2016_Hygiene_(1).ppt
- 1. 1
- 2. LEARNING OUTCOME Define hygiene Explain importance of hygiene Explain factors that influence individual hygiene. Describe skin, hair nails and mouth care. 2
- 3. Definition Hygiene: is self care by which people attend to such function as bathing, oral care, grooming hair, cleaning fingernails, genital area, ear and eye care. 3
- 4. Hygiene involves cleansing of the 4 Skin Mouth Teeth Hair Nails Eyes Ears Nose Perineal Area Feet
- 5. Hygiene Cleansing by nurse is part of historical giving of care The more ill patient, the more skill needed in providing the hygiene care. Cleansing skin is first line of defense against organisms protect the patient’s privacy during hygiene care procedures 5
- 6. IMPORTANCE OF NURSE PROVIDED HYGIENE Remove microorganisms promotes relaxation, and increases circulation Improve self image Provides comfort, safety, and health Prevents body and breath odors. Maintains the health of the skin and mucous membranes 6
- 7. Factor influencing individual hygiene Culture. Religion. Environment. Development level. Health and energy. Personal preferences 7
- 8. SOME PEOPLE PREFER SHOWERS, OTHERS PREFER TUB BATHS SOME PEOPLE BATHE IN THE MORNING , SOME BATHE AT BEDTIME BATHING FREQUENCY VARIES AMONG INDIVIDUALS OR CULTURES SOME PEOPLE CANNOT AFFORD SOAP, DEODORANT, SHAMPOO, TOOTHPASTE, OR OTHER HYGIENE PRODUCTS
- 9. Etiologies of self care deficit Visual impairment. Activity intolerance or weakness. Pain or discomfort. Mental impairment. Therapeutic procedures (cast, IV infusion) Neuromuscular or Skeletal impairment. 9
- 10. Functional level of the patient may described as following: Total dependent. Partial dependent. Independent. 10
- 11. 1) Skin Definition: is the largest organ that cover all surface of the body. The skin contains: Epidermis. Dermis. Subcutaneous layer. 11
- 12. Bathing Bathing: practice that use soap and water to remove sweat, oil, dirt, and microorganism from skin. 12
- 13. BED BATHING CONTD………………. WHEN GIVING A BATH YOU CAN EXAMINE THE PATIENT’S ENTIRE BODY. OBSERVE AND REPORT SKIN THAT IS: PALE, DARK, OR REDDENED IN COLOR. ROUGH OR CHAPPED IN TEXTURE. DRY OR FLAKING, LACKING IN MOISTURE. INJURED (BLISTERS, BRUISES, OR LACERATIONS) SORE (PRESSURE SORES OR INFECTIONS)
- 14. condition of skin Pain on movement Level of consciousness Skin turgor Wt loss or gain 14
- 15. REMOVES PERSPIRATION, DIRT, AND GERMS REFRESHES PATIENTS AND MAKES THEM MORE COMFORTABLE STIMULATES CIRCULATION HELPS PREVENT SKIN PROBLEMS PROVIDES EXERCISE
- 16. ASK THE NURSE OR CHECK THE CARE PLAN TO DETERMINE WHAT TYPE OF BATH THE PERSON SHOULD HAVE. ENCOURAGE THE PATIENT TO DO AS MUCH OF THE BATH AS HE CAN. OFFER THE BEDPAN OR URINAL BEFORE YOU BEGIN THE PROCEDURE. COLLECT ALL THE EQUIPMENT NECESSARY BEFORE BEGINNING THE PROCEDURE.
- 17. 17 PROTECT THE PERSON’S PRIVACY. CLOSE DOORS, CURTAINS, AND KEEP THE PERSON COVERED WITH A BATH BLANKET. KEEP THE WATER AT A SAFE TEMPERATURE. DRY UNDER BREASTS, BETWEEN SKIN FOLDS, AND BETWEEN TOES BATHE SKIN WHENEVER URINE OR FECES IS PRESENT
- 18. USE GOOD BODY MECHANICS USE STANDARD PRECAUTIONS AS NEEDED PROTECT THE PERSON FROM FALLING WASH FROM THE CLEANEST AREA TO THE DIRTIEST AREA RINSE ALL AREAS THROUGHLY PAT SKIN DRY. DO NOT RUB THE SKIN
- 20. PLACE EVERYTHING YOU NEED ON THE OVERBED TABLE BEFORE BEGINNING THE BATH. RAISE THE BED TO A COMFORTABLE HEIGHT AND RAISE THE RAIL ON THE FAR SIDE OF THE BED. WASH ONLY ONE PART OF THE BODY AT A TIME. WASH, RINSE, AND DRY EACH PART AND THEN COVER IT WITH THE BATH BLANKET. CHANGE THE WATER IN THE BASIN WHENEVER IT BECOMES SOAPY, DIRTY, OR COOL. KEEP THE SOAP IN THE SOAP DISH BETWEEN LATHERINGS. WASH FROM THE CLEANEST TO THE DIRTEST AREAS.
- 21. 21 Type of bathing: • COMPLETE • Tube bath. • Partial bath. • Shower
- 22. A COMPLETE BED BATH IS GIVEN TO PATIENTS WHO ARE NOT ABLE TO BATHE THEMSELVES. INVOLVES WASHING THE PERSON’S ENTIRE BODY IN BED. PERSONS WHO ARE: UNCONSCIOUS PARALYZED IN A CAST OR TRACTION WEAK FROM ILLNESS OR SURGERY
- 23. Contd………… Wash head to toe, front to back, distal to proximal Physical assessment as you are washing; must also loosen and secure lines as moving and turning patient Change wash clothes for different areas Change water if cold or soiled or very soapy Some put oil in bath water of elderly 23
- 24. WASH THE EYES FIRST. FROM THE INSIDE CORNER TO THE OUTSIDE, USING A DIFFERENT AREA OF THE CLOTH FOR EACH EYE. AFTER WASHING THE FACE, NECK, AND EARS, REMOVE THE GOWN AND WASH THE ARMS, ONE AT A TIME. PLACE THE TOWEL OVER THE PATIENT’S CHEST. LIFT THE CORNER AS YOU WASH THE CHEST. REPEAT FOR THE ABDOMEN. WASH AND DRY ONE LEG AT A TIME. CHANGE THE WATER AT THIS TIME IF YOU HAVE NOT ALREADY NEEDED TO DO SO. WASH THE BACK AND THE BUTTOCKS. A BACKRUB MAY BE GIVEN AT THIS TIME.
- 25. INVOLVES WASHING THE AREAS OF THE BODY THAT CAUSE DISCOMFORT AND ODOR OR NEED DAILY CLEANING. THE AREAS THAT ARE WASHED IN A PARTIAL BATH ARE THE FACE, HANDS, AXILLAE, BACK, AND PERINEAL AREA. OR A PARTIAL BATH MAY REFER TO BATHING THE AREAS THAT THE PATIENT CAN NOT REACH WHEN HE IS BATHING HIMSELF IN BED.
- 26. BECAUSE OF SAFETY CONCERNS TUB BATHS ARE NOT FREQUENTLY GIVEN IN MOST NURSING HOMES. SAFETY MEASURES: NEVER LEAVE A PATIENT ALONE IN THE TUB. A BATH SHOULD LAST NO LONGER THAN 20 MINUTES. PLACE A TOWEL ON THE BOTTOM OF THE TUB TO PREVENT SLIPPING. ADJUST THE WATER TEMPERATURE TO 105° DRAIN THE TUB BEFORE THE PERSON GETS OUT. CLEAN THE TUB BEFORE AND ATER USE.
- 27. A RESIDENT WILL BE PLACED ON A SHOWER CHAIR TO RECEIVE A SHOWER NEVER LEAVE THE PATIENT ALONE ON THE SHOWER CHAIR OR IN THE SHOWER ROOM. ADJUST THE WATER TEMPERATURE BEFORE YOU PLACE THE PERSON IN THE SHOWER. CLEAN THE SHOWER BEFORE AND AFTER USE. GLOVES MAY BE WORN WHILE BATHING A PATIENT IF DESIRED.
- 28. PATIENTS WILL NEED TO BE TRANSFERRED FROM THEIR WHEELCHAIR TO THE SHOWER CHAIR BE SURE TO LOCK BOTH CHAIRS BEFORE TRANSFERRING REMEMBER SHOWER FLOORS CAN BE SLIPPERY! ALWAYS HAVE NON-SKID FOOTWEAR ON PATIENT BEFORE STANDING FOR TRANSFER
- 29. A WHIRLPOOL BATH HELPS TO STIMULATE CIRCULATION AND RELAX MUSCLES A PORTABLE TUB CAN BE USED FOR COMATOSE PATIENTS
- 30. 2. Hair Hair is composed of column of dead keratinized. Its consists of shaft and root. Hair covers the whole body part but its distribution, color differ according to: 1. Location. 2. Age . 3. Gender. 30
- 31. Hair Importance of hair: Appearance. Prevent heat loss. Protection. 31
- 32. Assessment lice and ticks: are small parasites that bite into tissue and suck blood. Hirsutism: the growth of excessive body hair (women and children) Alopecia: hair loss. Dandruff 32
- 33. PEOPLE FEEL BETTER ABOUT THEMSELVES WHEN THEIR HAIR IS COMBED AND LOOKS ATTRACTIVE. PATIENTS SHOULD BE ASKED HOW THEY WOULD LIKE THEIR HAIR STYLED. DO NOT CHANGE A PATIENT’S HAIRSTYLE WITHOUT PERMISSION. NEVER CUT A PATIENT’S HAIR. MAKE SURE THE STYLE IS AGE-APPROPRIATE.
- 34. THE HAIR IS USUALLY SHAMPOOED DURING THE RESIDENT’S SHOWER PUT A WASHCLOTH OVER THE PATIENT’S EYES RETURN MEDICATED SHAMPOO TO THE NURSE TIP THE PERSON’S HEAD BACK TO PREVENT THE SHAMPOO FROM RUNNING IN THE EYES A SHAMPOO TRAY CAN BE USED TO SHAMPOO THE HAIR OF A BEDBOUND PATIENT
- 35. ALWAYS WEAR GLOVES. PLACE A TOWEL ON THE PATIENT’S CHEST APPLY SHAVING CREAM TO THE FACE SHAVE IN THE DIRECTION OF HAIR GROWTH HOLD THE SKIN TAUT WITH YOUR OTHER HAND RINSE THE RAZOR FREQUENTLY WASH THE FACE WHEN FINISHED
- 36. DAILY WASHING AND COMBING ARE NEEDED NEVER TRIM OR SHAVE A BEARD OR MUSTACHE WITHOUT THE PERSON’S CONSENT
- 37. PRACTICE VARIES AMONG CULTURES USUALLY SHAVED AFTER BATHING WEAR GLOVES AND FOLLOW STANDARD PRECAUTIONS UNDERARMS – SHAVE IN DIRECTION OF HAIR GROWTH LEGS – START AT ANKLE AND SHAVE UP THE LEG APPLY DIRECT PRESSURE TO CUTS
- 38. SOAKING THE HANDS HELPS TO SOFTEN THE NAILS BEFORE TRIMMING. SOAK FINGERNAILS FOR 5 TO 10 MINUTES ALWAYS USE A NAIL CLIPPER- NEVER SCISSORS FILE ROUGH NAILS WITH AN EMERY BOARD DO NOT TRIM TOENAILS!! ONLY AN RN OR DR. CAN TRIM TOENAILS.
- 39. EXAMINE THE FEET FOR: INGROWN NAILS HANG NAILS BROKEN OR TORN NAILS BLISTERS, RASH, OR REDDENED AREA CALLUSES AND CORNS SKIN BREAKS AND OTHER INJURIES. CHECK BETWEEN THE TOES FOR CRACKS AND SORES. COMPLAINTS OF PAIN OR ITCHING LET THE NURSE KNOW IF THE PATIENT’S TOENAILS NEED TRIMMING.
- 40. SOAK FEET FOR 15 TO 20 MINUTES CHECK WITH RN FOR WATER TEMPERATURE. AFTER SOAKING, APPLY LOTION TO THE FEET. DO NOT APPLY BETWEEN THE TOES. MAKE SURE YOU DRY THROUGHLY BETWEEN THE TOES FOLLOW STANDARD PRECAUTIONS
- 41. Diagnosis Self care deficit grooming R/T activity intolerance. Risk for infection R/T scalp laceration. 41
- 42. Implementation Brushing, shampooing that stimulate circulation and distribute the oil. 42
- 43. 3. Nail Nails made of keratin. Parts of nail: Nail root. Nail body. Nail bed. 43
- 44. Assessment Clubbing fingers: is condition in which the angle between the nail and nail bed is 180 degree or greater may cause by long term lack of oxygen. Koilonychias: is condition of nails which is like spoon shape may be caused by iron deficiency anemia 44
- 45. Assessment Test capillary refill: delayed return of pink or usual color indicate circulatory problem. 45
- 46. 4) Teeth Each tooth has three parts: 1. Crown: is exposed parts of the tooth which is out side of gum. 2. Root: is embedded in the jaw and covered by bony tissue called cementum. 3. Pulp: is the center of the tooth contains the blood vessels and nerves. 46
- 47. Teeth Deciduous teeth (temporary teeth). Teeth begin to erupt at six month to two year. Permanent teeth. Adults have 28 – 32 permanent teeth depending on wisdom teeth. 47
- 48. INCLUDES: BRUSHING THE TEETH, GUMS, AND TONGUE FLOSSING THE TEETH (REMOVES PLAQUE AND TARTAR) RINSING THE MOUTH WITH MOUTHWASH BRUSH THE TEETH IN AN UP AND DOWN MOTION, BRUSHING ALL SURFACES OF THE TEETH CLEANING DENTURES IS ALSO A PART OF ORAL HYGIENE
- 49. ORAL CARE SOME PATIENTS WILL BE ABLE TO PERFORM ORAL HYGIENE INDEPENDENTLY. OTHERS MAY NEED YOU TO ASSIST WITH ORAL HYGIENE SOME MAY NEED YOU TO PROVIDE THE CARE FOR THEM ORAL HYGIENE IS INCLUDED IN OUR ADL’S IT SHOULD BE PROVIDED IN THE MORNING, AFTER MEALS, AND AT BEDTIME.
- 50. ORAL HYGIENE IS GIVEN EVERY TWO HOURS FOR THE: COMATOSE PATIENT PATIENT WITH A NASOGASTRIC TUBE PATIENT RECEIVING OXYGEN
- 51. MOUTH CARE KEEPS THE MOUTH AND TEETH CLEAN - PREVENTS MOUTH ODORS PREVENTS INFECTIONS INCREASES COMFORT MAKES FOOD TASTE BETTER PREVENTS CAVITIES MUST BE DONE FOR: WEAK PERSONS CONFUSED PERSONS PEOPLE THAT CANNOT USE THEIR ARMS
- 52. DRY, CRACKED, SWOLLEN, OR BLISTERED LIPS UNPLEASANT MOUTH ODORS LOOSE, BROKEN OR DECAYED TEETH SWELLING , REDNESS, SORES, BLEEDING, OR WHITE PATCHES IN THE MOUTH OR ON THE TONGUE BLEEDING, SWELLING, OR REDNESS OF THE GUMS LOOSE, CHIPPED, OR BROKEN DENTURES PATIENT COMPLAINTS
- 53. Dental caries: teeth have darkened areas. Gingivitis: inflammation of gum. Glossitis: inflammation of tongue. Stomatitis: inflammation of the oral mucosa. Cheilosis: cracking of lips. Halitosis: bad breath. 53
- 54. THE MOUTH OF AN UNCONSCIOUS PERSON MAY HANG OPEN CAUSING THE MOUTH AND MUCOUS MEMBRANES TO DRY OUT. OR ORAL SECRETIONS MAY ACCUMULATE IN THE MOUTH DUE TO THE PERSON’S INABILITY TO COUGH OR CLEAR THE THROAT. THESE CONDITIONS MAY LEAD TO DISCOMFORT AND THE GROWTH OF PATHOGENS.
- 55. ALWAYS WEAR GLOVES WHEN PERFORMING ORAL HYGIENE. POSITION THE COMATOSE PATIENT ON HIS SIDE TO PREVENT ASPIRATION. PLACE A TOWEL UNDER THE PATIENT’S HEAD TO CATCH SECRETIONS. USE A PADDED TONGUE BLADE TO OPEN THE PERSON’S MOUTH.
- 56. A SPONGY PIECE OF FOAM ON A STICK – CALLED A TOOTHETTE IS USED TO CLEAN THE MOUTH OF A COMATOSE PATIENT. MAKE SURE THE SPONGE IS TIGHT ON THE STICK. CHECK THE CARE PLAN FOR WHAT CLEANING AGENT TO USE, USUALLY DILUTED MOUTHWASH. MAY ALSO USE A LARGE, PREPACKAGED COTTON SWAB CALLED A LEMON & GLYCERIN SWAB
- 57. BE SURE TO USE ONLY A SMALL AMOUNT OF FLUID TO PREVENT ASPIRATION ALWAYS ASSUME THE UNCONSCIOUS PERSON CAN HEAR YOU. ALWAYS EXPLAIN WHAT YOU ARE DOING.
- 58. DENTURES SHOULD BE CLEANED AS OFTEN AS NATURAL TEETH. DENTURES ARE SLIPPERY WHEN WET. THEY CAN EASILY BREAK IF DROPPED ONTO A HARD SURFACE. DENTURES ARE EXPENSIVE AND ARE THE RESIDENT’S PERSONAL PROPERTY. LOSING OR DAMAGING DENTURES IS NEGLIGENT CONDUCT. CARRY THE DENTURES BACK AND FORTH FROM THE SINK IN AN EMESIS BASIN LINED WITH A PAPER TOWEL.
- 59. CLEAN THE DENTURES IN A BASIN OR SINK LINED WITH PAPER TOWELS OR A WASHCLOTH. FILL THE BASIN OR SINK PART WAY WITH COOL WATER USE COOL WATER TO CLEAN THE DENTURES. ( HOT WATER WILL CAUSE THEM TO WARP )
- 60. 60 STORE THE DENTURES IN COOL WATER IN THE PERSON’S DENTURE CUP CHECK THE LINEN WHEN STRIPPING THE BED OR THE MEAL TRAY BEFORE RETURNING IT FOR WAYWARD DENTURES.
- 61. USE A GAUZE PAD TO GRASP THE UPPER DENTURE AND USING YOUR THUMB GENTLY BREAK THE SUCTION HOLDING THE DENTURE IN PLACE.
- 62. 5. Care of eyes Eyes considered sterile Patient must be able to blink to protect cornea Use artificial tear solution or normal saline every four hour, if blink reflex is absent. Clean from inner to outer canthus with wet, warm cotton ball or compress. 62
- 63. Care of eye Treat each eye separately. Contact lenses usually removed and stored in saline liquid; case labeled 63
- 64. 6) Ear and nose Wash external ear with wash cloth - covered finger . Clean nose by having patient blow. If indicated use nasal suction with bulb syringe. 64
- 65. Perineum Perineum: area around the genital and rectum, its required special cleaning technique. When perineal care: After vaginal delivery. Gynecological or rectal surgery. Urine, stool. 65
- 66. INVOLVES THE CLEANING OF THE GENITAL AND ANAL AREAS OF THE BODY THE PERINEAL AREA IS WARM, DARK, AND MOIST AND SO PROVIDES AN IDEAL ENVIRONMENT FOR MICROORGANISMS TO GROW. THE AREAS ARE CLEANED AT LEAST ONCE DAILY TO PREVENT INFECTION AND ODORS AND TO PROVIDE COMFORT. PERI-CARE SHOULD BE PROVIDED AFTER EACH INCONTINENT EPISODE. USE STANDARD PRECAUTIONS. MAY HAVE TO USE THE TERM PRIVATE AREA
- 67. ALWAYS CLEANSE FROM THE URINARY MEATUS TOWARD THE ANUS. ( CLEAN TO DIRTY ) MAY HAVE A PREPACKAGED KIT OR USE WET WASHCLOTHS. USE A DIFFERENT PART OF THE WASHCLOTH FOR EACH STROKE TO CLEAN THE ANAL AREA , CLEANSE FROM THE VAGINA TOWARD THE ANUS (CLEAN TO DIRTY)
- 68. START AT THE URINARY MEATUS AND USE CIRCULAR MOTIONS AS YOU WIPE DOWNWARD TO THE BASE RETRACT THE FORESKIN IF THE PATIENT IS UNCIRCUMCISED RETURN THE FORESKIN TO ITS NATURAL POSITION WHEN YOU ARE FINISHED
- 69. IN A HOSPITAL PATIENTS WEAR HOSPITAL GOWNS OR THEIR NIGHTCLOTHES IN A NURSING HOME RESIDENTS ARE REQUIRED BY THE STATE TO BE DRESSED IN STREET CLOTHES DURING THE DAY IF THE RESIDENT CAN NOT ASSIST, IT IS EASIER AND SAFER TO DRESS THE RESIDENT WHILE SHE IS STILL IN BED.
- 70. PROVIDE FOR PRIVACY. DO NOT EXPOSE THE PERSON. ENCOURAGE THE PERSON TO DO AS MUCH AS POSSIBLE. ALLOW THE PERSON TO CHOOSE WHAT TO WEAR. REMOVE CLOTHING FROM THE STRONG OR GOOD SIDE FIRST. PUT CLOTHING ON THE WEAK SIDE FIRST. TOS – TAKE OFF STRONG POW – PUT ON WEAK
- 71. A PERSON MAY HAVE TO BE TURNED FROM SIDE TO SIDE AS YOU PUT ON OR REMOVE THEIR PANTS.
- 72. THE GOWN IS FIRST REMOVED FROM THE GOOD ARM. IT IS THEN SLIPPED OVER THE IV SITE AND TUBING TO THE BAG. THE BAG IS PASSED THROUGH THE SLEEVE. THE CLEAN GOWN IS PASSED OVER THE IV BAG. DO NOT LOWER THE BAG BELOW THE LEVEL OF THE IV SITE
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