Hygiene

Question 1

what is personal hygiene?

Answer 1

cleanliness & grooming that promotes physical and psychological well being=enhances the healing process

Question 2

who is responsible for patient’s hygiene?

Answer 2

the nurse

Question 3

what is the body’s first line of defense?

Answer 3

INTACT skin

Question 4

4 skin function principles?

Answer 4

-intact skin
-injury resistance varies
-nutrition and hydration of cells help prevent injury
-adequate circulation needed to maintain skin cell life

Question 5

what is the braden scale?

Answer 5

risk assessment for pressure injuries
ranges from 6-23 lower the score=increased risk

Question 6

braden scale categories?

Answer 6

sensory perception
moisture
activity
mobility
nutrition
friction and shear

Question 7

skin in the elderly?

Answer 7

-thinning of SUBQ and dermal layer
-decreased gland activity: dry skin=cracks and breaks
-longer time for cell renewal/difficulty regenerating: prolonged healing
-nails: grow up and thick instead of longer
-decrease in collagen fiber: collagen requires for wound healing
*more disease processes

Question 8

what is involved in morning care?

Answer 8

-toileting
-oral/denture care
-bathing & ROM
-back massage
-hair care
-anti embolism stockings
-shaving
-nail/foot care
-eye, ears, nose
-peri care
-linens
-comfort positioning
-organize/clean bedside

Question 9

oral care gold standard?

Answer 9

brushing patients teeth

Question 10

what can bad oral care lead to?

Answer 10

-cardiac disease
-renal disease
-dementia
-VAP*
why?
pathogens enter bloodstream and destroy brain cells

Question 11

oral care assessment?

Answer 11

-lips
-color/surface gums
-teeth
-tongue
-hard/soft palates
-dentures

Question 12

teeth brushing for unconscious patient?

Answer 12

-head up and turned to side
-use suction
-rinse them out
-don’t froth toothpaste

Question 13

what medical treatments/diseases create a dry oral cavity?

Answer 13

-oxygen therapy
-nasogastric tubes
-med side effects
-mouth breathing (occurs with infection)
-mechanical ventilation

Question 14

evidence links poor oral care to?

Answer 14

serious disease processes

Question 15

who is oral care typically delegated to?

Answer 15

CNA’s or unlicensed personnel
*lack knowledge base for importance

Question 16

bathing purposes?

Answer 16

-cleansing and conditioning
-relaxation
-promotes circulation
-self image and emotional well being improvement
-movement and exercise
-assessment opportunities
-strengthens nurse/patient relationship

Question 17

types of baths?

Answer 17

-showers
-bathing:
complete (need everything done for them)
partial assist (can do some things themselves)
-CHG: chlorhexadine (if they have anything invasive: catheters, AV fists, ports, central lines, IVs, PICC and Mid lines) or if in ICU
-bag bath: pre moistened wipes

Question 18

why is soap not good for elderly?

Answer 18

is drying and requires rinsing

Question 19

why shouldn’t you use baby powder?

Answer 19

sources of bacterial infection

Question 20

why use CHG baths?

Answer 20

daily use of CHG cloths reduce risk of MDRO and HAI’s
*if using lotion, ensure compatibility with CHG wipes

Question 21

what are CHG wipes?

Answer 21

prepackaged: single pack contains 3 individuals packet
each packet: 2 CHG wipes
*warmed in CHG warming cabinet-required for CHG activation

Question 22

warming station light indicators?

Answer 22

yellow: warming, not ready
solid green: ready for use
blinking green: aging out, use first
red: expired - don’t use

Question 23

how to use CHG baths?

Answer 23

-6 wipes total
1: neck, chest, abdomen
2: back and butt
3: clean left arm
4: clean right arm
5: clean left leg
6: clean right leg
do not use on face or peri area
do not use on mucous membranes or severely abraded skin

Question 24

best practice for purewick external female catheter?

Answer 24

-attach to LOW suction
-replace at least every 8-12 hrs
-empty urine container Q8 or more
-NO barrier cream (may impede suction)
-change suction tubing every 30 days
-not rec: agitated or frequent BM

Question 25

criteria for purewick?

Answer 25

strictly I&O ordered
-must be incontinent AND unable to use bedpan/commode
-post surgery and requires immobilization
-approved by wound care and/or surgery
-palliative care CMO (comfort measures only)
-critically ill

Question 26

peri care?

Answer 26

clean from LEAST contaminated to MOST contaminated
-no rinse cleaners
- peri bottles for rinsing/cleaning
-barrier creams if appropriate (urine/stool breaking skin down)
*change gloves before peri care

Question 27

peri care for females?

Answer 27

front to back

Question 28

do not put condom cath on with___?

Answer 28

foreskin still pulled down
*don’t push tip too far in=breakdown

Question 29

foley care?

Answer 29

-wash peri area
-catheter attached to leg (can float in and out if not secured)
-clean 6 inches down the tubing
-clamp in place
-never lift cath over bladder level

Question 30

how to label cream?

Answer 30

initials and expiration

Question 31

when to use cream?

Answer 31

prior to injury/sore

Question 32

what is Mepilex?

Answer 32

sticky cream to prevent/protect

Question 33

eye, ear, nose care?

Answer 33

-eyes: inner to outer canthus, don’t forget glasses
-assess hearing aid function
-ONLY water soluble ointments for nares
-check 02 tubing for skin breakdown BEHIND EARS
vaseline? lips only (its occlusive)

Question 34

back massage benefits?

Answer 34

nonpharm option for pain or anxiety
-general body conditioner
-relieves muscle tension
-promotes relaxation
-can observe skin for breakdown signs
-improves circulation
-can decrease pain, distress, anxiety
-may improve sleep quality

Question 35

providing hair care?

Answer 35

wash & comb hair
shaving men: slow downward strokes with taut skin
women: against hair growth

Question 36

foot care for diabetes?

Answer 36

-daily: wash feet lukewarm (decreased heat perception) water
-dry well btwn toes
-moisturizer, not btwn toes
-check for cuts, blisters, redness
-trim/file nails
-change socks daily
-never barefoot
-examine shoes for irritants

Question 37

why is there special care for diabetic feet?

Answer 37

microvascular circulation problems
-50% amputations done on diabetics

Question 38

safety checks before you leave room?

Answer 38

-comfort position
-TV lighting/noise
-call light in reach
-bed low position
-HOB elevated
-side rails
*organize how you would want it

Question 39

environmental care for comfort and safety?

Answer 39

-label everything
-remove trash
-bedside bag
-curtains open
-room stocked
-sharps!