 One of the main functions of CNA  Patients depend on CNA for all aspects of personal care  Need to be sensitive to patient needs and respect right to privacy  Hygiene includes bathing, back care,perineal care, oral hygiene, hair care, nail care and shaving

 Promotes good hygiene habits  Provides comfort  Stimulates circulation  Provides an excellent opportunity to develop a good caring relationship with the patient

 Complete bed bath—the CNA bathes all parts of the patient’s body and provides oral hygiene, back care, nail care and perineal care  Partial bed bath—only parts of the body are bathed  Tub bath or shower

 Care of the mouth and teeth  Should be administered at least 3 times a day  Proper oral hygiene prevents dental caries, stimulates the appetite, prevents halitosis, and provides comfort

 Routine oral hygiene—regular, everyday brushing and flossing  Denture care—cleaning of dentures or artificial teeth (Extreme care should be taken not to damage dentures)  Special oral hygiene—provided for the unconscious or semiconscious patient

 An important aspect of personal care  Patients confined to bed often have tangles and knots in their hair  Braiding long hair helps prevent tangles and knots  Brushing hair stimulates the scalp and helps prevent scalp problems (it is important to observe the condition of the hair and scalp)

 Often neglected area of personal care  Nails harbor dirt which can lead to disease and infection  Do not cut nails unless you have been instructed to do so  NEVER clip toenails  Learn the agency policy on nail care

 Regular or electric razors may be used  Will always use an electric razor on a patient who is on anticoagulants  Correct technique must be used to avoid injury

 Unless contraindicated, a back rub is given as part of the bath  It should be done every 8 hours if a patient is confined to bed  Good back rub takes 4-7 minutes  Stimulates circulation  Prevents pressure ulcers  Leads to relaxation and comfort

 Most patients prefer to wear their own gown, pajamas or clothing  If the patient has a weak or injured arm or has an IV the gown must be positioned with care  Sleeve is removed from the uninjured or untreated arm first  Sleeve of clean gown is placed on the affected arm first

 Most residents in long term care wear their own clothing  It is important to help the resident as needed to choose and dress in appropriate clothing  If the resident is paralyzed always put the clothing on the affected side first and remove it from the affected side last

 Used to limit movement  Two kinds of restraints—chemical and physical  Chemical restraints are medications that affect patient behavior, ex-tranquilizers, sedatives  Physical restraints are protective devices that limit patient movement and are used only to protect themselves or others and when all other measures have failed

 Restraints can be applied only under the order of a physician  Order must state the type of restraint, the reason for its use, the length of time it can be used, and where or when it can be used  Least restrictive device is always used first

 A restraint applied unnecessarily can be considered false imprisonment  A health care worker should NEVER apply a restraint without proper authorization

 Irrational or confused patients  Skin conditions (to keep patient from scratching )  Paralysis or limited muscular coordination

 Usually found on wheelchairs  Used to prevent a patient from falling out of the device  Should not be applied too tightly as it could interfere with breathing or circulation

 Wrapped around an arm or leg to limit movement  Straps are then attached to the bed or stretcher  At least two fingers should be slipped between the restraint and the skin to assure it is not too tight

 Used to prevent a patient from sitting up, rolling, getting out of bed or falling out of a wheelchair  Come in different sized  Must be applied so that they do not interfere with breathing or circulation

 Use only when all other means of obtaining patient cooperation has failed  Restraints should be as unnoticeable to the patient as possible  Patients should be allowed as much freedom of movement as possible without danger of injury  Patient should always be informed of why restraint is being used

 Circulation below a limb restraint should be checked every min  Signs of poor circulation: paleness, cyanosis, cold skin, edema, weak or absent pulse, poor return of pink color after nail beds are blanched, patient c/o pain, numbness, or tingling  If any signs of poor circulation restraint should be removed immediately and supervisor informed

 ALL restraints MUST be removed every 2 hours for at least 10 minutes  Patient should be repositioned, ROM exercises, and skin care to skin under restraint  Restraints should be removed as soon as there is adequate supervision or as soon as the danger of self-injury has passed

 Physical and mental frustration—loss of freedom imposed by restraints can cause disorientation, depression, hostility, agitation or withdrawal  Impaired circulation  Pressure ulcers  Loss of muscle tone, stiffness, discomfort  Respiratory or breathing problems

 Each facility has it own rules and policies  It is your responsibility to know the rules in the facility that you work in