Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Chapter 16
Assisting With Hygiene
Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Hygiene Basics
 The skin is the body’s first line of defense
against disease.
 Intact skin prevents microbes from entering the
body and causing an infection.
 Good hygiene:
 Cleanses the skin and mucous membranes
 Prevents body and breath odors
 Is relaxing and increases circulation
 Culture and personal choice affect hygiene.
2
Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Daily Care
 Most people have hygiene routines and habits.
 You assist with hygiene whenever it is needed.
 Protect the right to privacy and to personal choice.
 Routine care is given during the day and evening.
 Routine care given before breakfast is called early
morning care or AM care.
 Morning care is given after breakfast.
 Afternoon care is given after lunch and before the
evening meal.
 Care given in the evening at bedtime is called evening
care or PM care.
3
Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Oral Hygiene
 Oral hygiene (mouth care) does the following:
 Keeps the mouth and teeth clean
 Prevents mouth odors and infections
 Increases comfort
 Makes food taste better
 Reduces the risk for cavities (dental caries) and
periodontal disease (gum disease, pyorrhea)
4
Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Oral Hygiene, cont’d.
 Flossing does the following:
 Removes food from between the teeth
 Removes plaque and tartar
• Plaque and tartar cause periodontal disease.
 You may have to perform oral hygiene for
persons who:
 Are very weak
 Cannot move or use their arms
 Are too confused to brush their teeth
5
Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Oral Care for the Unconscious
Person
 Mouth care for the unconscious person
 Unconscious persons may have mouth dryness and
crusting on the tongue and mucous membranes.
 The care plan tells you what cleaning agent to use.
• Use sponge swabs to apply the cleaning agent.
 To prevent cracking of the lips, apply a lubricant to the
lips after cleaning.
• Check the care plan.
 Protect unconscious persons from choking and
aspiration.
• Aspiration is breathing fluid, food, vomitus, or an object into the
lungs.
6
Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Oral Care for the Unconscious
Person, cont'd.
 To prevent aspiration:
 Position the person on one side with the head turned well to
the side.
 Use only a small amount of fluid to clean the mouth.
 Do not insert dentures.
 Keep the person’s mouth open with a padded tongue
blade.
 Unconscious persons cannot speak or respond to you.
 Always assume that unconscious persons can hear.
 Explain what you are doing step by step.
 Mouth care is given at least every 2 hours.
 Follow the nurse’s directions and the care plan.
7
Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Denture Care
 Denture care
 A denture is an artificial tooth or a set of artificial teeth.
 Mouth care is given and dentures cleaned as often as
natural teeth.
 Dentures are slippery when wet. Hold them firmly.
 To use a cleaning agent, follow the manufacturer’s
instructions.
 Hot water causes dentures to lose their shape (warp).
 Remind patients and residents not to wrap dentures in
tissues or napkins.
8
Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Bathing
 Bathing has the following benefits:
 It cleans the skin.
 It cleans the mucous membranes of the genital and anal
areas.
• Microbes, dead skin, perspiration, and excess oils are removed.
 A bath is refreshing and relaxing.
 Circulation is stimulated and body parts exercised.
 Observations are made.
 You have time to talk to the person.
9
Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Bathing, cont'd.
 Complete or partial baths, tub baths, or showers
are given.
 The method depends on:
• The person’s condition
• Self-care abilities
• Personal choice
 Personal choice, weather, activity, and illness
affect bathing frequency.
 The care plan tells you when to bathe the person.
10
Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Bathing, cont'd.
 The complete bed bath involves washing the
person’s entire body in bed.
 Bed baths are usually needed by persons who are:
• Unconscious
• Paralyzed
• In casts or traction
• Weak from illness or surgery
 The partial bath involves bathing the face, hands,
axillae (underarms), back, buttocks, and perineal
area.
 Some persons bathe themselves in bed or at the sink.
 You assist or give partial baths as needed.
11
Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Tub Baths and Showers
 Falls, burns, and chilling from water are risks.
 Tub baths are relaxing.
 A tub bath lasts no longer than 20 minutes.
 Showers
 If persons can stand, they use the grab bars for support
during the shower.
 Showers have non-skid surfaces or a bath mat is used.
 Never let weak or unsteady persons stand in the
shower.
 Some shower rooms have two or more stations.
• Protect the person’s privacy.
12
Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Perineal Care
 Perineal care (pericare) involves cleaning the
genital and anal areas.
 Cleaning prevents infection and odors, and it promotes
comfort.
 Perineal care is done:
 Daily during the bath
 Whenever the area is soiled with urine or feces
13
Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Perineal Care, cont'd.
 Perineal care is very important for persons who:
 Have urinary catheters
 Have had rectal or genital surgery
 Have given birth
 Are menstruating
 Are incontinent of urine or feces
 Are uncircumcised
 The person does perineal care if able.
14
Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved.
Perineal Care, cont'd.
 When giving perineal care, Standard Precautions,
medical asepsis, and the Bloodborne Pathogen
Standard are followed.
 Work from the cleanest area to the dirtiest.
 When giving perineal care:
 Use warm water, not hot.
 Use washcloths, towelettes, cotton balls, or swabs
according to agency policy.
 Rinse thoroughly.
 Pat dry after rinsing.
15

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Section 3 assisting with hygiene-1

  • 1. Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved. Chapter 16 Assisting With Hygiene
  • 2. Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved. Hygiene Basics  The skin is the body’s first line of defense against disease.  Intact skin prevents microbes from entering the body and causing an infection.  Good hygiene:  Cleanses the skin and mucous membranes  Prevents body and breath odors  Is relaxing and increases circulation  Culture and personal choice affect hygiene. 2
  • 3. Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved. Daily Care  Most people have hygiene routines and habits.  You assist with hygiene whenever it is needed.  Protect the right to privacy and to personal choice.  Routine care is given during the day and evening.  Routine care given before breakfast is called early morning care or AM care.  Morning care is given after breakfast.  Afternoon care is given after lunch and before the evening meal.  Care given in the evening at bedtime is called evening care or PM care. 3
  • 4. Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved. Oral Hygiene  Oral hygiene (mouth care) does the following:  Keeps the mouth and teeth clean  Prevents mouth odors and infections  Increases comfort  Makes food taste better  Reduces the risk for cavities (dental caries) and periodontal disease (gum disease, pyorrhea) 4
  • 5. Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved. Oral Hygiene, cont’d.  Flossing does the following:  Removes food from between the teeth  Removes plaque and tartar • Plaque and tartar cause periodontal disease.  You may have to perform oral hygiene for persons who:  Are very weak  Cannot move or use their arms  Are too confused to brush their teeth 5
  • 6. Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved. Oral Care for the Unconscious Person  Mouth care for the unconscious person  Unconscious persons may have mouth dryness and crusting on the tongue and mucous membranes.  The care plan tells you what cleaning agent to use. • Use sponge swabs to apply the cleaning agent.  To prevent cracking of the lips, apply a lubricant to the lips after cleaning. • Check the care plan.  Protect unconscious persons from choking and aspiration. • Aspiration is breathing fluid, food, vomitus, or an object into the lungs. 6
  • 7. Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved. Oral Care for the Unconscious Person, cont'd.  To prevent aspiration:  Position the person on one side with the head turned well to the side.  Use only a small amount of fluid to clean the mouth.  Do not insert dentures.  Keep the person’s mouth open with a padded tongue blade.  Unconscious persons cannot speak or respond to you.  Always assume that unconscious persons can hear.  Explain what you are doing step by step.  Mouth care is given at least every 2 hours.  Follow the nurse’s directions and the care plan. 7
  • 8. Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved. Denture Care  Denture care  A denture is an artificial tooth or a set of artificial teeth.  Mouth care is given and dentures cleaned as often as natural teeth.  Dentures are slippery when wet. Hold them firmly.  To use a cleaning agent, follow the manufacturer’s instructions.  Hot water causes dentures to lose their shape (warp).  Remind patients and residents not to wrap dentures in tissues or napkins. 8
  • 9. Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved. Bathing  Bathing has the following benefits:  It cleans the skin.  It cleans the mucous membranes of the genital and anal areas. • Microbes, dead skin, perspiration, and excess oils are removed.  A bath is refreshing and relaxing.  Circulation is stimulated and body parts exercised.  Observations are made.  You have time to talk to the person. 9
  • 10. Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved. Bathing, cont'd.  Complete or partial baths, tub baths, or showers are given.  The method depends on: • The person’s condition • Self-care abilities • Personal choice  Personal choice, weather, activity, and illness affect bathing frequency.  The care plan tells you when to bathe the person. 10
  • 11. Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved. Bathing, cont'd.  The complete bed bath involves washing the person’s entire body in bed.  Bed baths are usually needed by persons who are: • Unconscious • Paralyzed • In casts or traction • Weak from illness or surgery  The partial bath involves bathing the face, hands, axillae (underarms), back, buttocks, and perineal area.  Some persons bathe themselves in bed or at the sink.  You assist or give partial baths as needed. 11
  • 12. Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved. Tub Baths and Showers  Falls, burns, and chilling from water are risks.  Tub baths are relaxing.  A tub bath lasts no longer than 20 minutes.  Showers  If persons can stand, they use the grab bars for support during the shower.  Showers have non-skid surfaces or a bath mat is used.  Never let weak or unsteady persons stand in the shower.  Some shower rooms have two or more stations. • Protect the person’s privacy. 12
  • 13. Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved. Perineal Care  Perineal care (pericare) involves cleaning the genital and anal areas.  Cleaning prevents infection and odors, and it promotes comfort.  Perineal care is done:  Daily during the bath  Whenever the area is soiled with urine or feces 13
  • 14. Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved. Perineal Care, cont'd.  Perineal care is very important for persons who:  Have urinary catheters  Have had rectal or genital surgery  Have given birth  Are menstruating  Are incontinent of urine or feces  Are uncircumcised  The person does perineal care if able. 14
  • 15. Elsevier items and derived items © 2014, 2010 by Mosby, an imprint of Elsevier Inc. All rights reserved. Perineal Care, cont'd.  When giving perineal care, Standard Precautions, medical asepsis, and the Bloodborne Pathogen Standard are followed.  Work from the cleanest area to the dirtiest.  When giving perineal care:  Use warm water, not hot.  Use washcloths, towelettes, cotton balls, or swabs according to agency policy.  Rinse thoroughly.  Pat dry after rinsing. 15