hygiene Flashcards
Epidermis func
- barrier for microbes
- dryness inhibits microbe growth
- sebum removes bacteria from hair fillicles
- acidity retards bacterial growth
- Scraping/stripping skin
- excessive dryness
- excessive moisture
- alkaline soap
- friction
- weakens skin
- causes cracks where microbes can enter
- maceration which promotes ulcer formation and bacterial growth
- undoes the acidic benefits
- loss of stratum corneum which prevents pressure injuries
Skin excretion and secretion
sweat promotes heat loss by evaporation
sebum lubricates skin and hair
can sometimes harbor microbes though, so bathing is important
Healthy vs unhealthy nails
healthy: transparent, smooth, convex, with pink bed
Unhealthy: caused by inadequate nutrition and disease
xerostomia
dry mouth
-meds, radiation, dehydration, and mouth breathing
gingivitis
inflation of gums
dental caries
tooth decay from interactions bt food and bacteria
What causes unhealthy hair?
hormones nutrition emotional or physical stress aging infection some illnesses
cerumen
ear wax
Factors affecting hygiene
Social practices: influence of friends/fam
Personal preferences: sometimes need to override this
Body image: sometimes changed by surgery/ illness/ change in emotional status
Socioeconomic: can’t afford it
Health beliefs and motivation: motivate them by telling them the risks
Cultural variables: provide info - allow choices
Developmental stage
Physical condition: pain, chronic conditions (tiring), limited mobility
what to do 30 mins before hygiene?
analgesic
Developmental stages of the skin
neonate: thin, loosly bound, prone to tearing and bruising
toddler: tighter bound layers- more resistant to irritation/infection –> need good hygiene though
adolescence: estrogen makes girls’ soft, smooth, thick, and vascular –> boys’ get thicker and darker–> sebaceous and sweat glands more active –> need more bating
adult: usually elastic, hydrated, firm, and smooth –> gets dryer and thinner as they age (itchy)
Morton’s neuroma
common in mid age women
causes burning, numbness, and pain of foot on weightbearing
Who gets feet problems?
old ppl –> fucked up sebaceaous glands dry out the feet
ppl with diabetes or decreased peripheral circulation
ppl with bad-fitting shoes
women who use excessive nail polish remover
Mouth development
babies start getting teeth at 6-8 months
kids start losing teeth at 6 years old
adults have good teeth usually –> gums get less vascular and elastic in old ppl (makes dentures harder)
Critical thinking model for hygiene assessment
knowledge base attitiude (be curious and humble) environment standards experience with patient
Poor oral care in patients who’ve had a stroke or have dementia
increases risk of aspiration pneumonia
Skin folds
esp in overweight patients
imp that they’re kept dry
can use cornstarch to decrease friction and absorb moisture
Dry skin cures
bathe less use warm water use air humidifier drink water moisturize
Acne cures
wash regularly with soap and water
use cosmetics sparingly
maybe dietary restrictions
topical antibiotics if severe
skin rash cures
dont itch
wash and apply antiseptic spray/lotion
warm or cold soaks
contact dermititis
(inflammation and scarring, oozing, pain)
avoid the causing agent
abrasion cure
wash
make sure dressing stays dry
don’t wear rings while dealing with this person
who gets mouth problems?
- upper arm paralysis
- dehydrated ppl
- ppl with NG tubes
- ppl getting chemo or radiation
- ppl who take hella OTC stuff (sugar)
- ppl with diabetes melitis
- ppl on dialysis
who gets skin problems
-immobilized ppl
-ppl with casts/masks/ tubes
-ppl w/ med tape on skin
-obese ppl
ppl with nerve damage
-ppl with fucked up brains
-ppl who don’t eat/drink enough
ppl with secretions from anywhere
-ppl with heart probs
glossitis
chelitis
halitosis
edentulous
inflamed tongue
cracked lips
bad breath
without teeth
pediculosis capitis
alopecia
head lice
hair loss
what does red eyes with crusty drainage indicate?
conjunctivitis –> vey contagious
risk of broad spectrum antibiotics
risk of chemo
opportunistic infection bc normal mouth flora is disrupted
mouth ulcers
corns
keratosis from friction
usually on toes and bony prominences
Dont use oval corn pads
wear wider softer shoes
callus
thickened portion of epidermis from pressure
use orthotic devices
plantar warts
fungating legions caused by papillomavirus
athlete’s foot
tinea pedis
fungal infection induced by constricting footwear
dry, ventilated feet are good
Paronchia
inflammation of tissue between nail fold and nail plate
soak and apply antibiotics
oral mucositis
painful inflammation of oral mucous membranes
can happen bc of chemo
Nursing diagnoses of hygiene
activity intollerance impaired mobility impaired health maintenance impaired skin integrity low self esteem
sitz bath
cleans and reduces pain and inflammation of perineal and anal areas
medicaed baths
oatmeal, cornstarchm or aveeno
relieve skin irritation and create antibacterial and drying effect
Chlorohexidine gluconate
often added to baths to prevent HAIs
complete bed bath
bath administered to a totally dependent patient in bed
turning to expose back causes O2 need
partial bed bath
for old, dependent, or unable to reach all body parts
-wear clean gloves
HAIs are lessened by washing with CHG
why are bath basins with soap and water falling out of vogue?
alternatives?
reservoirs for bacteria from biofilms from water bacteria
4% CHG in bath basins reduces methilin resistant Staphylococcus aureas (MRSA)
2% CGH impregnated cloths are good esp in ICU –> downside is stickiness
Don’t rinse off CGH
when not to use CGH cloths
inside deep wounds
eyes, ears, face
Who needs extra perineal care?
- ppl with incontinence-associated dermatitis (IAD)
- ppl with foley catheters
- postpartem women
- ppl recovering from rectal or genital surgery
- ppl on their period
what shouldn’t someone with diabetes or peripheral vascular disease do with feet
soak
who requires extra oral care?
stroke, trauma to oral cavity, or presence of endotracheal tube
1-2 hrs
What to use and what not to use when brushig teeth
12% CGH toothpaste is good
small toothbrush is good –> reaches everywhere
No fluoride rinse under 6 years old
no sponges –> ineffective
no lemon-glycerin sponges –> dry out the mouth
Unconscious patient oral hygiene
-risk for ventilator-associated pneumonia
put in semi-fowler’s position
use padded tongue blade to keep mouth open –> not fingers
tell patient when its over
Stomatitis
causes burning pain and change in food and fluid tolerance
soft flossing and brushing (maybe no flossing)
saline rince in morning, at bedtime, and at meals
no smoking, drinking, or mouthwash
dentures
imp to clean
can cause stomatitis if not cleaned (also candida albicans)
store in warm water at night to keep from warping
What shampoo to use on lice
pediculicidal shampoo
How to avoid pseudofolliculitis barbae
don’t pull skin taught
don’t do close shave
don’t use bar soap –> dulls razor
MDRPI
medical device related pressure injuries
from O2 tubes, feeding tubes, NG tubes
cushion with dressing and don’t put devices over other injuries
clean daily
What happens if person can’t blink?
exposure keratopathy
cornea is prone to dehydration, abrasion, perforation, and infection
eye patch and possibly eye drops necessary
what causes pseudomononas aerufinosa
wearing contacts too long
ear irrigation
pull up if over 3; pull down if 3 or younger
make sure patient isn’t experiencing nasea, pain, or vertigo
types of hearing aids
CIC = complete in canal (prone to clogging from cerumen
ITE = in the ear (stronger but more noticable)
BTE = behind the ear (can be fine tuned)
Nose care
wipe outside
don’t stick q-tip past cotton part
replace tape of NG tubes daily
Bed positions
Fowlers: head at 45-90 degree –> foot may be raised at knee (eating, NG insertion, nasotracheal suction, easier breathing)
Semi-fowlers: 30-45 degree –> foot may be raised at knee ( lung expansion esp ventilator assisted patients, oral care, gastric feedings, reduce regurgitation/aspiration)
Trendelenburg: head down; feet up (postural drainage, veinous return)
Reverse trendelenburg: head up; feet down (gastric emptying, no esophegeal reflux) –> rare
Flat: (vertebral injuries or in cervical traction; hypotensive)
Surgical recovery bed
not mitered or tucked at corners
folded to one side or to bottom third of bed
Through patient’s eyes
seeing how they feel about treatment provided
sometimes takes time for ppl to feel better aft hygiene
