Chapter 21 Grooming Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Grooming  Grooming measures:  Are important to many people  Prevent infection and promote comfort  Address 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 grooming. Slide 2 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Hair Care  The look and feel of hair affect mental well- being.  You assist with hair care whenever needed.  The nursing process reflects:  The person’s culture  Personal choice  Skin and scalp condition  Health history  Self-care ability Slide 3 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Hair Care (cont’d)  Skin and scalp conditions  Alopecia means hair loss. Male pattern baldness occurs with aging. Male pattern baldness occurs with aging. Hair also thins in some women with aging. Hair also thins in some women with aging. Other causes include cancer treatments, skin disease, stress, poor nutrition, pregnancy, some drugs, and hormone changes. Other causes include cancer treatments, skin disease, stress, poor nutrition, pregnancy, some drugs, and hormone changes.  Hirsutism is excessive body hair. It can occur in men, women, and children from heredity and abnormal amounts of male hormones. It can occur in men, women, and children from heredity and abnormal amounts of male hormones.  Dandruff is the excessive amount of dry, white flakes from the scalp. Slide 4 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

 Pediculosis (lice) is the infestation with wingless insects. Pediculosis capitis is the infestation of the scalp with lice. Pediculosis capitis is the infestation of the scalp with lice. Pediculosis pubis is the infestation of the pubic hair with lice. Pediculosis pubis is the infestation of the pubic hair with lice. Pediculosis corporis is the infestation of the body with lice. Pediculosis corporis is the infestation of the body with lice. Report signs and symptoms of lice to the nurse at once. 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 Slide 5 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Hair Care (cont’d)

 Scabies is a skin disorder caused by a female mite. The female mite burrows into the skin and lays eggs. The female mite burrows into the skin and lays eggs. The person has a rash and intense itching. The person has a rash and intense itching. Scabies is highly contagious. Scabies is highly contagious. Persons at risk include those living in crowded living settings and those with weakened immune systems. Persons at risk include those living in crowded living settings and those with weakened immune systems. Slide 6 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Hair Care (cont’d)

 Brushing and combing hair  Encourage patients and residents to do their own hair care. Assist as needed. Assist as needed.  Provide hair care for those who cannot do so.  The person chooses how to brush, comb, and style hair.  Brushing and combing prevent tangled and matted hair.  To brush and comb hair, start at the scalp. Then brush or comb to the hair ends. Slide 7 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Hair Care (cont’d)

 Do not braid hair without the person’s consent.  Never cut matted or tangled hair.  Special measures are needed for curly, coarse, and dry hair.  The person’s hair care practices and products are part of the care plan. Slide 8 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Hair Care (cont’d)

Shampooing  Many factors affect frequency, including:  The condition of the hair and scalp  Hairstyle  Personal choice  Shampoo hair when the nurse tells you to.  The nurse tells you what method to use.  The shampoo method depends on:  The person’s condition  Safety factors  Personal choice Slide 9 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Shampooing (cont’d)  Shampoo methods include: During the shower or tub bath During the shower or tub bath At the sink At the sink On a stretcher On a stretcher In bed In bed  Hair is dried and styled as quickly as possible after the shampoo.  Check with the nurse before curling or rolling up hair. Slide 10 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Shaving  Many men shave for comfort and mental well-being.  Many women:  Shave their legs and underarms  Shave facial hair  Use other hair-removal methods Waxing, hair removal products, plucking, threading Waxing, hair removal products, plucking, threading Slide 11 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Shaving (cont’d)  Safety razors or electric shavers are used.  Follow agency policy for cleaning electric shavers.  Safety razors are not used on persons who:  Have healing problems  Take anticoagulant drugs  Soften the beard before shaving.  Mustaches and beards need daily care.  Ask the person how to groom his mustache or beard.  Never trim a mustache or beard without the person’s consent. Slide 12 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

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. Slide 13 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Nail and Foot Care (cont’d)  Injuries occur from:  Stubbing toes  Stepping on sharp objects  Being stepped on  Shoes that fit poorly  Poor circulation prolongs healing.  Infections or foot injuries are very serious for older persons and persons with circulatory disorders. Slide 14 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

 Trimming and clipping toenails can easily cause injuries.  Use nail clippers to cut fingernails. Never use scissors. Never use scissors.  Some agencies do not let nursing assistants cut or trim toenails. Follow agency policy. Follow agency policy. Slide 15 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Nail and Foot Care (cont’d)

Changing Clothing and Hospital Gowns  You may need to assist with changing garments.  Follow these rules: Provide for privacy. Provide for privacy. Encourage the person to do as much as possible. Encourage the person to do as much as possible. Let the person choose what to wear. Let the person choose what to wear. Make sure garments and footwear are the correct size. Make sure garments and footwear are the correct size. Remove clothing from the strong or “good” side first. Remove clothing from the strong or “good” side first. Put clothing on the weak side first. Put clothing on the weak side first. Support the arm or leg when removing or putting on a garment. Support the arm or leg when removing or putting on a garment. Slide 16 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

 Changing hospital gowns  Gowns are usually worn for IV therapy. Some agencies have special gowns for IV therapy that open along the sleeve and close with ties, snaps, or Velcro. Some agencies have special gowns for IV therapy that open along the sleeve and close with ties, snaps, or Velcro. Sometimes standard gowns are used. Sometimes standard gowns are used.  If there is injury or paralysis: Remove the gown from the strong arm first. Remove the gown from the strong arm first. Support the weak arm while removing the gown. Support the weak arm while removing the gown. Put the clean gown on the weak arm first and then on the strong arm. Put the clean gown on the weak arm first and then on the strong arm. Slide 17 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved. Changing Clothing and Hospital Gowns (cont’d)