2Bathing……... cleanses and conditions the skin helps relax restless patientpromotes circulationacts as musculoskeletal exercisepromotes comforthelps improve self imagetime to develop relationship with pt.
3allows you an opportunity to observe skin, hair, nails etc for signs of breakdown form of therapeutic touchopportunity to do a good patient assessment, ask questions, get to know the patient better
4The bed bath…….. only if patient not able to get up practice proper body mechanicsensure privacyassist pt or completely by nursegather equipment neededallow pt to go to BR first if necessaryclose curtain and door to room
5use bath blanket and drape parts not being washed - remember dignity!!!! fold washcloth like a mittwash face first - inner to outer eyesoak hands and feet if possibleface, neck, arms, chest, abdomen, legs, feet, back, buttocks and anal areabackrub nice at this point!!!!
6change water, get new cloth and towel clean perineal area last!!!!!Wear gloves for peri carefemale - wash from pubic area to anusmale - retract foreskin if necessary and wash from tip of penis towards pubis (remember to replace foreskin!!!!)- be gentle with scrotum/testiclespowder promotes bacterial growth so use only if necessary
7Showers and tub baths…...determine how much assistance the patient will needprovide a chair or bench for patientcheck water temperaturehelp pt in and out as neededbring all supplies with youensure privacy
8assist as neededif patient alone, do not allow to lock doorhang sign on door to indicate room in use to avoid interruptionsalways ensure safety of patient!!!!
9Giving a back rub…... position patient for comfort warm lotion in hand provide privacyuse light, gliding strokes to apply lotion to shoulders, back and sacral areaplace hands beside each other and start at sacral area, work up and back down using slow, continuous strokes
10massage shoulders, back iliac crests and sacrum with circular strokes apply additional lotion as neededobserve skin for redness or breakdowntowel off excess lotion or moistureassess patients response and document
11Oral care……... wear gloves gather equipment provide privacy sit patient up if possibleassist as necessary - be gentle!!offer mouthwash if availableCLEAN DENTURES AT LEAST BID!!!!if pt unconscious, turn head to side
12toothbrush works best- use some “elbow grease” but don’t overdo it brush tongueeven if not alert - brushuse gauze & tongue depressor if no brushfloss once a daytoothpaste, salt, bicarb or diluted mouth washimportant for nutrition!!!!!
13don’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 shrinkstore dentures in water so they don’t dry out
14line sink when cleaning dentures so if you drop them they won’t break don’t use hot water when cleaning dentures or they may warprinse patients mouth before reinserting
15Hair care and shaving……... doing this for your patient can make a huge difference to his/her dayit takes time but it’s worth it!!!!can wash hair in bed or at sinkremember, shaving isn’t just for men!!!imagine going a few days without washing your hair, shaving your legs!!!
16Shaving……….mostly use electric razors - esp if on anticoagulants or are at risk for bleedingrazor shave: use shaving cream, check re anti-coagulants, short, firm strokes in direction of hair growth, pull skin tautwear gloves when shaving - risk of exposure to bloodlet pt direct you if he can
17Foot and nail care……...check feet carefully for signs of breakdown or other problemssoak hands and feet in warm waterdry well between toes, fingersfile nails as necessarygently push cuticles backapply lotionsclean under nails with blunt instrument
18trim toenails straight across to avoid ingrown nails don’t cut too shortfoot powders absorb perspiration and reduce odourswatch for areas of pressure or skin breakdown
19Diabetic foot care…….. File nails get consult for specialist if presence of callouses, corns, ingrown nails etcavoid heating pads, hot water bottlesprop feet if swellingavoid crossing legs, stockings with elastic tops
20Hearing aids………. be sure ears are clean wipe off hearing aid if wax buildupcheck functioning before placing in earremove at bedtime (usually)
21Offering and removing a bedpan or urinal…….. gather equipmentwarm pan if possibleif patient able to assist, have them bend knees and raise buttocksif unable to assist, roll to side and back on to bedpanraise head of bed if possible - more normal position
22place urinal between legs and position penis if patient unable to do so place call bell nearbyprovide toilet paper if patient able to wipe selfremove in same manner (hold it steady!!!!!)wear gloves to remove, provide peri care, clean equipmentwash hands!!!!!!
23Applying and removing an adult brief…….. it takes practice!!!!!lift buttocks or roll from side to sidealways provide peri care when changingcheck frequently to determine if needs to be changeddispose of according to institutions policy