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NUR350 Midterm > Hygiene and Comfort > Flashcards

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

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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)
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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
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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
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5
Q

The Nursing Process

A 
Assessment
Diagnosis
Plan
Implement
Evaluate
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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
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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)
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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

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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
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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
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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
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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
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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
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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
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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
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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
Q

Fowler’s bed position

A
  • 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
Q

Support Surfaces

A
  • 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
Q

Safety Issues Related to Bedmaking

A
  • 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
Q

Things to remember before leaving the room

A
  • 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
Q

Risk factors for skin impairment

A
  • Immobilization
  • Reduced sensation
  • Nutrition and hydration alterations
  • Secretions and excretions on the skin
  • Vascular insufficiency
  • External devices
30
Q

Semi-Fowler’s bed position

A
  • 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
Q

Trendelenburg’s bed position

A
  • Entire bed frame tilted with head of bed down.
  • Is used for postural drainage.
  • Facilitates venous return in patients with poor peripheral perfusion.
32
Q

Reverse Trendelenburg’s bed position

A
  • Entire bed frame tilted with foot of bed down. Is used infrequently.
  • Promotes gastric emptying.
  • Prevents esophageal reflux.
33
Q

Flat bed position

A
  • 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
Q

How to follow medical asepsis when bed making

A

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
Q

A client’s bed must be frequently inspected to ensure linens are:

A
  • Clean
  • Dry
  • Free of wrinkles

NUR350 Midterm (11 decks)

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