Hygiene and Comfort Flashcards
1
Q
What is Hygiene?
A
Condition or practices used to maintain health, especially cleanliness
- Attending to the body, body work
2
Q
Why is hygiene important?
A
- Prevent infection
- Spread of disease
- Socially important
- Bonding experience
- Nursing perspective (getting to know your patient and talk to them while assessing)
3
Q
Why give a bed bath?
A
- Cleanse the skin
- Decrease body odour
- Stimulate circulation
- Perform physical/mental assessment(s)
- Perform ROM exercises
- Improve self-image
- Promote relaxation
- Promote nurse/client relationship
4
Q
What factors influence personal hygiene practices?
A
- Socio-economic status
- Social practice
- Cultural variables
- Daily schedule
- Religious
- Personal preferences
- Body image
- Health beliefs and motivations
- Physical condition
5
Q
The Nursing Process
A
Assessment Diagnosis Plan Implement Evaluate
6
Q
Bed Bath Assessment
A
- Physical ability (what can the client do independently)
- Skin assessment
- LOC
- Hearing aids
- Medical equipment
- Patient’s willingness
- Motor function
- Client preferences
7
Q
Hygiene Care Schedules
A
Acute and Long-term care facilities
- Early morning care
- Routine morning care
- Afternoon care
- Evening or Hour-Before-Sleep (HS) care
- Comfort measure for someone who sweats a lot, have to be cleaned more often
- May not be doing a full bed bath; have to be mindful of what is needed or wanted
- Can add other comfort measures (i.e. bed baths)
8
Q
Types of Bed Baths
A
1) Complete
- Client is totally dependent and require total hygiene care
- Work with another person
- Make sure bed is adjusted to appropriate height for you
2) Partial
- Bathing only body parts that the client is unable to do on their own
- Bag bath; big wet nap in package and kept in warmer
- Shower (or tub bath); may be with older persons
- Let them do what they’re capable of then you help with the additional care
9
Q
Bed Bath Devices
A
- Only can do so much in a bed bath
- Something very therapeutic to have running water over the body
- Maybe in a stretcher
- Shower chairs
- Be mindful of sitting in a hospital gown; cover backside
10
Q
Principles to Consider - Bed Bath
A
- Provide privacy
- Maintain warmth; monitoring skin temperature
- Promote independence
- Anticipate needs; bring everything with you in the room
- Maintain safety; bed good height for you, put shoes or slippers on their feet, don’t leave someone alone in the shower room, temperature for water
- Respecting choices; can offer something less if they’re not up for a shower; be mindful
11
Q
Bed Bath Considerations
A
- Bring all needed equipment to room before beginning
- Where to put equipment
- How to ensure enough work space
- Clients personal space
12
Q
Additional Care Considerations
A
- Back rubs
- Perineal Care
- Foot and Nail care
- Oral hygiene
- Hair and scalp care
- Eye, ear, and nasal care
13
Q
Benefits of Back Rub
A
- Stimulates circulation
- Reduces risk of pressure injury development
- Relieves muscular tension
- Promotes relaxation and enhances comfort
- Promotes nurse/client relationship
14
Q
Perineal Care
A
- Especially important if client has a catheter
- If a person can do it and wants to; let them
- Women go front to back
- Catheter care; perineal car e then catheter care from patient out, catheters can stay in for 3 months or longer
- Men retract foreskin if uncircumcised and clean then put back
15
Q
Nail and Foot Care
A
- Assessment is important; especially if known condition
- Inspect surfaces of fingers, toes, feet, and nails
- Colour and temperature
- Nurses don’t often cut toenails or fingernails
- Look for skin breakdown on heels, ankles
- High risk patients; PPD, some with poorly managed diabetes
16
Q
Oral Hygiene
A
- Important because it reduces incidences of pneumonia or VRE
- Best practices are oral care for clients at least twice daily
Patients with special needs;
- Use of oxygen; can be very drying, being thoughtful about that and do mouth care more regularly, hydration
- People with no teeth still need mouth care
- People with tracheostomy still need mouth care regularly to get rid of all the build up in the mouth
- Presence of stomatitis
- Unconscious patient
17
Q
Oral Care for Unconscious Patient
A
- Patient lying on side with HOB (head of bed) lowered
- Check gag reflex by touching the posterior pharyngeal wall with tongue blade (reveals whether patient is at risk for aspiration)
- Have suction at hand
- Insert padded tongue blade between back molars; do not use force
- Assess mouth, tongue, cheeks, and lips carefully; tongue white-coated can indicate fungal infection, dehydrated; many medications such an antibiotics increase risk of fungal infection (thrush)
- If using toothbrush (best care) make sure it is soft
- Clean mouth using toothbrush or toothette (pink sponge)
- Be cautious about bite down)
- Might need to use bulb syringe to rinse; suction extra secretions
- Lip care; lip balm
18
Q
Care of Dentures
A
- Self care if possible
- They are very breakable
- Keep in denture cup if not in mouth; not on other surfaces
- Make sure gums are being assessed if patient has dentures, and that they fit well
- Wash and store in tepid water
- If cleaning in sink, use washcloth at bottom of sink to prevent breaking them
- Removing them from mouth or inserting them; use suction
19
Q
Hair and Scalp Care
A
- Easiest way to wash hair is in the shower
- Brushing and combing
- Can use shampoo cap or in bed hair washing station
Shaving
- Does not occur in hospitals often anymore
- Advocate for electric shavers over manual
- For facial hair; do in direction of hair growth
- For legs; shave in opposite direction of hair growth
20
Q
Ear, Eye, and Nasal Care
A
Eyes
- If crusting soak eyelids for a few minutes to remove
- If no blink reflex, may need lubricating eye drops of patches
- Prosthetic eyes; ask patient how they usually care for it
Ears
- Hearing aids; ensure these are kept in a safe place and have them cleaned when needed
- Be aware of risks of skin breakdown behind ears from oxygen tubing or glasses
Nasal
- Oxygen is drying so water soluble lubricant is okay
- If NG tube present; clean around, observe tape and replace if necessary
- G tube; shower technique is fine around the established stoma
21
Q
Factors to consider when providing comfort
A
- Patient’s environment; temperature, lighting, privacy, personal belongings, cleanliness, distraction
- Patient preferences
- Positioning
- Monitoring equipment; practice of the facility
- Prevention of complications
- Safety; bed down to low position, rail if needed, call bell available, all their needs are met and available
Textbook
- Temperature
- Ventilation
- Noises
- Light control
22
Q
Considerations when bedmaking
A
- Level of mobility
- Level of comfort and ability to assist
- Treatments or procedures scheduled
- Infection control issues
23
Q
Principles of Bedmaking
A
- Linen should be dry, clean, and wrinkle free
- Principles of asepsis are followed
- Do not fan or shake linens
- Do not place soiled linen on the floor
24
Q
Making a Bed
A
- Open; top covers are folded back (allows patients to get into bed)
- Closed; triggers patient not to go back to bed, done during the day
- Surgical; modified version of an open bed (sheets are sideways)
25
Fowler's bed position
- Head of bed raised to angle of 45 degrees or more
- Semi-sitting position, foot of bed may also be raised at knee.
- It is preferred while patient eats.
- Is used during nasogastric tube insertion and nasotracheal suction.
- Promotes lung expansion.
26
Support Surfaces
- Specialized devices for pressure redistribution designed for management of tissue loads, microclimate, and/or other therapeutic functions
- i.e. any mattress integrated bed system, mattress replacement, overlay, or seat cushion, or seat cushion overlay
Pressure redistribution surfaces
- Replaces older terms of pressure relieving and pressure reducing
- Recommendations for support surfaces to prevent pressure injury in new places
27
Safety Issues Related to Bedmaking
- Review client chart for specific precautions for movement and positioning; know how they can move and what they can do
- Be sure that the wheels of the bad are in the locked position
- Use proper body mechanics to prevent injury
- Lower side rail on near side of bed
- Adjust bed height to comfortable working position
28
Things to remember before leaving the room
- Look at the whole person before you leave the room
- Call bell and personal items within reach
- Bed/chair position
- Told when you're coming back
- Promote choice and independence
- Is client safe and comfortable
- If potential memory issues; bring to populated area of unit
29
Risk factors for skin impairment
- Immobilization
- Reduced sensation
- Nutrition and hydration alterations
- Secretions and excretions on the skin
- Vascular insufficiency
- External devices
30
Semi-Fowler's bed position
- Head of bed raised approximately 30 degrees
- Inclination less than Fowler’s position
- Foot of bed may also be raised at knee.
- Promotes lung expansion.
- Used when patients receive gastric feedings to reduce regurgitation and risk of aspiration.
31
Trendelenburg's bed position
- Entire bed frame tilted with head of bed down.
- Is used for postural drainage.
- Facilitates venous return in patients with poor peripheral perfusion.
32
Reverse Trendelenburg's bed position
- Entire bed frame tilted with foot of bed down. Is used infrequently.
- Promotes gastric emptying.
- Prevents esophageal reflux.
33
Flat bed position
- Entire bed horizontally parallel with floor.
- Is used for patients with vertebral injuries and in cervical traction.
- Is used for patients who are hypotensive.
- Is generally preferred by patients for sleeping.
34
How to follow medical asepsis when bed making
1) Keeping soiled linens away from your uniform.
2) Soiled linen is placed in special linen bags before discarding it in a hamper.
3) To avoid air currents, which can spread microorganisms, ben linens should never be shaken.
4) To avoid transmitting infection, do not place soiled linen on the floor; if clean linen touches the floor, it should be immediately discarded.
35
A client's bed must be frequently inspected to ensure linens are:
- Clean
- Dry
- Free of wrinkles
