Hygiene Flashcards
What are the factors influencing personal hygiene?
D RICHS
- Developmental Level
- Religious/Spiritual Practices
- Individual/ Personal Preferences
- Culture
- Health Status
- Socioeconomic Status
How can development level influence personal hygiene?
- Older adults may have changes in skin/oral health
- Typically, bathing frequency ↓ when age ↑
How can religious/spiritual practices influence personal hygiene?
- some religions require ceremonial washings/purifications before prayer/eating
How can individual/personal preferences affect personal hygiene?
- Personal habit affect hygiene
- Adequate hygiene varies from person to person
-> Nurses need ot respect these differences/preferences
–>only provide care to PT that they cannot do for themselves; value each PT as a person
How can culture affect personal hygiene?
- Cultural background influences hygiene preferences, including bathing habits, frequency, and use of hygiene products
- Some cultures value daily bathing/weekly bath; bathing is private/communal.
How can a PTs health status affect personal hygiene?
- Illnesses (physical/mental)/surgery/injury = need modifications in hygiene practices (typically)
-> Conditions can cause muscle weakness, decreased ROM, fatigue, or lack of coordination.
–> Diabetes Melletius (peripheral vascular disease complications): require meticulous foot care
How can a PTs socioeconmonic status affect personal hygiene?
- A person’s financial resources can limit access to toiletries, clean clothing, and facilities for bathing, impacting their ability to maintain personal hygiene. For example, a person renting a room may have limited access to a tub or shower.
An 80-year-old patient reports bathing less frequently than when they were younger. Which of the following is the MOST likely contributing factor?
a) A change in religious beliefs
b) A change in personal preference
c) An increase in age and changes associated with the aging process
d) A decrease in socioeconomic status
C) An increase in age and changes associated with the aging process
A male patient, who identifies as Muslim, requires assistance with bathing. He states that he would prefer a male nurse to assist him with his hygiene due to his religious beliefs. The nurse’s BEST initial response would be:
a) To explain that hospital policy requires all nurses to provide care regardless of the patient’s preference.
b) To respect the patient’s religious and cultural preferences and attempt to arrange for a male nurse to provide care.
c) To inform the patient that his preferences are not reasonable and that hygiene care is essential.
d) To ask the patient why he does not want a female nurse assisting him with his hygiene care
B) To respect the patient’s religious and cultural preferences and attempt to arrange for a male nurse to provide care.
List the topics that would be asked when you are taking a PTs hygiene history
- Daily and Weekly Bath Habits: (How often do you bathe? Do you prefer a shower, spnge bath or tub?)
- Barriers to Maintaining Hygiene: (Do you have any pain? Do you have access to clean water? Do you need assistance when bathing?)
- Pain and Movement Disorders: (Do you have any disorder that can hinder your hygiene tasks?)
- Special Hygiene Practices: (Do you have dentures? Do you use glasses or contact lenses? Are you diabetic (foot care)?)
- Patient’s Ability to Perform Self-Care: (Are you able to perform this task on your own?)
-> always encourage independence. only help when required
Describe the following Hygiene Practice:
Bathing
(Assessment, Benefit, Implementation, Types, Special Consideration; pt foley catheter/central line; pt with dementia)
Assessment:
- Assess for skin leasions
- Assess how often PT bathes and preferred bathing method
- Assess if PT is independent/req. assistance
Benefit:
- Removes oil, perspiration, dead skin, bacteria
- Improves circulation
- Provides oppurtunity to assess skin
Implementation:
- Clean top -> bottom or front -> back
- Change water prn
- Keep PT covered for warmth and privacy
- Dry gently (patting)
Types:
- Complete Bed Bath
- Bag/Disposable Bath
- Partial Bed Bath
- Shower
- Tub (not recommended)
Special Considerations:
- PT with foley catheter/central line: Use chloronexadine wipes
- If PT has dementia: Wash face and hair last. PLay claming music
Describe the following Hygiene Practice:
Hair Care
(Assessment, Implementation, Types, Special Consideration)
Assessment:
- Note history of hair/scalp/ problems
-> (dandruff, hair loss, baldness) - Inspect hair/scalp
-> (scabies, lice, bald spot, itching)
Benefit:
- X
Implementation:
- Brush/comb hair
- if matted, comb gently at tip of hair strand
- Shampoo
- Dry and style hair based on PT preference
Types:
- Dry/spray shampoo
- Cap shampoo
Special Considerations:
- note if PT requires special type of shampoo
- Use wide-toothe brush for PTs with tight curls/kinky hair
Describe the following Hygiene Practice:
Eye Care
(Assessment, Implementation, Special Consideration)
Assessment:
- Assess for contact/glasses/prosthesis
- Assess drainage, redness, dryness
Benefit:
- X
Implementation:
- Wiper inner -> outer canthus
- Water ONLY
- Unuse part of wash cloth for each eye
Types:
- X
Special Considerations:
- If PT requires contact/glasses, make sure PT has them on before talking to them
- Use baby shampoo for crusty drainage
Describe the following Hygiene Practice:
Nose Care
(Assessment, Implementation)
Assessment:
- Assess for drainage/patency (degree of openness)
- Assess for skin breakdown if naso-gastric tube/nasal cannula present
Benefit:
- X
Implementation:
- Have PT blow nose if both nares are patent
- Cleanse with washcloth and remove crust secretion by applying warm, moist compress
Types:
- X
Special Considerations:
- X
Describe the following Hygiene Practice:
Ear Care
(Assessment, Implementation, Special Considerations)
Assessment:
- Assess for drainage.cerumen
- Asses for hearing aids
- Assess behind ears if PT is recieving O2
Benefit:
- X
Implementation:
- Clean auricles with washcloth
Types:
- X
Special Considerations:
- If PT has hearing aids, place in cup/lid and label
Describe the following Hygiene Practice:
Mouth Care
(Assessment, Implementation, Special Considerations; pt with denture; unconcious pt; oral candidiasis; arthritis)
Assessment:
- Assess for open sores, plaque, gingivitis
- Assess oral candidiasis/thrush (may be more common for people on steroids/immunocompromised)
- Assess wether PT has natural teeth, dentures (partial, upper, lower), edentulous (no teeth)
Benefit:
- X
Implementation:
- Soft bristled toothbrush
- Brush tongue with toothbrush/tongue scraper
- Anticavity rinses with flouride (if PT requests)
- Lip balm if lips are dry
Types:
- X
Special Considerations:
- PT with dentures
-> remove with gloves and use paper towl (pvt slipping)
-> clean daily with denture cleaner/dishwashing liquid
-> remove dentures and rinse mouth after meals
-> fill sink with water when cleaning (pvt breakage)
-> store dentures in water to pvt warping - Unconscious PT
-> lemon glycerin sponge swabs
-> suction devices (pvt aspiration) - Oral Candidiasis
-> may need nystatin swish/swallow - PT has arthritis
-> use electric toothbrush
Describe the following Hygiene Practice:
Nail Care
(Assessment, Implementation, Special Considerations)
Assessment:
- Ask if PT has diabetes melitus
- Assess for hardened nails
- Assess capillary refill
Benefit:
- X
Implementation:
- DO NOT CUT W/O DOCTOR ORDER
- If trimming, trim striaght across and then round the tips (if toenails, cut straight)
- File with emery board in ONE direction
- PT may need to see podiatrist (6 months)
Types:
- X
Special Considerations:
- Only use nail file with PT with diabetes
Describe the following Hygiene Practice:
Foot Care
(Assessment, Implementation, Special Considerations; pt diabetes mellitus)
Assessment:
- Ask if PT has diabetes melitus
- Assess for onychomycosis (fungus), calluses, skin breaks
Benefit:
- X
Implementation:
- Avoid soaking feet
- Keep feet clean and dry, especially between toes
Types:
- X
Special Considerations:
PT with diabetes
- inspect feet/between toes daily
- wash with lukewarm water and dry
- apply moisturizer to top and bottom of feet, but not between toes
- use talcum powder/cornstarch between toes to keep dry
- wear appropriate shoes size and dry sock (non-skid)
- do not smoke/cross legs (circulatory issues)
- wiggle toes/move ankles for 5min bid/tid
- Never cut corns/calluses
Describe the different Types of Care. When should they occur? What happens during PT care?
E, M, A, E
- Early Morning: upon walking
-> Elimination, face, hands, oral care - Morning: after breakfast
-> Elimination, bath, shave, nail care - Afternoon: after lunch
-> Elimination, face, hands - Evening: night/before bed
-> Elimination, face, hands, oral care, back rub (anytime)
How do back rubs benefit PTs?
- Improve circulation
- relieve muscle tension
- promote relaxation
- improve sleep quality
List the functions of the Skin
- Protect/Provides barrier
- Regulates temperature
- Secrets sebum
- Transmits sensations
- Produces Vitamin D
Describe each type of bath
- Complete bed bath
- Bag Bath/Disposable Bath
- Partial Bed Bath
- Shower
- Tub
- Complete bed bath: wash entire body in bed with basin of water and washcloth
-
Bag Bath/Disposable Bath: wash entire body in bed with warmed, disposable wipes (pre-packaged, single-use)
-> Each part of PT body cleaned with FRESH cloth
-> Rinsing not required
-> Skin air dry for 30 sec
–> Chlorhexidine wipes (CHG bath): reduces colonization of skin with pathogens, HAI, CLABSIs (central line associated bloodstream infection)
—> Used for: PT with foley catheter/central line - Partial Bed Bath: face, hands, axillae, groin, and perineal area, under breasts and other folds
- Shower: use shower chair and hand held shower head
- Tub: not often used; not safe (don’t want to submerge incision under water)
CHG
What is CHG? What does CHG reduce?
- CHG = reduces colonization of skin with pathogens
-> Reduce HAI
-> Reduce CLABSIs (central line-associated bloodstream infections)
-> Reduce CAUTIs (catheter associated urinary tract infections)
-> Reduce transmission/infection by MDRO/DRO
-> Reduce risk of ventilator-associated infections/pneumonia
Cap Shampoo
What is Cap Shampoo? How do you use a Cap Shampoo?
-
Cap shampoos: disposable caps that contain a rinseless shampoo product
-> How to Use:
–> Cap is warmed in a microwave or warmer until use
–>Place cap on the PT head
–> Hair and scalp massaged through the cap to lather the shampoo
–> After shampooing for the time suggested by the manufacturer, the cap is removed and discarded
What are the important rules when it comes to the removal of PT contacts?
- PT should always perform hand hygiene before touching eye surface/lenses
- PT only use sterile contact lens solution
- Discard solution in contact lens case each time the lenses are disinfected and stores
- NEVER rinse with tap water or saliva
- NEVER sleep with contact lens in
- If eye injury, do not remove lenses
List the different types of bed making
Open: Fold linens back to allow client to get in; use if recieving PT
Closed: Linen up; use if PT discharged
Occupied
Unoccupied
Describe Bed Making Principles
(Frequency/TIme, Considerations)
- Time: Daily/prn
- Rules:
-> Wear gloves if soiled
-> Hold linen AWAY from uniform
-> NEVER place linen on another bed/floor
-> Place linen directly in hamper (1) or in pillow case (2)
-> Never shake linen
-> Gather all needed linen prior to beginning
What material are need for making a bed?
- Fitted sheet
- Half sheet
- Draw sheet
- Chucks
- Pillow cover
- Blanket
List Safety Principles of Bed Making
- Elevate bed to height that prevents you from stooping over
- ALWAYS put bed down before leaving PT bedside
- Keep side rails on opposite side of bed up
- Wheels/casters locks
Review how to make an occupied/unoccupied bed
