures are slippery when wet. - To use a cleaning agent, follow the manufacturer's instructions. ## Denture Care (2 of 2) - Hot water causes dentures to lose their shape (warp). - Remind clients and residents not to wrap dentures in tissues or napkins. - You clean dentures for those who cannot do so themselves. - Follow agency policies regarding cleaning dentures. - See textbook procedure: Providing Denture Care ## Bathing (1 of 2) - Bathing has the following benefits: - Cleans the skin-removes microbes, dead skin, perspiration, excess oils - Cleans the mucous membranes of the genital and anal areas - A bath is refreshing and relaxing - Circulation is stimulated and body parts are exercised - Observations are made - You have time to talk to the person ## Bathing (2 of 2) - Complete or partial baths, tub baths, or showers may be given. - The bathing method depends on: - The client's condition - Self-care abilities - Personal choice - The client's choice of bath time is respected whenever possible. - Bathing frequency is a personal choice or employer policy. - Weather, physical activity, and illness may also affect bathing frequency. ## Observations for Bathing a Client - Report and record the following: - Colour of skin, lips, nail beds and sclera (whites of the eyes) - Location and description of rashes - Dry skin - Bruises or open skin areas - Pale or reddened areas - Drainage or bleeding from wounds or body openings - Swelling of the feet and legs - Corns or calluses on the feet - Skin temperature - Complaints of pain or discomfort ## The Complete Bed Bath - Involves washing the client's entire body in bed. - Bed baths are usually needed by clients who are: - Unconscious - Paralyzed - In casts or traction - Weak from illness or surgery - This may be a new experience for many clients-it may cause embarrassment, feelings of loss of privacy. - See textbook procedure: Giving a Complete Bed Bath ## Towel Baths and Bag Baths - For a towel bath, an oversized towel is used - Covers client's body from neck to feet - Bath towel is saturated with a cleaning solution – quick and soothing - Bag baths are commercially prepared or prepared at the agency - 8-10 washcloths are moistened with a cleaning agent that does not require rinsing - Before use, they are warmed in microwave ## The Partial Bath - Involves bathing the face, hands, axillae (underarms), back, buttocks, and perineal area - Some clients bathe themselves in bed or at the sink. - You assist as needed. ## Tub Baths and Showers (1 of 3) - Tub baths and showers - Falls, burns, and chilling from water are risks. - Safety is important. - Protect the client's privacy. - Tub bath should be no longer than 20 minutes. - Follow the nurse's directions and the care plan. ## Tub Baths and Showers (2 of 3) - Safety with a tub bath or shower: - Be alert—the client may become faint, weak, or very tired during the bath. - The tub is cleaned before and after use-to prevent the spread of microbes and infection - See textbook box: Think About Safety: Safety Guidelines for Assisting Clients During Tub Baths and Showers box ## Tub Baths and Showers (3 of 3) - Safety with a tub bath or shower: - When using hydraulic lifts, apply all safety devices - Follow employer policy using lifts requires two staff members. - Lock wheels of shower chair. - Test water temperature. - In client's home - Safety devices such as grab bars, transfer boards or shower chairs may be helpful for some clients. ## Dealing with Bathing Challenges (1 of 3) - Client has the right to refuse a bath-you need the client's informed consent. - Reasons for refusal: - Client feels too ill or weak - Client is afraid of falling or getting chilled - Client is embarrassed - Client cannot tolerate the bathing position. - Inform your supervisor of a client's refusal-do not bathe the client against their wishes. ## Dealing with Bathing Challenges (2 of 3) - Clients with dementia may be frightened by bathing procedures - Use a calm, pleasant voice - Do not rush - Divert the client's attention - Try the bath again later ## Dealing with Bathing Challenges (3 of 3) - Client urinates or defecates - Drain tub - Remove stool - Control your verbal and nonverbal reactions - Hardened secretions of stool on the client's body - Erection - Privacy is important - Provide for safety; give the client some time alone, if possible ## The Back Massage (1 of 2) - Back massages (back rubs): - Relax muscles and stimulate circulation - Are given after the bath and with evening care - Can be given after repositioning or to help the client relax - Last 3 to 5 minutes ## The Back Massage (2 of 2) - Observe the skin before the massage. - Lotion reduces friction during the massage - Warm the lotion by placing it in warm water - During the massage, use firm strokes - After the massage, apply some lotion to the elbows, knees, and heels ## Perineal Care (1 of 4) - Perineal care (pericare) involves cleaning the genital and anal areas. - Cleaning prevents infection and odours, and promotes comfort - Removes smegma - Perineal care is done: - Daily during the bath - Whenever the area is soiled with urine or feces - Clients do their own perineal care if they can. ## Perineal Care (2 of 4) - This procedure embarrasses many clients and nursing staff. - Follow Standard Practices and medical asepsis-always wear gloves. ## Perineal Care (3 of 4) - When giving perineal care: - Use warm water, not hot - Work from cleanest (urethra) to the dirtiest (anal) area - Use washcloths, towelettes, cotton balls, or swabs, according to agency policy - Clean down each side and then the centre - Rinse thoroughly; pat dry after rinsing ## Perineal Care (4 of 4) - Reporting and Recording - When providing perineal care, report the following observations at once: - Redness, swelling, discharge, or irritation - Presence of hemorrhoids - Odours - Complaints of pain, burning, or other discomfort - Signs of urinary or fecal incontinence - A male client's foreskin not retracting - Report and record the care given - If care is not recorded, it is assumed that care was not given. ## Menstrual Care (1 of 2) - Menstruation is the monthly bleeding of a client with female genitalia, when blood flows from the uterus through the vaginal opening. - Sanitary pads should be changed often (every 3–5 hours) to promote good hygiene and comfort and prevent odours and infection. - Wear gloves when providing menstrual care. - Dispose of sanitary pads according to employer policy. ## Menstrual Care (2 of 2) - Reporting and Recording: - When providing menstrual care, report and record the following: - Odours - Fever - Redness, swelling, or irritation in the perineum - Complaints of pain, burning, difficulty urinating, or other discomforts - Heavy bleeding-for example, the sanitary pad becomes soaked within 1 hour of application (report this at once) - Large number of blood clots on the pad (report this at once)