JUDITH M. WILKINSON LESLIE S. TREAS KAREN BARNETT MABLE H. SMITH FUNDAMENTALS OF NURSING Copyright © 2016 F.A. Davis Company Chapter 25: Facilitating Hygiene

Copyright © 2016 F.A. Davis Company General Concepts Related to Hygiene Activities involved in personal grooming and cleanliness Activities of daily living (ADLs) –Bathing –Showering –Combing hair

Copyright © 2016 F.A. Davis Company General Concepts Related to Hygiene (cont’d) Maintenance of personal hygiene Promotes comfort Improves self-image Decreases infection and disease

Copyright © 2016 F.A. Davis Company Nursing Role Assess self-care abilities Provide assistance with ADLs Promote self-care in ADLs Delegate appropriate parts of hygiene care

Copyright © 2016 F.A. Davis Company Factors That Influence Hygiene and Self-Care Practices Psychosocial factors Personal preferences –When to bathe, what products to use Culture and religion –Beliefs about hygiene and cleanliness

Copyright © 2016 F.A. Davis Company Factors That Influence Hygiene and Self-Care Practices (cont’d) Economic status –Availability of facilities –Monetary constraints Developmental level –Parents, media, peers, age Knowledge level

Copyright © 2016 F.A. Davis Company Factors That Influence Hygiene and Self-Care Practices (cont’d) Physical factors: health status Pain: limit to mobility and energy Limited mobility: decreased range of motion, weakness, bedrest Sensory deficits: decreased independence and increased safety concerns

Copyright © 2016 F.A. Davis Company Factors That Influence Hygiene and Self-Care Practices (cont’d) Physical factors: health status (cont’d) Cognitive impairments –Cannot determine need for hygiene –Cannot problem-solve ADL processes –Forgets when last performed hygiene and ADLs Emotional disturbances –Profound lack of energy for ADLs –Altered reality does not include hygiene

Copyright © 2016 F.A. Davis Company Types of Scheduled Hygiene Care Routine hygiene care in the in-client facility Early morning care: on awakening—wash face and hands, mouth care A.M. care: after breakfast—bathing, toileting, hair, skin, bed making

Copyright © 2016 F.A. Davis Company Types of Scheduled Hygiene Care (cont’d) P.M. care: afternoon—toileting, handwashing, oral care, readying for visitors H.S. care: prior to sleep—relaxation activities, readying environment to facilitate sleep

Copyright © 2016 F.A. Davis Company Delegating Hygiene Care Assess prior to delegating Instruct nursing assistive personnel (NAP) regarding –Client’s limitations –Amount of assistance needed –Use of assistive devices –Presence and care of tubes –Observations to make during hygiene care

Copyright © 2016 F.A. Davis Company Major Areas of Hygiene Care: Bathing Bathing a client facilitates Assessment of the integumentary system –Color: pallor, erythema, jaundice –Conditions that affect the skin: maceration, pruritus, acne –Alterations in skin integrity: abrasions, pressure ulcers RN assessment of client’s functional abilities and status

Copyright © 2016 F.A. Davis Company Common Types of Baths Assist bath –Bathe areas hard to reach Partial bath –Bathe only those areas absolutely necessary, including perineum Bed bath –Complete –Partial –Help bath

Copyright © 2016 F.A. Davis Company Other Types of Baths Towel bath Bag or packaged bath Shower Tub bath Therapeutic bath

Copyright © 2016 F.A. Davis Company Major Areas of Hygiene Care: Oral Care Oral care facilitates Removal of food particles and secretions Improved appetite Assessment of client’s oral status Care of dentures

Copyright © 2016 F.A. Davis Company Major Areas of Hygiene Care: Oral Care (cont’d) Oral care facilitates (cont’d) Assessment of the oral cavity –Condition of the teeth, cavities, gingivitis –Conditions affecting the mouth: stomatitis, glossitis, oral lesions/malignancies

Copyright © 2016 F.A. Davis Company Other Hygiene Care Areas Care of the feet –Special considerations for care of the diabetic client Care of the nails Hair care –Special considerations for cultural variations in hair –Care for mustaches and beards

Copyright © 2016 F.A. Davis Company Hair Care

Copyright © 2016 F.A. Davis Company Care of the eyes – Special considerations for clients with contact lenses – Care of an artificial eye Care of the ears – Care of a hearing aid Other Hygiene Care Areas (cont’d)

Copyright © 2016 F.A. Davis Company Think Like a Nurse Suppose you have been providing towel baths to a patient who has mild dementia. One day a visiting family member says, “My father tells me that he has not had a bath all week. What’s going on here?” What would you do? How could you help to prevent this misunderstanding in the future?