Ch 31: Hygiene Flashcards
When assessing hygiene what do you want to do first what do you want to do second
Define personal hygiene
What is the link between good hygiene
When assessing hygiene: #1 assess #2 hygiene practice

 personal hygiene: is ensuring to keeping a minimal level of personal cleanliness
There is a link between good hygiene and patient health
What do hygiene practices include
When we assess the skin what are two other structures we are assessing “ accessory structures of skin” 
What health does a client general health influence
What kind of deficiency can lead to cavities
Hygiene practices include caring for:
- Skin
- hair
- nails
- eyes ears nose mouth
- feet
- perineal area
When assessing skin also assess hair and nails as accessory structures to skin
A patient’s general health influences the health of the mouth and teeth
Deficiencies in calcium, phosphorus, vitamin D can lead to cavities
What is the perineal area that provides a condition that favors bacterial growth and what may happen
The perineal areas characteristics of being dark, warm, moist provide conditions of favor bacterial growth that may cause skin breakdown and odors
What endocrine abnormalities can affect skin integrity and hair
- DM (dry, fungal skin, high risk of wound)
- higher temperature
- poor nutrition
- anxiety
are endocrine abnormalities that may affect skin integrity and hair
What are factors affect personal hygiene
Culture 
-beating habits and behavior + use of hygiene products
socioeconomic class -May lack access to a bath, milk funds to purchase toiletries and clean clothing  spiritual practices - beliefs dictate ceremonial washing
developmental level
- Family practices may dictate habits of hygiene (when do you shower)
- elders may not bathe every day due to dry skin
health state
-please, surgery, injury can reduce ability to perform hygiene and motivation to follow habits
personal preference
- shower> Bath
- some people shower to promote self image
When you’re doing your nursing history how do you assess hygiene practices what do you want to ask the patient
When doing nursing history use all senses to assess hygiene practices
Ask the patient different thing interferes with them not being able to clean like they would like to
When doing a focused assessment for hygiene practices what are you assessing
- habits
- factors
- exposure
- problems
- history / changes
-daily/weekly bathing habits
-factors that affect practices
-pain/sun exposure
-history of skin or mucus mean problems
-any changes or history of problems

During the focus assessment for hygiene what are question they want to ask
- How long have you had this problem
- Does it bother you (painful/ADL)
- Have you found anything helpful in relieving symptoms 
What are a few factors to consider when assessing the skin
Cleanliness color temperature turgor moisture sensation vascularity (ecchymosis and Petichiea)  evidence of lesions
When do you want to incorporate the assessment of the skin and what is the best time (activity/time of day) and why
How do you compare for symmetry
What terminology is used to report and record findings 
What direct your skin assessment
what is vital to identify
You want to incorporate the assessment of the skin during the other assessment of the body systems
The best time is doing bathtime in the daylight to avoid assessment mistakes
Compare for symmetry using bilac comparison
Use standard terminology to report and record findings
Allow data Obtained in nursing history to direct skin assessment (guide focus)
Identify any variable known to cause skin problems

If you do not have the opportunity to be patient how do you want to assess the skin
If you do not have the opportunity to bathe the patient thouroughly assess the skin especially for pressure ulcers
What do you want to look for in the assessment of the oral cavity
What is vital to remember if the patient has prosthetic teeth
Lips buccal mucosa color and surface if the gums teeth tongue hard/ soft palate oropharynx
If the patient has proceed teeth remove and assist the gums for fungi
What are you looking for when you are assessing the eyes ears nose
Eyes : position, alignment, discharge
ears
nose: Patency, discharge
What do you want to look for when assessing the hair
Texture cleanliness oiliness
-consider ethnicity in hair (Products and characteristics)
Scalp for lesions inflammation infection (pediculosis)
Dandruff alopecia infestations
What are you looking for when you are assessing the nails, feet and perineal vaginal area’s
What do you want to look for in a patient’s feet and what do you suspect if there’s a history of falls
Regarding the vaginal and perineal area -what do you want to Pay special attention to
- how often do you assess and clean clean
- what do you want to avoid andvwhy
Nails
feet
perineal vaginal areas
-CLEANLINESS IN ALL 4!
- Look at the footwear worn
- There may be a history of falls if foot issues
Vaginal and perineal area:
- Pay special attention if urinary or fecal incontinence as well as indwelling catheters
- assess and clean every 12 hours
- do not over clean as you may cause irritation And dryness
What are risk factors for skin alterations (cuts or issues)
-nutrition
- sunbathing
-fillers/ Botox
-smokers
being diabetic
When creating a nursing diagnosis would do you carefully want to assess that may lead to the development of one or more diagnosis related to hygiene
Give three nursing diagnosis is related to hygiene
When creating a nursing diagnosis carefully assess patient’s hygiene practice and skin, mucous membranes, other areas I may lead to the development of one or more nursing diagnosis related to hygiene
- Self-care deficit
- BOT WANTING TO DO feeding bathing dressing toileting - Impaired oral mucous membranes
- impaired hygiene
- malnutrition
- dehydration - Impaired social interaction
- negative body image
Good hygiene care or practices are provided early morning
Early morning:
-after waking:
•wash hands, face ,mouth
•toilet
-after breakfast:
•bathe
•back massage
•special care (patient getting ready for date)
•dress
- change bed linensWhen bathing the patient how do you introduce the topic and what do you say
 what do you never want to do regarding bathing
When bathing:
-clearly state SHOWER TIME give the patient the equipment and say you’ll be back in 10 to 15 minutes
🚫Never ask “IF” The patient wants to shower 
What is provided in afternoon care

Afternoon care:
- Toilet
- wash hands
- oral care
Straighten bed linens
- help client preposition
What is provided during hour of sleep care
Hour of sleep care:
- toilet, washing (bath?), oral care
- back massage
- change soiled linens and clothing
- Position patient comfortably
What is considered as needed care
- hygiene measures as needed
- frequency of clothing and bed line changing as well as oral and bathing
- Oral care every two hours if indicated
What is the reason for providing back massages
Who do you specially want to provide that massages for
***Promote opportunity to observe skin for breakdown
-General body conditioner
- relieves tension, relaxation
-Improve circulation
-decrease pain anxiety
-improve sleep
-means to Communicate through touch
• shows caring
Provide back massages especially if your patient is non-ambulatory
What are a few purposes of bathing
- Cleaning conditioning skin
- Relaxing patient
- promote circulation
- serves as musculoskeletal exercise -stimulates rate and depth of respirations
- helps improve self image
- strengthens nurse patient relationship
When providing a bed bath
- how do you want to avoid Disruptions
- when is the best time for bed bath
- what do you want to replace linens with
- what do you want to place within reach
- Who do you want to assist
And you’re older population what do you want to be cautious with when beating
-avoid disruptions  by ensuring all items are in close proximity
-Best time: non-visiting hours for privacy
-replace linens with bath blankets
• decrease splash
-please cosmetics inconvenient within reach places
-assist those who cannot self bath
 an older because she of generational differences regarding being exposed (expose what you need drip as you go)
When observing for oral problems: Define: -Peridontitis -gingivitis -carries -plaque -Cheilosis -Stomatitis -Glossitis
***Peridontitis: information of gum + Degen of dental tissue and bone

-gingivitis: information of gums

-carries : decay of teeth to cavities

-plaque: invisible destructive bacterial film destroying enamel
**Cheilosis: ulceration of the lips at the mouth angle

**Stomatitis: Inflammation of oral mucosa

***Glossitis: inflammation of tongue
What are risks for oral problems and what do you do a patient cannot do self oral care
Risk for oral problems:
- coma
- Confused
- depressed
- chemo
If oatient cannot do oral care do it for the patient
What is the angle placing of the brush to the gums in what direction do you brush in
What is the technique for oral hygiene
Please brush at 45° angle to gumline brush from gumline to crown of EACH tooth
Moisten mouth clean mouth care for dentures brush and floss use mouthwash
What direction do you clean the eye + why, what is the temperature of the water
What do you want to use if your patience blink reflex is gone
What do you want to assess for if you note an abnormal Eye
Clean the eye from inner to outer direction with warm cloth to prevent introduction of infection
Patient does not have blink reflex use artificial tears or normal sailing every four hours
Assess for prosthetic eye
What should you wash when caring for ear
What do you AVOID USING
How do you have the patient clean their nose
How do you remove crusted secretions around nose
When caring for ear wash external ear
NEVER USE COTTON SWABS
Have the patient clean nose by blowing
Remove Kirsten secretions by applying warm moist compress
When providing hair care what do you want to give preference to
What do you want to treat and how does it spread
In males what is important to care for
One providing care give preference to patients preferences
Treat any infestations by Películosis
-Spreads direct (contact) indirect (close linens brushes)
In males: care for beards and mustaches
Give the technique for shampoo and hair using protective pad or plastic tray
- Prepare several pictures with warm water (100 -125°) + towels
- Please protect a pad or plastic tree underhead
- Play patient overpad so water drains into receptacle
- With hair, apply shampoo, massage scalp
- Rinse hair thouroghly and reapply shampoo if needed
- Apply conditioner if requested or dry scalp
- Dry hair as quickly as possible to prevent chills
- Do hair to patient preference
What action may assist with cleaning and trimming of nails
-Soak nails and feet to assist with -cleaning and trimming massage feet -provide diabetic foot care
What do you do before caring for the peroneal or vaginal area
How do you want to perform perineal care
-What do you do if patient requires an erection during care
How do you want to cleanse vaginal area + Perineal area (men)
What do you want to AVOID 
PhysicallyAssess Peroneal or vaginal area FIRST
 perform perineal care in a matter of fact and dignified manner
-if erection: excuse yourself give patient time and come back
Cleanse vaginal area + perineal area (men) with plain soap and water
AVOID LAUGHING!


How do you clean a woman’s vagina
-Direction and towel
How do you clean a mans penis
Woman: 
- use front to back direction
- change folding of the towel each pass
Men:
- Circular motion from the meatus out
- go from shaft head to base
What do you do to ensure bedside safety
Ensure bed is in lowest position
The position is safe for patient and controls are functioning
 call light within reach

What side rail do you always want to have up when turning the patient
Always have upper side rails up to prevent falls when turning patient
What are patient outcomes for the hygiene assessment
Ensure participation of patient in hygiene program
Eliminate, reduce, compensate for factors interfering with independent execution of hygiene measures
Changes related to specific skin problems and independent patient management of prescribed treatment program
-ensure patient can self-care skin conditions
What is number one regarding patient care
When bathing what do you bathe last
1 Is patient preference
Face face and hair last
Who is at risk for nail in foot problems
Diabetics
obese
nailbiter‘s
frequent washers
