1. Understand nurse aide skills needed for residents’ hygiene and grooming. Unit B Resident Care Skills Resident Care Skills Essential Standard NA5.00 Understand nurse aide’s role in providing residents’ hygiene, grooming, and skin care. Understand nurse aide’s role in providing residents’ hygiene, grooming, and skin care. Indicator 5.01 Understand nurse aide skills needed for residents’ hygiene and grooming. Understand nurse aide skills needed for residents’ hygiene and grooming. 15.01Nursing Fundamentals

2. Nursing Fundamentals 72432 PERSONAL CARE AND GROOMING: RELATIONSHIP TO SELF-ESTEEM 5.01 Nurse aides are the members of the health care team responsible for providing personal care and grooming for the resident. They encourage the resident to do as much as possible for themselves, but assist as needed with personal cleanliness, oral hygiene, nail care, shaving, dressing, care of hair and skin care.

3. Nursing Fundamentals 72433 PERSONAL CARE AND GROOMING: RELATIONSHIP TO SELF-ESTEEM 5.01 Personal grooming is important for a positive self-image and every effort should be made to encourage and assist the resident to maintain a pleasing and attractive appearance.

4. Nursing Fundamentals 72434 DAILY HYGIENE NEEDS 5.01 BathingBathing Skin careSkin care Back careBack care Oral hygieneOral hygiene ShavingShaving Shampooing hairShampooing hair Hair careHair care Nail careNail care Perineal carePerineal care Dressing and undressingDressing and undressing

5. Nursing Fundamentals 72435 FACTORS THAT AFFECT HYGIENE PRACTICES 5.01 CultureCulture Family PracticesFamily Practices IllnessIllness Individual preferencesIndividual preferences –Bath in morning or before going to bed –Frequency of bathing, shaving –Shampooing hair daily or weekly

6. Nursing Fundamentals 72436 FACTORS THAT AFFECT HYGIENE PRACTICES 5.01 EconomicsEconomics –Unable to afford deodorant, shampoo, etc. –Unable to afford utilities

7. Nursing Fundamentals 72437 PERSONAL CARE AND GROOMING: ROLE OF THE NURSE AIDE 5.01 Assist to follow their personal hygiene practicesAssist to follow their personal hygiene practices Encourage to do as much of their daily care as possibleEncourage to do as much of their daily care as possible Assist residents to select their own clothingAssist residents to select their own clothing

8. Nursing Fundamentals 72438 PERSONAL CARE AND GROOMING: ROLE OF THE NURSE AIDE 5.01 Promote independence and self esteemPromote independence and self esteem Encourage use of deodorant, perfume, aftershave lotion, and cosmeticsEncourage use of deodorant, perfume, aftershave lotion, and cosmetics Be patient and encouragingBe patient and encouraging

9. Nursing Fundamentals 72439 ORAL HYGIENE 5.01

10. Nursing Fundamentals 724310 ORAL HYGIENE 5.01 Definition: measures used to keep mouth and teeth clean and free of microorganisms

11. Nursing Fundamentals 724311 ORAL HYGIENE 5.01 Purpose –Prevent odors –Prevent infections –Prevent tooth decay and loss of teeth –Prevent gum disease –Increase comfort –Enhance taste of food

12. Nursing Fundamentals 724312 ORAL HYGIENE 5.01 Oral hygiene is provided: Before breakfastBefore breakfast After mealsAfter meals At bedtimeAt bedtime Other times as requested or necessaryOther times as requested or necessary

13. Nursing Fundamentals 724313 ORAL HYGIENE 5.01 Oral hygiene is provided frequently for residents receiving oxygen to prevent the mucous membranes from drying and to promote comfort

14. Nursing Fundamentals 724314 ORAL HYGIENE 5.01 Observations to report: –Foul mouth odors –Bleeding –Loose or broken teeth or dentures –Sores in or around mouth –Coated tongue –Complaints of pain

15. Nursing Fundamentals 724315 PRINCIPLES FOR BRUSHING TEETH 5.01 Hold brush at 45 degree angleHold brush at 45 degree angle Use circular motion to brush teethUse circular motion to brush teeth Brush well where teeth and gums meetBrush well where teeth and gums meet Brush all surfaces and tongueBrush all surfaces and tongue Brush upper teeth firstBrush upper teeth first Brush gentlyBrush gently Offer diluted mouth washOffer diluted mouth wash

16. Nursing Fundamentals 724316 DENTURE CARE 5.01

17. Nursing Fundamentals 724317 DENTURE CARE 5.01 Handle carefully – expensive to replaceHandle carefully – expensive to replace Clean as often as natural teethClean as often as natural teeth Protect from loss or breakageProtect from loss or breakage Store safely, when out of mouth, in labeled containerStore safely, when out of mouth, in labeled container Never use hot water, which can warp denturesNever use hot water, which can warp dentures

18. Nursing Fundamentals 724318 DENTURE CARE 5.01 Store dry, in water or in special solutionStore dry, in water or in special solution For long term storage, put container holding dentures in bedside standFor long term storage, put container holding dentures in bedside stand

19. Nursing Fundamentals 724319 REMOVING DENTURES 5.01 1.Sit resident upright 2.Apply gloves 3.Remove lower denture first, it is easier to remove 4.Grasp lower denture with a gauze for a good grip 5.Give a slight downward pull to break suction 6.Turn at an angle to get out of mouth

20. Nursing Fundamentals 724320 INSERTING DENTURES 5.01 Sit resident uprightSit resident upright Apply glovesApply gloves Apply denture adhesive if neededApply denture adhesive if needed Place upper denture into the mouth by turning it at an anglePlace upper denture into the mouth by turning it at an angle Straighten the denture and press onto upper gum line firmly and evenlyStraighten the denture and press onto upper gum line firmly and evenly Insert lower denture, press firmlyInsert lower denture, press firmly

21. Nursing Fundamentals 724321 MOUTH CARE FOR THE UNCONSCIOUS RESIDENT 5.01

22. Providing mouth care for the unconscious resident 224.02Nursing Fundamentals Unconscious residents may be able to hear. Hearing is the last sensory function a resident loses. Talk to the resident just as you would if they were alert.

23. Nursing Fundamentals 724323 SPECIAL MOUTH CARE PRODUCTS 5.01 SwabsSwabs Toothettes:Toothettes: –usually soaked in mouthwash or plain water –hydrogen peroxide, salt water solution if specified on care plan Petroleum jelly or olive oil for dry lipsPetroleum jelly or olive oil for dry lips

24. 5.01Nursing Fundamentals 724324 NAIL CARE

25. Nursing Fundamentals 724325 NAIL CARE 5.01 Purpose: Prevent infectionPrevent infection Prevent injuryPrevent injury Prevent odorsPrevent odors

26. Nursing Fundamentals 724326 NAIL CARE 5.01 Requires daily cleaning and trimming of fingernails and toenails as neededRequires daily cleaning and trimming of fingernails and toenails as needed Maintain nails by keeping nails:Maintain nails by keeping nails: –short –clean –free of rough edges

27. Nursing Fundamentals 724327 NAIL CARE GUIDELINES 5.01 Easier to trim and clean after soakingEasier to trim and clean after soaking Nail clipper used to cut and trim nails. Use care not to injure skin when clipping.Nail clipper used to cut and trim nails. Use care not to injure skin when clipping. Clip nails straight acrossClip nails straight across

28. Nursing Fundamentals 724328 NAIL CARE GUIDELINES 5.01 Use file or emery board to smooth rough edgesUse file or emery board to smooth rough edges Softened cuticle can be pushed back with orange stickSoftened cuticle can be pushed back with orange stick

29. Nursing Fundamentals 724329 NAIL CARE CAUTION! 5.01 Diabetics and residents with circulatory problems will have their nails trimmed only by a licensed nurse or podiatrist.Diabetics and residents with circulatory problems will have their nails trimmed only by a licensed nurse or podiatrist. Review resident care plan and check with supervisor prior to trimming nails.Review resident care plan and check with supervisor prior to trimming nails.

30. Nursing Fundamentals 724330 FOOT CARE 5.01 Wash feet using warm water and mild soapWash feet using warm water and mild soap Dry feet carefully, especially between the toesDry feet carefully, especially between the toes Apply lotion to tops and bottoms of feet only, not between the toesApply lotion to tops and bottoms of feet only, not between the toes

31. Nursing Fundamentals 724331 FOOT CARE 5.01 Check feet daily for: redness, warmth or constant painredness, warmth or constant pain numbness or tinglingnumbness or tingling dry, cracked skindry, cracked skin swellingswelling blisters, cuts, scratches or other soresblisters, cuts, scratches or other sores ingrown toenails, corns, callusesingrown toenails, corns, calluses

32. Nursing Fundamentals 724332 FOOT CARE 5.01 Do not use a heating pad on resident’s feetDo not use a heating pad on resident’s feet Keep footwear on; residents never go barefootKeep footwear on; residents never go barefoot Change socks and shoes dailyChange socks and shoes daily

33. Nursing Fundamentals 724333 FOOT CARE 5.01 Foot injuries and infections can lead to gangrene and amputation, especially in diabeticsFoot injuries and infections can lead to gangrene and amputation, especially in diabetics Notify supervisor immediately of any unusual observations of the feetNotify supervisor immediately of any unusual observations of the feet

34. Nursing Fundamentals 724334SHAVING 5.01 Daily activity for menDaily activity for men Promotes:Promotes: –Physical comfort –Psychological well-being

35. Nursing Fundamentals 724335 ASSIST WITH SHAVING 5.01 Factors to consider: –Electric razor provides greatest safety.Do not use electric razors when oxygen in use –Electric razor provides greatest safety. Do not use electric razors when oxygen in use Use own equipment or a disposable safety razorUse own equipment or a disposable safety razor Soften beard and skin prior to shavingSoften beard and skin prior to shaving

36. Nursing Fundamentals 724336 ASSIST WITH SHAVING 5.01 Factors to consider (continued): Use care not to cut or irritate skin while shavingUse care not to cut or irritate skin while shaving Shave in direction hair growsShave in direction hair grows

37. Nursing Fundamentals 724337 ASSIST WITH SHAVING 5.01 Razor bumps are tiny, irritated bumps that develop after shaving. People with curly hair are most affected by them. The sharp edge of closely shaven hair can curl back and grow into the skin, causing irritation and pimples, and even scarring. To minimize razor bumps, take a hot shower before shaving, shave in the direction of hair growth, and don't stretch the skin while shaving. Rinse with cold water, then apply moisturizer.

38. Nursing Fundamentals 724338 SHAVING - SURGERY PREPARATION 5.01 Razor used for surgery preparation. The head/blade of the razor is disposable. The battery handle is disinfected after each use.

39. 5.01Nursing Fundamentals 724339 HAIR CARE http://www.webmd.com/skin-problems-and-treatments/slideshow-hair-and-scalp-conditions

40. Nursing Fundamentals 724340 HAIR CARE 5.01 Hair care includes Daily brushing and combingDaily brushing and combing StylingStyling ShampooingShampooing Keeping hair tools cleanKeeping hair tools clean

41. Nursing Fundamentals 724341 HAIR CARE 5.01 Because hair style is personal preference, ask about styleBecause hair style is personal preference, ask about style Make brushing and combing part of morning careMake brushing and combing part of morning care

42. Nursing Fundamentals 724342 HAIR CARE 5.01 Protect resident’s clothing by placing towel around shouldersProtect resident’s clothing by placing towel around shoulders Cover pillow with towel for residents confined to bedCover pillow with towel for residents confined to bed

43. Nursing Fundamentals 724343 HAIR CARE 5.01 Brushing hair:Brushing hair: –refreshes resident –improves morale –stimulates circulation –distributes natural oils evenly –removes lint and dust Handle hair gently when brushing or combingHandle hair gently when brushing or combing

44. Nursing Fundamentals 724344 HAIR CARE 5.01 Section hair and work on one area at a timeSection hair and work on one area at a time Note appearance of scalp and hairNote appearance of scalp and hair Hair style should be age appropriateHair style should be age appropriate

45. Nursing Fundamentals 724345 HAIR CARE 5.01 Residents are encouraged to do as much as possible for themselvesResidents are encouraged to do as much as possible for themselves Comb and brush are cleaned after useComb and brush are cleaned after use Combs and brushes are never sharedCombs and brushes are never shared

46. Nursing Fundamentals 724346 HAIR CARE 5.01 Frequency individualizedFrequency individualized Resident’s shampoo, conditioner and other hair care products are usedResident’s shampoo, conditioner and other hair care products are used Resident assisted to beauty shop if availableResident assisted to beauty shop if available

47. Nursing Fundamentals 724347 HAIR CARE 5.01 Methods of shampooing: during showerduring shower at sinkat sink using stretcherusing stretcher in bedin bed dry shampoosdry shampoos

48. Nursing Fundamentals 724348 HAIR CARE 5.01 Eyes and ears protectedEyes and ears protected Hair dried as fast as possibleHair dried as fast as possible Cold or drafty areas eliminatedCold or drafty areas eliminated Female residents assisted to curl or set hairFemale residents assisted to curl or set hair

49. Nursing Fundamentals 724349 HAIR CARE 5.01 Barbers or beauticians may be contacted by facility to care for hair of residentsBarbers or beauticians may be contacted by facility to care for hair of residents Care plan to be checked for any special instructions prior to shampooingCare plan to be checked for any special instructions prior to shampooing

50. Nursing Fundamentals 724350 HAIR CARE - FYI 5.01 Traction Alopecia Damages Follicles Pulling hair too tight -- as can happen with ponytails, braids, and cornrows -- can damage hair follicles and cause hair to break or fall out. Hair extensions and hairpieces can sometimes cause traction alopecia, too, because their extra weight pulls on existing hair. Changing your hairstyle usually lets hair grow back. Pulling hair back tightly for a long time, though, can lead to permanent hair loss. http://www.webmd.com/skin-problems-and-treatments/slideshow-hair-and-scalp-conditions

51. Nursing Fundamentals 724351 HAIR CARE - FYI 5.01 Head Lice: Itchy! In hair — that's where you'll find lice. They like to hide in the neck area of the scalp and behind the ears. If you have lice, you likely got it from sharing a hat, brush, or other item with a person who has lice. Lice are itchy, but scratching can lead to infection. In severe cases, hair may fall out. http://www.webmd.com/allergies/slideshow-bad-bugs

52. 5.01Nursing Fundamentals 724352 MAKE UP MAKE UP http://www.wikihow.com/Apply-Makeup http://www.wikihow.com/Apply-Makeup

53. Nursing Fundamentals 724353 MAKE UP 5.01 Apply make-up per resident wishesApply make-up per resident wishes Apply make-up in an age appropriate mannerApply make-up in an age appropriate manner Do not share make up with other residentsDo not share make up with other residents Be alert for allergic reactions to make upBe alert for allergic reactions to make up

54. 5.01Nursing Fundamentals 724354 DRESSING AND DRESSING AND UNDRESSING UNDRESSING

55. Nursing Fundamentals 724355 DRESSING & UNDRESSING 5.01 Encourage resident to choose own clothingEncourage resident to choose own clothing Dress daily own clothing and underwearDress daily own clothing and underwear Make sure clothes are in good repairMake sure clothes are in good repair

56. Nursing Fundamentals 724356 DRESSING & UNDRESSING 5.01 Dress weak or affected side firstDress weak or affected side first Undress weak or affected side lastUndress weak or affected side last

57. Nursing Fundamentals 724357 DRESSING & UNDRESSING 5.01 Ensure clothing is appropriate for weather and environment

58. Nursing Fundamentals 724358 DRESSING & UNDRESSING 5.01 Encourage resident to wear clothing that matches and is clean and neatEncourage resident to wear clothing that matches and is clean and neat Dress should be age appropriateDress should be age appropriate Do not put clothing on backwardsDo not put clothing on backwards

59. Nursing Fundamentals 724359 DRESSING & UNDRESSING 5.01 Be gentleBe gentle Always be patient and provide time for residents to do as much as possible for themselvesAlways be patient and provide time for residents to do as much as possible for themselves

60. 5.01Nursing Fundamentals 724360 BATHING BATHING

61. Nursing Fundamentals 724361BATHING 5.01 Purpose of Bathing Removes perspiration, dirt and microorganismsRemoves perspiration, dirt and microorganisms Stimulates circulationStimulates circulation Exercises body partsExercises body parts

62. Nursing Fundamentals 724362BATHING 5.01 Purpose of Bathing (continued) Refreshes, relaxes and promotes physical comfortRefreshes, relaxes and promotes physical comfort Removes odorsRemoves odors Allows for evaluation of skin conditionAllows for evaluation of skin condition

63. Nursing Fundamentals 724363BATHING 5.01 Methods of Bathing Partial bathPartial bath Complete bed bathComplete bed bath Tub bathTub bath ShowerShower

64. Nursing Fundamentals 724364BATHING 5.01 Receive instructions from supervisor regarding method of bathing and skin care products to useReceive instructions from supervisor regarding method of bathing and skin care products to use Provide privacyProvide privacy Reduce drafts by closing windows, drapes and doors!Reduce drafts by closing windows, drapes and doors!

65. Nursing Fundamentals 724365 BATHING - GUIDELINES 5.01 Use good body mechanicsUse good body mechanics Keep covered for warmth and privacyKeep covered for warmth and privacy Protect safety of resident:Protect safety of resident: –never leave unattended in bathtub or shower –take precautions to prevent slips and falls –have temperature no higher than 105°F for tub or shower

66. Nursing Fundamentals 724366 BATHING GUIDELINES 5.01 Establish a schedule.Establish a schedule. Refer to agency policy/procedure for shower scheduleRefer to agency policy/procedure for shower schedule Do not force bathe!Do not force bathe! If the resident refuses a bath, come back later to see if the resident has changed their mind and is ready for a bathIf the resident refuses a bath, come back later to see if the resident has changed their mind and is ready for a bath

67. Nursing Fundamentals 724367 BATHING GUIDELINES 5.01 Rinse skin completely if not using no-rinse productRinse skin completely if not using no-rinse product Encourage to do as much as possible for selfEncourage to do as much as possible for self Pat skin dryPat skin dry Observe condition of skinObserve condition of skin

68. Nursing Fundamentals 724368 BATHING GUIDELINES 5.01 Color of skin, lips, nail beds and sclera of eyesColor of skin, lips, nail beds and sclera of eyes Location and description of rashesLocation and description of rashes Dry skinDry skin Bruises or open areas on skinBruises or open areas on skin

69. Nursing Fundamentals 724369 BATHING GUIDELINES 5.01 Pale or reddened areas, especially over bony parts Drainage or bleeding from wounds or orifices Skin temperature Complaints of pain or discomfort

70. 5.01Nursing Fundamentals 724370 Perineal Care Perineal Care

71. Nursing Fundamentals 724371 PERINEAL CARE 5.01 Used to clean genital and anal areas Prevents infectionPrevents infection Prevents odorsPrevents odors Promotes comfortPromotes comfort 1 st washcloth to wash the front perineum 2nd washcloth to rinse the front perineum

72. Nursing Fundamentals 724372 PERINEAL CARE 5.01 Rules of medical asepsis and Standard Precautions followed Work from cleanest to dirtiest area (front to back) urethral area – cleanest anal area – dirtiest

73. Nursing Fundamentals 724373 PERINEAL CARE 5.01 Delicate area that needs special careDelicate area that needs special care –Use warm water –Wash gently (1 cloth) –Rinse well (2 nd cloth) –Pat dry

74. 5.01Nursing Fundamentals 724374 Back Rub Back Rub

75. Nursing Fundamentals 724375 GIVING A BACKRUB 5.01 Purpose Stimulate circulationStimulate circulation Prevent skin breakdownPrevent skin breakdown SoothingSoothing RefreshingRefreshing

76. Nursing Fundamentals 724376 GIVING A BACKRUB 5.01 Use a combination of strokesUse a combination of strokes –Long, smooth strokes – relaxing –Short, circular strokes – stimulating Use warmed lotion applied with palms of handsUse warmed lotion applied with palms of hands Rub 3 - 5 minutesRub 3 - 5 minutes

77. Understand nurse aide skills needed for residents’ hygiene and grooming. 77  END  5.01 5.01Nursing Fundamentals