Hygiene Flashcards by Kent Niño Perdez

_ is the science of health and its maintenance.

Hygiene

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_ is the self-care by which people attend to such functions as bathing, toileting, general body hygiene, and grooming.

Personal hygiene

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_ is a highly personal matter determined by individual values and practices.

Hygiene

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It involves care of the skin, feet, nails, oral and nasal cavities, teeth, hair, eyes, ears, and perineal-genital areas.

Hygiene

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Factors Influencing Individual Hygienic Practices

Culture
Religion
Environment
Developmental level
Health and energy
Personal preferences

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_ is provided to clients as they awaken in the morning.

Early morning care

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This care consists of providing a urinal or bedpan to the client confined to bed, washing the face and hands, and giving oral care.

Early morning care

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_ is often provided after clients have breakfast, although it may be provided before breakfast.

Morning care

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It usually includes providing for elimination needs, a bath or shower, perineal care, back massages, and oral, nail, and hair care.

Morning care

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Making the client’s bed is part of _.

morning care

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_ is provided to clients before they retire for the night. It usually involves providing for elimination needs, washing face and hands, giving oral care, and giving a back massage.

Hour of sleep or PM care

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_ is provided as required by the client.

As-needed (prn) care

For example, a client who is diaphoretic (sweating profusely) may need more frequent bathing and a change of clothes and linen.

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Skin’s Five major functions:

It protects underlying tissues from injury by preventing the passage of microorganisms.
It regulates the body temperature.
It secretes sebum,
It transmits sensations through nerve receptors, which are sensitive to pain, temperature, touch, and pressure.
It produces and absorbs vitamin D in conjunction with ultraviolet rays from the sun, which activate a vitamin D precursor present in the skin.

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_ are on all body surfaces except the lips and parts of the genitals. The body has from 2 to 5 million, which are all present at birth.

Sudoriferous (sweat) glands

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They are most numerous on the palms of the hands and the soles of the feet.

Sudoriferous (sweat) glands

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Sweat glands are classified as _ and _.

apocrine and eccrine

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_ located largely in the axillae and anogenital areas, begin to function at puberty under the influence of androgens.

apocrine glands

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_ are important physiologically. They are more numerous than the apocrine glands and are found chiefly on the palms of the hands, soles of the feet, and forehead.

eccrine glands

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The sweat they produce cools the body through evaporation.

eccrine glands

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Assessment of the client’s skin and hygienic practices includes

(a) a nursing health history to determine the client’s skin care practices, self-care abilities, and past or current skin problems; and
(b) physical assessment of the skin.

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Four self-care deficit diagnoses, specified as

Bathing Self-Care Deficit,
Dressing Self-Care Deficit,
Toileting Self-Care Deficit, and
Feeding Self-Care Deficit

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• Deficient Knowledge related to:

a. Lack of experience with skin condition (acne) and need to prevent secondary infection
b. New therapeutic regimen to manage skin problems
c. Lack of experience in providing hygiene care to dependent person
d. Unfamiliarity with devices available to facilitate sitting on or rising from toilet.

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• Situational Low Self-Esteem related to:

a. Visible skin problem (e.g., acne or alopecia)
b. Body odor.

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Etiologies of Self-Care Deficits

• Decreased or lack of motivation • Weakness or tiredness
• Pain or discomfort
• Perceptual or cognitive impairment • Inability to perceive body part or spatial relationship
• Neuromuscular or musculoskeletal impairment
• Medically imposed restriction
• Therapeutic procedure restraining mobility (e.g., intravenous infusion, cast)
• Severe anxiety
• Environmental barriers

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The specific, detailed nursing activities provided by the nurse may include

assisting dependent clients with bathing, skin care, and perineal care; providing back massages to promote circulation; instructing clients/families about appropriate hygienic practices and alternative methods for dressing; and demonstrating use of assistive equipment and adaptive activities.

Home Care Assessment Hygiene CLIENT AND ENVIRONMENT

• Self-care abilities for hygiene: • Self-care aids required: • Facilities: • Mechanical barriers:

Home Care Assessment Hygiene FAMILY

• Caregiver availability, skills, and responses • Education needs • Family role changes and coping

Home Care Assessment Hygiene COMMUNITY

• Explore resources that will provide assistance with bathing, laundry, and foot care (e.g., home health aide, podiatrist). • Consult a social worker as needed to coordinate placement of a client unable to remain in the home or to identify community resources that will help the client stay in the home. • Consider a consult with (a) a physical therapist to assess, develop, and improve the client’s motor function; (b) a home health nurse to provide follow-up for care, teaching, and support; and (c) an occupational therapist to assess and develop abilities to perform activities of daily living.

Planning to assist a client with personal hygiene includes

consideration of the client’s personal preferences, health, and limitations; the best time to give the care; and the equipment, facilities, and personnel available.

General Guidelines for Skin Care

1. Intact, healthy skin is the body’s first line of defense. 2. The degree to which the skin protects the underlying tissues from injury depends on the general health of the cells, the amount of subcutaneous tissue, and the dryness of the skin. 3. Moisture in contact with the skin for more than a short time can result in increased bacterial growth and irritation. 4. Body odors are caused by resident skin bacteria acting on body secretions. 5. Skin sensitivity to irritation and injury varies among individuals and in accordance with their health. 6. Agents used for skin care have selective actions and purposes.

_ removes accumulated oil, perspiration, dead skin cells, and some bacteria.

Bathing

In addition to cleaning the skin, bathing also

stimulates circulation. Bathing also produces a sense of well-being. Bathing offers an excellent opportunity for the nurse to assess clients and opens the door for establishing trust.

Agents Commonly Used on the Skin

Soap Chlorhexidine gluconate (CHG) Bath oil Skin cream, lotion Powder Deodorant Antiperspirant

Two categories of baths are given to clients:

cleaning and therapeutic.

_ are given chiefly for hygiene purposes

Cleansing baths

Types of Cleansing Baths

• Complete bed bath • Self-help bed bath • Partial bath (abbreviated bath) • Bag bath • Towel bath • Tub bath • Shower

The nurse washes the entire body of a dependent client in bed.

Complete bed bath

Clients confined to bed are able to bathe themselves with help from the nurse for washing the back and perhaps the feet.

Self-help bed bath

Only the parts of the client’s body that might cause discomfort or odor, if neglected, are washed: the face, hands, axillae, perineal area, and back.

Partial bath (abbreviated bath).

This bath is a commercially prepared product that contains 10 to 12 presoaked disposable washcloths that contain norinse cleanser solution.

Bag bath.

This bath is similar to a bag bath but uses regular towels. It is useful for clients who are bedridden and clients with dementia.

Towel bath

_ are often preferred to bed baths because it is easier to wash and rinse in a tub. _ are also used for therapeutic baths.

Tub bath

_ are suggested for the newborn because daily tub baths are not considered necessary.

Sponge baths

Many ambulatory clients are able to use _ facilities and require only minimal assistance from the nurse.

Shower.

_ are given for physical effects, such as to soothe irritated skin or to treat an area (e.g., the perineum). Medications may be placed in the water.

Therapeutic baths

Perineal-genital care is also referred to as _ or _. _ as part of the bed bath is embarrassing for many clients.

perineal care or pericare Perineal care

Clinical Alert! Always wash or wipe from “_.” For a female, cleanse perineal area from _ to _. For a male, cleanse the urinary meatus by moving in a _ from the center of the urethral opening around the glans.

clean to dirty front to back circular motion

SKIN NURSING MANAGEMENT Implementing Client Teaching - Clients often need information about _, _, and _.

dry skin, skin rashes, and acne

SKIN NURSING MANAGEMENT Implementing Client Teaching - Clients often need information about dry skin, skin rashes, and acne.

- The _ are essential for ambulation and merit attention even when people are confined to bed. - Each foot contains _ bones, _ ligaments, and _ muscles. These structures function together for both standing and walking.

feet 26, 107, 19

Safety Alert! Clients with diabetes are at high risk for _. Routine foot assessment and client education in proper foot care can significantly reduce the risk for _.

lower extremity amputations (LEAs)

FEET NURSING MANAGEMENT Assessing - Assessment of the client’s feet includes _, _, and _.

a nursing health history, physical assessment of the feet, and identifying clients at risk for foot problems.

FEET NURSING MANAGEMENT Nursing History - The nurse determines the client’s history of (a) _, (b) _, (c) _, (d) _, (e) _, and (f) _.

(a) normal nail and foot care practices, (b) type of footwear worn, (c) self-care abilities, (d) presence of risk factors for foot problems, (e) any foot discomfort, and (f) any perceived problems with foot mobility.

FEET Physical Assessment - A _ is a thickened portion of epidermis, a mass of keratotic material.

callus

FEET Physical Assessment - A _ is a keratosis caused by friction and pressure from a shoe.

corn

FEET Physical Assessment - _ occur as a result of perspiration and its interaction with microorganisms.

Unpleasant odors

FEET Physical Assessment - _ appear on the sole of the foot. These warts are caused by the papovavirus hominis virus.

Plantar warts

FEET Physical Assessment - _, or _, frequently occur between the toes as a result of dryness and cracking of the skin.

Fissures deep grooves

FEET Physical Assessment - _, or _ (_), is caused by a fungus. The symptoms are scaling and cracking of the skin, particularly between the toes.

Athlete’s foot tinea pedis ringworm of the foot

FEET Physical Assessment - An _, the growing inward of the nail into the soft tissues around it, most often results from improper nail trimming.

ingrown toenail

Clinical Alert! Clients with _ often have extremely dry skin. Tell them to use a _ and to avoid putting lotion between the toes. Advise to not soak their feet in water because it is drying to the skin.

diabetes nonperfumed lotion

FEET Diagnosing The most common diagnostic labels, along with possible related or contributing factors, are as follows:

• Bathing Self-Care Deficit (foot care) related to: a. Visual impairment b. Impaired hand coordination c. Other related or contributing factors • Risk for Impaired Skin Integrity related to: a. Altered tissue perfusion: peripheral (associated with edema, inadequate arterial circulation) b. Poorly fitting shoes. • Risk for Infection related to: a. Impaired skin integrity (ingrown toenail, corn, trauma) b. Deficient nail or foot care. • Deficient Knowledge (diabetic foot care) related to: a. Lack of teaching/learning activities about diabetic foot care b. Newly established medical diagnosis (diabetes) and necessary foot hygiene practices.

FEET Planning - Planning involves (a) _ and (b) _.

(a) identifying nursing interventions that will help the client maintain or restore healthy foot care practices and (b) establishing desired outcomes for each client

FEET Implementing - During these procedures, the nurse has the opportunity to _, including those designed to prevent tissue injury and infection.

teach the client appropriate methods for foot care

FEET Evaluating Examples of desired outcomes for foot hygiene include the client being able to:

• Participate in self-care (foot hygiene) to optimal level of capacity (specify). • Describe hygienic and other interventions (e.g., proper footwear) to maintain skin integrity, prevent infection, and maintain peripheral tissue perfusion. • Demonstrate optimal foot hygiene, as evidenced by: a. Intact, pink, smooth, soft, hydrated, and warm skin b. Intact cuticles and skin surrounding nails c. Correct foot care and nail care practices

_ are normally present at birth. They continue to grow throughout life and change very little until people are older. At that time, the _ tend to be tougher, more brittle, and in some cases thicker. The _ of an older person normally grow less quickly than those of a younger person and may be ridged and grooved.

Nails

NAILS NURSING MANAGEMENT Assessing - During the nursing health history, the nurse explores the _, _, and _. Physical assessment involves inspection of the nails (e.g., nail shape and texture, nail bed color, and tissues surrounding the nails).

client’s usual nail care practices, self-care abilities, and any problems associated with them

NAILS NURSING MANAGEMENT Diagnosing - Examples of these nursing diagnoses and contributing factors follow:

• Bathing Self-Care Deficit related to: a. Impaired vision b. Cognitive impairment. • Risk for Infection around the nail bed related to: a. Impaired skin integrity of cuticles b. Altered peripheral circulation.

NAILS NURSING MANAGEMENT Planning - The nurse identifies measures that _. A schedule of nail care needs to be established.

will assist the client to develop or maintain healthy nail care practices

NAILS NURSING MANAGEMENT Implementing - Clients who have _ or circulatory problems should have their nails filed rather than cut; inadvertent injury to tissues can occur if scissors are used.

diabetes

NAILS NURSING MANAGEMENT Evaluating - Examples of desired outcomes for nail hygiene include the client being able to:

• Demonstrate healthy nail care practices, as shown by: a. Clean, short nails with smooth edges b. Intact cuticles and hydrated surrounding skin. • Describe factors contributing to the nail problem. • Describe preventive interventions for the specific nail problem. • Demonstrate nail care as instructed.

NAILS NURSING MANAGEMENT Evaluating - In addition, the client should have pink nail beds and quick return of nail bed color after the _.

blanch test

MOUTH - Each tooth has three parts: _, _, and _. The _ is the exposed part of the tooth, which is outside the gum. It is covered with a hard substance called _. The ivory-colored internal part of the crown below the enamel is the _. The root of a tooth is embedded in the jaw and covered by a bony tissue called _. The _ in the center of the tooth contains the blood vessels and nerves.

the crown, the root, and the pulp cavity crown enamel dentin cementum pulp cavity

MOUTH Developmental Variations - Many _ experience more bleeding from the gingival sulcus during brushing and increased redness and swelling of the gingiva (the gum).

pregnant women

MOUTH Developmental Variations - Loss of teeth occurs mainly because of _ (_) rather than dental caries (cavities); however, caries are also common in middle-aged adults.

periodontal disease (gum disease)

MOUTH NURSING MANAGEMENT Assessing - Assessment of the client’s mouth and hygiene practices includes (a) _, (b) _, and (c) _.

(a) a nursing health history, (b) physical assessment of the mouth, and (c) identification of clients at risk for developing oral problems

MOUTH NURSING MANAGEMENT Nursing History - During the nursing health history, the nurse obtains data about the client’s oral hygiene practices, including _, _, and _.

dental visits, self-care abilities, and past or current mouth problems

MOUTH NURSING MANAGEMENT Physical Assessment - _ is an invisible soft film that adheres to the enamel surface of teeth; it consists of bacteria, molecules of saliva, and remnants of epithelial cells and leukocytes.

Plaque

MOUTH NURSING MANAGEMENT Physical Assessment - When plaque is unchecked, _ (_) is formed. - _ is a visible, hard deposit of plaque and dead bacteria that forms at the gum lines.

tartar (dental calculus)

MOUTH NURSING MANAGEMENT Physical Assessment - _ is characterized by gingivitis (red, swollen gingiva), bleeding, receding gum lines, and the formation of pockets between the teeth and gums.

Periodontal disease

MOUTH NURSING MANAGEMENT Physical Assessment - In _ (_), the teeth are loose and pus is evident when the gums are pressed.

advanced periodontal disease (pyorrhea)

Clinical Alert! Clients in _ are at high risk for oral health problems. The nurse must assess the client’s oral health and teach the UAP about the importance of and methods to promote oral hygiene.

long-term care settings

MOUTH NURSING MANAGEMENT Diagnosing - Two nursing diagnoses related to problems with oral hygiene and the oral cavity are _ and _.

Impaired Oral Mucous Membrane and Deficient Knowledge

MOUTH NURSING MANAGEMENT Promoting Oral Health Throughout the Life Span - A major role of the nurse in promoting oral health is _.

to teach clients about specific oral hygienic measures

MOUTH NURSING Brushing and Flossing the Teeth - One of the techniques recommended for brushing teeth is called the _, which removes plaque and cleans under the gingival margins.

sulcular technique

Clients with Special Oral Hygiene Needs - Dry mouth—called _— occurs when the supply of saliva is reduced. This condition can be caused by side effects of certain medications (e.g., antihistamines, antidepressants, antihypertensives).

xerostomia

- The appearance of the _ often reflects a person’s feelings of selfconcept and sociocultural well-being. - The _ may also reflect state of health (e.g., excessive coarseness and dryness may be associated with endocrine disorders such as hypothyroidism).

hair

Hair Developmental Variations - Newborns may have _ (the fine hair on the body of the fetus, also referred to as down or woolly hair) over their shoulders, back, and sacrum.

lanugo

HAIR NURSING MANAGEMENT Nursing History - Chemotherapeutic agents and radiation of the head may cause _ (_). Hypothyroidism may cause the hair to be thin, dry, and/or brittle.

alopecia (hair loss)

HAIR NURSING MANAGEMENT Physical Assessment - Often accompanied by itching, _ appears as a diffuse scaling of the scalp.

dandruff

HAIR NURSING MANAGEMENT Physical Assessment - _ and _ are continual processes. Some permanent thinning of hair normally occurs with aging.

Hair loss and growth

HAIR NURSING MANAGEMENT Physical Assessment - Small gray-brown parasites that bite into tissue and suck blood, _ transmit several diseases to people, in particular Rocky Mountain spotted fever, Lyme disease, and tularemia.

ticks

HAIR NURSING MANAGEMENT Physical Assessment - _ are parasitic insects that infest mammals. Infestation with lice is called _.

Lice pediculosis

HAIR NURSING MANAGEMENT Physical Assessment - Three common kinds are _, _, and _.

Pediculus capitis (the head louse), Pediculus corporis (the body louse), and Pediculus pubis (the crab louse)

Clinical Alert! _ or _ may be infested with lice.

Excessively matted or tangled hair

Clinical Alert! A _ or _ should not be shaved off without the client’s consent.

beard or mustache

EYES NURSING MANAGEMENT Diagnosing - Examples of these diagnoses and possible contributing factors follow:

• Risk for Infection related to: a. Improper contact lens hygiene b. Accumulation of secretions on eyelids. • Risk for Injury related to: a. Prolonged wearing of contact lenses b. Absence of blink reflex associated with unconsciousness.

EAR - Clients who have excessive _ (_) and dependent clients who have hearing aids may require assistance from the nurse. Hearing aids are usually removed before surgery.

cerumen (earwax)

Care of Hearing Aids There are several types of hearing aids:

• Behind-the-ear (BTE) open fit. • Behind-the-ear (BTE) with earmold. • In-the-ear (ITE) aid. • In-the-canal (ITC) aid. • Completely-in-the-canal (CIC) aid. • Eyeglasses aid. • Body hearing aid.

SUPPORTING A HYGIENIC ENVIRONMENT Environment - In Florence Nightingale’s book, _, she discussed many concepts including ventilation and warming, light, cleanliness of rooms, noise, and beds and bedding.

Notes on Nursing

Making Beds:

Unoccupied Bed Occupied Bed