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Chapter 20 Personal Hygiene Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Personal Hygiene Hygiene promotes comfort, safety, and health. Intact skin: Is the body’s first line of defense against disease Prevents microbes from entering the body and causing an infection Mucous membranes of the mouth, genital area, and anus must be clean and intact. Slide 2 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Personal Hygiene (cont’d) Good hygiene: Cleanses the body Prevents body and breath odors Is relaxing Increases circulation Culture and personal choice affect hygiene. Slide 3 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Did you know? In response to the popularity of Roman baths, the early Christian church frequently discouraged cleanliness. Queen Isabella of Castile boasted that she had had only two baths in her life—at birth and before her marriage. Colonial America’s leaders deemed bathing impure, since it promoted nudity, which could only lead to promiscuity. Laws in Pennsylvania and Virginia either banned or limited bathing. For a time in Philadelphia, anyone who bathed more than once a month faced jail Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 4
Did you know? Although scholars point to advances in medical science; such as, vaccines and antibiotics, as the major factors in turning the tide against disease, the changes in personal and domestic hygiene should be given considerable credit for improvements in better health conditions. Pasteurization and vaccines didn’t come along until the mortality decline was well established. But nearly 40 diseases are transmitted by feces, urine, and other secretions on contaminated hands or other objects. The greatest cause of fatal infant diarrhea came from mothers who went to the toilet, didn’t wash their hands and passed along intestinal bacteria to their babies. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 5
Did you know? Body odor is not caused by the human body or sweat itself. The skin has more than two million sweat glands, and the perspiration that comes from the abundant sweat glands is fundamentally clear and odorless. Common skin flora, consisting of several kinds of benign bacteria, feed off the secretions and skin particles on the body and clothing. In the process of eating and eliminating waste, the bacteria cause the stench. Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 6
Daily Care Most people have hygiene routines and habits. Routine care is given during the day and evening. Early morning/AM care is given before breakfast. Morning care is given after breakfast. Afternoon care is done after lunch and before the evening meal. Evening/PM care is given at bedtime (includes back massages). You assist with hygiene whenever it is needed. Slide 7 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Oral Hygiene Oral hygiene (mouth care) – done with gloves on Keeps the mouth and teeth clean Prevents mouth odors and infections Increases comfort Makes food taste better Reduces the risk for cavities (dental caries) and periodontal disease (inflammation of the tissues around the teeth with red, swollen gums) Flossing-done after brushing teeth Removes plaque and tartar from the teeth Removes food from between the teeth Do at least at bedtime Slide 8 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Brushing Teeth Brush is held at a 45 degree angle to the gums Brush with short strokes Teeth are brushed from the gum to the crown of the tooth Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Slide 9
Mouth care for the unconscious person Unconscious persons may have mouth dryness and crusting on the tongue and mucous membranes. If the person is on oxygen, may need more frequent mouth care due to dry mouth The care plan tells you what cleaning agent to use. Use sponge swabs to apply the cleaning agent. 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. Check the care plan. Slide 10 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Oral Hygiene (cont’d)
Protect unconscious persons from choking and aspiration (breathing fluid, food, vomitus, or an object into the lungs). Position the person on one side with the head turned well to the side. Position the person on one side with the head turned well to the side. Use only a small amount of fluid to clean the mouth. Use only a small amount of fluid to clean the mouth. Do not insert dentures. Do not insert dentures. Keep the person’s mouth open with a padded tongue blade. Always assume that unconscious persons can hear. Mouth care is given at least every 2 hours. Follow the nurse’s directions and the care plan. Follow the nurse’s directions and the care plan. Slide 11 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Oral Hygiene (cont’d)
Denture care-stored in cool or warm water in denture cup A denture is an artificial tooth or a set of artificial teeth. They are expensive so handle with care! Full and partial dentures are common. Mouth care is given and dentures cleaned as often as natural teeth. Dentures are slippery when wet. To use a cleaning agent, follow the manufacturer’s instructions. Hot water causes dentures to lose their shape (warp). Remind patients and residents not to wrap dentures in tissues or napkins. Remove dentures with a dry piece of gauze Slide 12 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Oral Hygiene (cont’d)
Bathing Bathing has the following benefits: It cleans the skin. It cleans the mucous membranes of the genital and anal areas. It is refreshing and relaxing. Circulation is stimulated and body parts exercised. Observations are made and concerns reported to the nurse You have time to talk to the person. Complete or partial baths, tub baths, or showers are given. Complete bed baths are usually given 2 x week Start with most clean (face) and finish with most dirty (perineum) Re-clean if patient is incontinent Maintain privacy throughout the bath! Slide 13 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
For a complete bed bath, you wash the person’s entire body in bed (ideal temp degrees Fahrenheit) Bed baths are usually needed by persons who are: Unconscious Unconscious Paralyzed Paralyzed In casts or traction In casts or traction Weak from illness or surgery Weak from illness or surgery For a towel bath, an oversized towel is used which is wet with a solution-water, cleaning, skin softening and drying agents. Bag baths are 8-10 wash clothes in a bag with solution that does not need to be rinsed. Slide 14 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Bathing (cont’d)
The partial bath involves bathing the face, hands, axillae (underarms), back, buttocks, and perineal area. Some persons bathe themselves in bed or at the sink. You assist as needed. Tub baths and showers Falls, burns, and chilling from water are risks Safety is important-always keep soap in dish Protect the person’s privacy. Pat the skin dry-don’t rub Follow the nurse’s directions and the care plan. Powder may be used to absorb moisture and prevent friction Slide 15 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Bathing (cont’d)
Back Massage (Back Rub) Relax muscles and stimulate circulation Given after baths and showers and with evening care Can be given after repositioning or to help the person relax Last 3 to 5 minutes Observe the skin before the massage. Lotion reduces friction during the massage. During the massage, use firm strokes. After the massage, apply some lotion to the elbows, knees, and heels. Slide 16 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Perineal Care Perineal care (pericare) involves cleaning the genital and anal areas. Cleaning prevents infection and odors, and it promotes comfort. Clean from front to back-or urethra to anus Ensure the foreskin on the uncircumcised male resident is returned to the covered position Penis is cleaned with circular motions starting at the meatus Perineal care is done: Daily during the bath Whenever the area is soiled with urine or feces Always wear gloves! Slide 17 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Perineal Care (cont’d) Perineal care is very important for persons who: Have urinary catheters Have had rectal or genital surgery Are menstruating Are incontinent of urine or feces Are uncircumcised Slide 18 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
The person does perineal care if able. This procedure embarrasses many people and staff. Standard Precautions, medical asepsis, and the Bloodborne Pathogen Standard are followed. When giving perineal care: Use warm water, not hot. Use washcloths, towelettes, cotton balls, or swabs according to agency policy. Start at the urethra Rinse thoroughly. Pat dry after rinsing. Slide 19 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Perineal Care (cont’d)
Reporting and Recording Report the following observations at once: Bleeding Signs of skin breakdown Discharge from the vagina or urinary tract Unusual odors Changes from prior observations Report and record the care given. If care is not recorded, it is assumed that care was not given. Slide 20 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.
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