1. Personal/Oral Hygiene and Foot Care

2. Bathing……... cleanses and conditions the skin
helps relax restless patient
promotes circulation
acts as musculoskeletal exercise
promotes comfort
helps improve self image
time to develop relationship with pt.

3. allows you an opportunity to observe skin, hair, nails etc for signs of breakdown
form of therapeutic touch
opportunity to do a good patient assessment, ask questions, get to know the patient better

4. The bed bath…….. only if patient not able to get up
practice proper body mechanics
ensure privacy
assist pt or completely by nurse
gather equipment needed
allow pt to go to BR first if necessary
close curtain and door to room

5. use bath blanket and drape parts not being washed - remember dignity!!!!
fold washcloth like a mitt
wash face first - inner to outer eye
soak hands and feet if possible
face, neck, arms, chest, abdomen, legs, feet, back, buttocks and anal area
backrub nice at this point!!!!

6. change water, get new cloth and towel
clean perineal area last!!!!!
Wear gloves for peri care
female - wash from pubic area to anus
male - retract foreskin if necessary and wash from tip of penis towards pubis (remember to replace foreskin!!!!)
- be gentle with scrotum/testicles
powder promotes bacterial growth so use only if necessary

7. Showers and tub baths…...
determine how much assistance the patient will need
provide a chair or bench for patient
check water temperature
help pt in and out as needed
bring all supplies with you
ensure privacy

8. assist as needed
if patient alone, do not allow to lock door
hang sign on door to indicate room in use to avoid interruptions
always ensure safety of patient!!!!

9. Giving a back rub…... position patient for comfort warm lotion in hand
provide privacy
use light, gliding strokes to apply lotion to shoulders, back and sacral area
place hands beside each other and start at sacral area, work up and back down using slow, continuous strokes

10. massage shoulders, back iliac crests and sacrum with circular strokes
apply additional lotion as needed
observe skin for redness or breakdown
towel off excess lotion or moisture
assess patients response and document

11. Oral care……... wear gloves gather equipment provide privacy
sit patient up if possible
assist as necessary - be gentle!!
offer mouthwash if available
CLEAN DENTURES AT LEAST BID!!!!
if pt unconscious, turn head to side

12. toothbrush works best- use some “elbow grease” but don’t overdo it
brush tongue
even if not alert - brush
use gauze & tongue depressor if no brush
floss once a day
toothpaste, salt, bicarb or diluted mouth wash
important for nutrition!!!!!

13. don’t forget to moisten liips
to remove dentures use a gentle rocking motion to break suction (may use gauze)
keep dentures in or gum line will shrink
store dentures in water so they don’t dry out

14. line sink when cleaning dentures so if you drop them they won’t break
don’t use hot water when cleaning dentures or they may warp
rinse patients mouth before reinserting

15. Hair care and shaving……...
doing this for your patient can make a huge difference to his/her day
it takes time but it’s worth it!!!!
can wash hair in bed or at sink
remember, shaving isn’t just for men!!!
imagine going a few days without washing your hair, shaving your legs!!!

16. Shaving……….
mostly use electric razors - esp if on anticoagulants or are at risk for bleeding
razor shave: use shaving cream, check re anti-coagulants, short, firm strokes in direction of hair growth, pull skin taut
wear gloves when shaving - risk of exposure to blood
let pt direct you if he can

17. Foot and nail care……...
check feet carefully for signs of breakdown or other problems
soak hands and feet in warm water
dry well between toes, fingers
file nails as necessary
gently push cuticles back
apply lotions
clean under nails with blunt instrument

18. trim toenails straight across to avoid ingrown nails
don’t cut too short
foot powders absorb perspiration and reduce odours
watch for areas of pressure or skin breakdown

19. Diabetic foot care…….. File nails
get consult for specialist if presence of callouses, corns, ingrown nails etc
avoid heating pads, hot water bottles
prop feet if swelling
avoid crossing legs, stockings with elastic tops

20. Hearing aids………. be sure ears are clean
wipe off hearing aid if wax buildup
check functioning before placing in ear
remove at bedtime (usually)

21. Offering and removing a bedpan or urinal……..
gather equipment
warm pan if possible
if patient able to assist, have them bend knees and raise buttocks
if unable to assist, roll to side and back on to bedpan
raise head of bed if possible - more normal position

22. place urinal between legs and position penis if patient unable to do so
place call bell nearby
provide toilet paper if patient able to wipe self
remove in same manner (hold it steady!!!!!)
wear gloves to remove, provide peri care, clean equipment
wash hands!!!!!!

23. Applying and removing an adult brief……..
it takes practice!!!!!
lift buttocks or roll from side to side
always provide peri care when changing
check frequently to determine if needs to be changed
dispose of according to institutions policy