Ch 38. Hygine

Question 1

Skin Layers 3

Answer 1

Epidermis
Dermis
Subcutaneous

Question 2

What can affect someones hygiene?

Answer 2

1) Social practices
Social and family influences on hygiene patterns
2) Personal preferences
Dictate hygiene practices
3) Body image
A person’s subjective concept of his of her body appearance
4) Socioeconomic status
Can influence the type and extent of hygiene practices used
5) Health beliefs and motivation
Motivation as the key factor to hygiene
6) Cultural variables
Cultural beliefs and personal values
7) Physical condition
Pain, disability, physical limitations

Question 3

Risk factors for skin impairment

Answer 3

Immobilization
Reduced sensation
Nutrition and hydration alterations
Secretions and excretions on the skin
Vascular insufficiency
External devices

Question 4

Skin Problem Interventions: Dry Skin

Answer 4

• less frequent bathing
• increase fluid intake
• use nonallergic moisturizing cream to form protective barrier
• use creams to clear skin

Question 5

Skin Problem Interventions: contact dermatitis

Answer 5

contact dermatitis: inflammation of skin characterized by abrupt onset of scaly oozing lesions, pruritus this pain and erythmia.

Avoid positive agents like cleaners and soaps

Question 6

Skin Problem Interventions: psoriasis

Answer 6

non contagious chronic skin condition characterized by abnormal growth inflammatory reaction that results in thick silvery scaly inflamed patches of skin.

Treatment aimed at reducing the extent and severity of the condition an improving quality of life patient avoid triggers like smoking, stress, alcohol and sunburn

Question 7

Skin Problem Interventions: abrasion

Answer 7

abrasion scraping or rubbing away of epidermis that may result in localized bleeding and later weeping of cirrhosis fluid.

Caregivers Trim fingernails not wear jewelry, clean the area and dry thoroughly and gently, observe for retained moisture in bandages and dressings, lift not pull when transferring or repositioning at patient

Question 8

Skin Problem Interventions: acne

Answer 8

acne wash hair and skin thoroughly, use cosmetics sparingly, used prescribed topical or oral antibiotics

Question 9

Skin Problem Interventions: skin rash

Answer 9

skin rash wash area thoroughly and apply antiseptic spray or lotion to prevent further itching and aid in healing, apply warm or cold compress to relieve inflammation

Question 10

Interventions: Callus

Answer 10

thikckened portion of epidermis

advise patient to wear gloves when using tools, soak in warm water. apply cream/lotion

Question 11

Interventions: Keratosis (corns)

Answer 11

cone shaped, round and raised normally between toes

may need surgical removal. wider softer shoes. warm water soaks to soften corns before gentle rubbing with callus file or pumice stone

Question 12

Interventions: Plantar warts

Answer 12

fun gating lesion on sole of foot

salicylic acid electrodessication, freezing with solid CO2

Question 13

Interventions: Tinea pedis (athlete’s foot)

Answer 13

fungal infection. Small blisters containing fluid. scaliness and cracking of skin

well ventilated feel. Dry feet after bath, clean socks

Question 14

Interventions: Ingrown nails

Answer 14

nail grows inward into soft tissue

freq hot soaks in antiseptic, remove part of nail, educate patient on proper nail trimming

Question 15

Interventions: Ram’s horn nails

Answer 15

usually long curved thicker nail

refer to podiatrist

Question 16

Interventions: Paronychia

Answer 16

Inflammation of tissue surrounding the nail after a hangnail or other injury.

hot compresses or soak, topical or oral antibiotics can be prevented by careful manicuring

Question 17

Interventions: Odours

Answer 17

results from excess perspiration promoting microorganism growth

frequent washing, using foot deodorants and powders, wearing clean footwear

Question 18

Interventions: Dandruff

Answer 18

Scaling of the sculp accompanied by itching

shampoo regularly with medical soap

Question 19

Interventions: Ticks

Answer 19

small grey brown parasite that Burrows into skin and sucks blood

don’t pull ticks quickly from skin remove slowly with tweezers

Question 20

Interventions: Pediculosis capitis (head lice)

Answer 20

transmission by direct contact

check entire scalp. use medicated shampoo use fine toothed comb for manual removal

Question 21

Interventions: Pediculosis corporis (body lice)

Answer 21

ask the patient to bathe her shower thoroughly.

Recommend pediculicide lotion big infested clothing vacuum rooms

Question 22

Interventions: Pediculosis pubis (crab lice)

Answer 22

found in pubic hair grayish white with red legs

clean pubic hair remove lice treat sexual partners

Question 23

Interventions: Alopecia (hair loss)

Answer 23

caused by genetics hair curlers hair pics type rating

advise patient to stop her care practices that might be damaging

Question 24

Guidelines for Bathing - What to consider

Answer 24

Provide privacy
Maintain safety
Maintain warmth
Promote independence
Anticipate needs

Question 25

Perineal care Female

Answer 25

• Separate the labia with your nondominant hand, exposing the urethral meatus and vaginal orifice.
• Wash downward from the pubic area toward the rectum in one smooth stroke (see Step 7A[28][a3] illustration).
• Use a separate section of cloth for each stroke.
• Cleanse thoroughly around the labia minora, clitoris, and vaginal orifice.
• clense the labia major from front to back (don’t carry fecal matter to urethra )

Question 26

Perineal care Male

Answer 26

• retract foreskin
• wash tip on penis at urethral meatus using circle notion from meatus outward, rise/dry
• return foreskin
• wash penis shaft, downward strokes
• wash sctrosum and underlying skin folds

Question 27

How to Bath a patient

Answer 27

• but on bath blanket, remove top sheet + gown
• form washcloth mitt
• Wash face, neck and arms with 1 washcloth
• Wash arms/legs from distal to proximal, long smooth strokes
• soak patients hands for 3-5 min before washings hands/fingernails
• wash chest
• wash abdomen
• Make sure no moisture remains between toes
• perineal care

Question 28

diabetes mellitus considerations

Answer 28

• don’t cut toenails

* don’t soak hands/feet

Question 29

Patients with special needs for oral hygiene

Answer 29

Presence of stomatitis
Diabetes mellitus
Unconscious state
Impared gag reflex (need lots of suction)