Chapter 22 Personal Hygiene Copyright 2017 Elsevier Inc

Chapter 22 Personal Hygiene Copyright © 2017, Elsevier, Inc. All rights reserved.

Personal Hygiene promotes comfort, safety, and health. Intact skin: Is the body’s first line of defense against disease Ø Prevents microbes from entering the body and causing an infection Ø Mucous membranes of the mouth, genital area, and anus must be clean and intact. Copyright © 2017, Elsevier, Inc. All rights reserved. 2

Personal Hygiene (Cont. ) Good hygiene: Cleanses the body Ø Prevents body and breath odors Ø Is relaxing Ø Increases circulation Ø Culture and personal choice affect hygiene. Many factors affect hygiene needs. The nurse uses the nursing process to meet the person’s hygiene needs. Ø Follow the nurse’s directions and the care plan. Copyright © 2017, Elsevier, Inc. All rights reserved. 3

Daily Care Most people have hygiene routines and habits. Routine care is given during the day and evening. Early morning/AM care is given before breakfast. Ø Morning care is given after breakfast. Ø Afternoon care is done after lunch and before the evening meal. Ø Evening/PM care is given in the evening at bedtime. Ø You assist with hygiene whenever it is needed. Copyright © 2017, Elsevier, Inc. All rights reserved. 4

Oral Hygiene Oral hygiene (mouth care) Keeps the mouth and teeth clean Ø Prevents mouth odors and infections Ø Increases comfort Ø Makes food taste better Ø Reduces the risk for cavities (dental caries) and periodontal disease Ø Flossing Removes plaque and tartar from the teeth Ø Removes food from between the teeth Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 5

Oral Hygiene (Cont. ) Many people perform oral hygiene themselves. Others need help gathering and setting up equipment. You perform oral hygiene for persons who: Are very weak Ø Cannot move or use their arms Ø Are too confused to brush their teeth Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 6

Oral Hygiene (Cont. ) Mouth care for the unconscious person Unconscious persons may have mouth dryness and crusting on the tongue and mucous membranes. Ø The care plan tells you what cleaning agent to use. • Use sponge swabs to apply the cleaning agent. Ø Applying a lubricant to the lips after cleaning prevents cracking of the lips. • Check the care plan. Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 7

Oral Hygiene (Cont. ) Ø Protect unconscious persons from choking and aspiration (breathing fluid, food, vomitus, or an object into the lungs). • 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. Ø Always assume that unconscious persons can hear. Ø Mouth care is given at least every 2 hours. • Follow the nurse’s directions and the care plan. Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 8

Oral Hygiene (Cont. ) Denture care Ø Ø Ø Ø A denture is an artificial tooth or a set of artificial teeth. Full and partial dentures are common. Mouth care is given and dentures cleaned as often as natural teeth. Dentures are slippery when wet. 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. You clean dentures for those who cannot do so. Copyright © 2017, Elsevier, Inc. All rights reserved. 9

Bathing has the following benefits: It cleans the skin. Ø It cleans the mucous membranes of the genital and anal areas. Ø It is refreshing and relaxing. Ø Circulation is stimulated and body parts exercised. Ø Observations are made. Ø You have time to talk to the person. Ø Complete or partial baths, tub baths, or showers are given. Copyright © 2017, Elsevier, Inc. All rights reserved. 10

Bathing (Cont. ) The bathing method depends on: The person’s condition Ø Self-care abilities Ø Personal choice Ø The person’s choice of bath time is respected whenever possible. Bathing frequency is a personal matter. Copyright © 2017, Elsevier, Inc. All rights reserved. 11

Bathing (Cont. ) For a complete bed bath, you wash the person’s entire body in bed. Ø Bed baths are usually needed by persons who are: • Unconscious • Paralyzed • In casts or traction • Weak from illness or surgery For a towel bath, an oversized towel is used. Bag baths are commercially prepared or prepared at the agency. Copyright © 2017, Elsevier, Inc. All rights reserved. 12

Bathing (Cont. ) The partial bath involves bathing the face, hands, axillae (underarms), back, buttocks, and perineal area. Ø Some persons bathe themselves in bed or at the sink. You assist as needed. Tub baths and showers Falls, burns, and chilling from water are risks. Ø Safety is important. Ø Protect the person’s privacy. Ø Follow the nurse’s directions and the care plan. Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 13

Perineal Care Perineal care (pericare) involves cleaning the genital and anal areas. Ø Cleaning prevents infection and odors, and it promotes comfort. Perineal care is done: Daily during the bath Ø Whenever the area is soiled with urine or feces Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 14

Perineal Care (Cont. ) Perineal care is very important for persons who: Have urinary catheters Ø Have had rectal or genital surgery Ø Are menstruating Ø Are incontinent of urine or feces Ø Are uncircumcised Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 15

Perineal Care (Cont. ) The person does perineal care if able. This procedure embarrasses many people and staff. Standard Precautions, medical asepsis, and the Bloodborne Pathogen Standard are followed. When giving perineal care: Use warm water, not hot. Ø Use washcloths, towelettes, cotton balls, or swabs according to agency policy. Ø Rinse thoroughly. Ø Pat dry after rinsing. Ø Copyright © 2017, Elsevier, Inc. All rights reserved. 16

Reporting and Recording Report the following observations at once: Bleeding Ø Signs of skin breakdown Ø Discharge from the vagina or urinary tract Ø Unusual odors Ø Changes from prior observations Ø Report and record the care given. Ø If care is not recorded, it is assumed that care was not given. Copyright © 2017, Elsevier, Inc. All rights reserved. 17