1. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 20 Grooming

2. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 2  Grooming measures: Are important to many people Are important to many people Prevent infection and promote comfort Prevent infection and promote comfort Affect love, belonging, and self-esteem needs Affect love, belonging, and self-esteem needs  People differ in their grooming measures.  The person should tend to his or her own grooming measures to the extent possible.  The person may use adaptive devices for hair care and dressing.

3. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 3  HAIR CARE  How the hair looks and feels affects mental well-being.  You assist with hair care whenever needed.  The nursing process reflects: The person’s culture The person’s culture Personal choice Personal choice Skin and scalp condition Skin and scalp condition Health history Health history Self-care ability Self-care ability

4. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 4  Skin and scalp conditions Alopecia means hair loss. Alopecia means hair loss.  Male pattern baldness occurs with aging.  Hair thins in some women with aging.  Other causes include cancer treatments, skin diseases, stress, poor nutrition, pregnancy, some drugs, and hormone changes. Hirsutism is excessive body hair. Hirsutism is excessive body hair.  It occurs in women and children from heredity and abnormal amounts of male hormones. Dandruff is the excessive amount of dry, white flakes from the scalp. Dandruff is the excessive amount of dry, white flakes from the scalp.

5. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 5 Pediculosis (lice) is infestation with wingless insects. Pediculosis (lice) is infestation with wingless insects.  Pediculosis capitis is the infestation of the scalp with lice.  Pediculosis pubis is the infestation of the pubic hair with lice.  Pediculosis corporis is the infestation of the body with lice.  Report signs and symptoms of lice to the nurse at once: –Complaints of a tickling feeling or something moving in the hair –Itching –Irritability –Sores on the head or body caused by scratching –Rash

6. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 6 Scabies is a skin disorder caused by a female mite. Scabies is a skin disorder caused by a female mite.  The female mite burrows into the skin and lays eggs.  The person has a rash and intense itching.  Scabies is highly contagious.  Persons at risk include those living in crowded living settings and those with weakened immune systems.

7. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 7  Brushing and combing hair Encourage patients and residents to do their own hair care. Encourage patients and residents to do their own hair care.  Assist as needed. Perform hair care for those who cannot do so. Perform hair care for those who cannot do so. The person chooses how to brush, comb, and style hair. The person chooses how to brush, comb, and style hair. Brushing and combing prevent tangled and matted hair. Brushing and combing prevent tangled and matted hair. When brushing and combing hair, start at the scalp. Then brush or comb to the hair ends. When brushing and combing hair, start at the scalp. Then brush or comb to the hair ends.

8. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 8 Do not braid hair without the person’s consent. Do not braid hair without the person’s consent. Never cut hair for any reason. Never cut hair for any reason. Special measures are needed for curly, coarse, and dry hair. Special measures are needed for curly, coarse, and dry hair. The person’s hair care practices and hair care products are part of the care plan. The person’s hair care practices and hair care products are part of the care plan.

9. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 9  Shampooing Many factors affect frequency, including: Many factors affect frequency, including:  The condition of the hair and scalp  Hairstyle  Personal choice Do not shampoo a person’s hair unless the nurse tells you to do so. Do not shampoo a person’s hair unless the nurse tells you to do so. The nurse tells you what method to use. The nurse tells you what method to use. The shampoo method depends on: The shampoo method depends on:  The person’s condition  Safety factors  Personal choice

10. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 10 Shampoo methods include: Shampoo methods include:  Shampoo during the shower or tub bath  Shampoo at the sink  Shampoo on a stretcher  Shampoo in bed Hair is dried and styled as quickly as possible after the shampoo. Hair is dried and styled as quickly as possible after the shampoo. Check with the nurse before curling or rolling up hair. Check with the nurse before curling or rolling up hair.

11. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 11  SHAVING  Many men shave for comfort and mental well- being.  Many women: Shave their legs and underarms Shave their legs and underarms Shave coarse facial hair Shave coarse facial hair Use other hair removal methods Use other hair removal methods

12. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 12  Safety razors or electric shavers are used. Follow agency policy for cleaning electric shavers. Follow agency policy for cleaning electric shavers.  Safety razors are not used on persons: Who have healing problems Who have healing problems Who take anticoagulant drugs Who take anticoagulant drugs  Soften the beard before using an electric shaver or safety razor.  Mustaches and beards need daily care. Ask the person how to groom his mustache or beard. Ask the person how to groom his mustache or beard. Never trim a mustache or beard without the person’s consent. Never trim a mustache or beard without the person’s consent.

13. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 13  NAIL AND FOOT CARE  Nail and foot care prevents infection, injury, and odors.  Hangnails, ingrown nails, and nails torn away from the skin cause skin breaks.  Long or broken nails can scratch skin or snag clothing.  Dirty feet, socks, or stockings harbor microbes and cause odors.

14. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 14  Injuries occur from: Stubbing toes Stubbing toes Stepping on sharp objects Stepping on sharp objects Being stepped on Being stepped on Shoes that fit poorly Shoes that fit poorly  Poor circulation prolongs healing. Infections or foot injuries are very serious for older persons and persons with circulatory disorders. Infections or foot injuries are very serious for older persons and persons with circulatory disorders.

15. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 15  Trimming and clipping toenails can easily result in injuries. Use nail clippers to cut fingernails. Use nail clippers to cut fingernails.  Never use scissors. Some agencies do not let nursing assistants cut or trim toenails. Some agencies do not let nursing assistants cut or trim toenails.  Follow agency policy.

16. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 16  CHANGING CLOTHING AND HOSPITAL GOWNS  You may need to assist with changing clothes and hospital gowns. Follow these rules: Follow these rules:  Provide for privacy.  Encourage the person to do as much as possible.  Let the person choose what to wear.  Remove clothing from the strong (unaffected) or “good” side first.  Put clothing on the weak (affected) side first.  Support the arm or leg when removing or putting on a garment.

17. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 17  Changing hospital gowns Gowns are usually worn for IV therapy. Gowns are usually worn for IV therapy.  Some agencies have gowns for IV therapy that open along the sleeve and close with ties, snaps, or Velcro.  Sometimes standard gowns are used. If there is injury or paralysis: If there is injury or paralysis:  The gown is removed from the strong arm first.  Support the weak arm while removing the gown.  Put the clean gown on the weak arm first and then on the strong arm.