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N143 !!!! > Module 2: Personal Hygiene and comfort > Flashcards

Module 2: Personal Hygiene and comfort Flashcards

1
Q

why is mouth health so important?

A
  • Diabetes link
  • Heart and stoke link
  • respiratory link (aspiration of bacteria)
  • premature babies
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2
Q

why should you do an oral inspection?

A
  • catch a dental problem before it becomes serious
  • adjust daily mouth care to meet residents needs
  • identify cancers or life threatening infections
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3
Q

What are the 2 parts of an oral inspection

A

1) Inspect the neck and face

2) inspect the inside of the mouth

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4
Q

what should you look for on the neck and face

A
  • symetry
  • lumps and bumps
  • can they swallow
  • patches
  • bleeding
  • numbness
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5
Q

how to help with oral care for ppl with manual dexterity problems

A
  • consider modifying handle
  • electric toothbrush
  • check for pocketing for stroke
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6
Q

Special considerations for dry mouth

A
  • biotene
  • avoid alcohol mouthwash
  • avoid sugar
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7
Q

Special considerations for cancer

A
  • will have dry mouth
  • club soda rinses often
  • dont brush or floss if platelet clot is inadequate
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8
Q

Other words for urination

A

micturition, voiding

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9
Q

What are the factors that commonly influence urinary elimination

A

psychological, sociocultural, feud balance, diagnostic examination, surgical procedures, pathological conditions, medication

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10
Q

3 psychological factions that can influence urinary elimination

A

anxiety, emotional stress, privacy & time,

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11
Q

4 common alterations in urinary elimination

A

Infection, incontinence, nocturne, urinary retention, urinary diversions, renal failure

  • infection
  • impaired function
  • obstruction to urine outflow
  • inability to control urination
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12
Q

when should voiding first occur after removal of urinary catheter

A

within 8 hrs

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13
Q

increased or excessive urine output is

A

diuresis

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14
Q

normal adult urine output

A

1500ml

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15
Q

signs and symptoms of urinary retention

A
  • lower abdominal pain/discomfort
  • decreased urinary output for several hours
  • bladder distentsion
  • restlessness
  • diaphoresis
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16
Q

3 factors that contribute to hospital-acquired urinary tract infections in pt. with an indwelling urinary catheter

A
  • poor hand hygiene
  • improper
  • catheter care
  • faulty catherization technique
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17
Q

7 things about leg bags

A

1) some prefer a leg bag
2) need clean technique
3) initials should be on bag
4) know how often to change or reuse
5) outside should be cleaned during bathing
6) inside should be cleaned with bleach
7) should be stored in dry clean container when not in use

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18
Q

What position should the pt. be in for bladder scanning

A

supine

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19
Q

where should you place gel for bladder scanner

A

3 cm above synthesis pubis & tilt scanner down toward the bladder

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20
Q

Is hygiene care routine?

A

no. it requires intimate contact, good communication skills

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21
Q

What can the nurse learn while doing hygiene care?

A

health promotion practices and needs,

needs pertaining to health care eduction and emotional needs

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22
Q

A pt. preference for hygiene can be influenced by…

A
  • social practice
  • personal preference
  • body image
  • socioeconomic status
  • health beliefs & motivation
  • cultural variables
  • physical condition
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23
Q

Hygiene assessment includes:

A
  • Developmental changes
  • skin, feet, nails, oral cavity, eyes/ears/nose
  • use of sensory aids
  • self care ability
  • hygiene practices
  • cultural factors
  • patients at risk of hygiene problems
  • special consideration
  • patient expectations
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24
Q

guidelines for dressing and undressing

A
  • Provide privacy
  • encourage them to do as much as possible
  • allow person to wear what they want
  • remove clothing on strong or good side first
  • put clothing on weak side first
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25
what does POW mean
put on weak (put clothes on weak side first)
26
what are the benefits of bathing
- removes perspiration, dirt, germs - refreshes patients and makes them mrore comfortable - stimulates circulation - helps prevent skin problems - provides exercise
27
what part of ur arm should u use to test water at a safe temp
wrist or elbow
28
What are the rules for bathing
- use good body mechanics - use routine precautions - protect the person from falling - wash the cleanest part to dirtiest part - pat skin dry (no rub) - bathe skin whenever urine or feces is present
29
who would need a complete bed bath?
- unconscious - paralyzed - cast or traction - weak from illness or surgery
30
Tub bath rules
- never leave pt alone - no longer than 20 mins - put towel on bottom of tub to prevent slipping - drain tub before person gets out
31
Bed bath sequence
- eyes first, face, neck ears - arms - chest & abdomen - legs - peri, buttocks
32
what parts are for a partial bed bath
- Face - Hands - axillae - under breasts - back - perineal
33
What are back rubs good for
- circulation - prevent skin breakdown - sooth and refresh pt.
34
who is at risk for foot or nail problems
- older - diabetes - heart failure or renal disease - stroke
35
Nail care
soak 10-20 minutes (unless they have diabetes) | -never share clippers pt. needs own pair
36
What are you examining the feet for
- ingrown nails - hang nails - broken or torn nails - blisters, rash, reddened area - calluses, corns - skin breakdown, injurires - check between toes for cracks & sores - complains of pain or itching
37
what is involved in AM care
- assist with elimination - apply clean incontinence brief if they use them - assist with oral hygiene - assist with bathing - assist with perineal care - assist with dressing - assist with grooming - assist with activities - make beds and straighten residents room
38
What is included in afternoon care
- Assist with elimination - provide clean incontinence brief - perineal care as needed - grooming as needed - activities - striaghten up unit
39
What is included in evening care
- assist with elimination - inconinent briefs - partial bed bath - oral hygiene - night clothes - backrub - position resisdent and straighten linin - straighten residents unit
40
Rules for shaving the patient
- always wear gloves - towel on pt. chest - shaving creme on face - shave in direction of hair growth - hold skin taut - rinse razor - should have own razor.. don't share - clean with alcohol swab after
41
developmental considerations for neonatal skin
thin, fragile, friction can cause bruises | can easily break and start an infection
42
Developmental considerations for toddlers skin
more tightly bound, more resistant
43
developmental considerations for adolescents
Girls: smooth skin from estrogen Male: thick and darkening skin acne
44
developmental considerations for older adults
decreased residency & moisture & sweat very dry shouldn't bath daily fragile tears easily
45
what are some causes of common foot problems
- poor foot care - improperly fitting footwear - aging - systemic disease
46
When do infants start teething
6-8mo
47
when do adult teeth start coming in
6yo
48
what happens to the oral cavity as ppl age
- brittle, dry, dark teeth - gumes lose vascularity, elastiscity - endentulous (no teeth)
49
what to look for when assessing self care ability
- assess physical and cognitive status - determine which parts need what level of assitance - muscular strength, flexibility, dexterity, balance, coordination, activity tolerance - vision, hearing - sit w/o support, strength, ROM, - home environemtn - can friends and family help
50
who are at risk for hygiene problems
- adverse medication effects - lack of knowledge - inability to perform hygiene - physical condition - fever/sweat/diaphoretic - chemo
51
what is stomatitis
inflammation of mouth and lips
52
key ideas about implementation of hygiene
- Symptom relief first - soft calm voice & touch - pt's need to know risks - promote independence
53
What are the 5 bathing guidelines
1) Privacy 2) safety 3) warmth 4) independence 5) anticipate needs
54
Tips for bathing a pt. with alzheimers
- bath history - identify preference - method least distressing - try coloured water or bubble bath - prepare bath environment in advance - warmth, minimize time unclothed - distraction & negotiation (no demands) - minimize sound, or favourite music - set priorities - praise
55
What kind of items are placed on bedside table
Only clear or sterile
56
strategies for aseptic technique with bed making
- Wash hands - carry linen away from uniform - don't shake linens - keep linens off floor and bedside table
57
Where do you put dirty linens
-In dirty linen hamper. | CANNOT go on floor, on footstool, another pt bed or over bed side tables
58
When should you empty a catheter bag
8-12 hr or when full
59
when should u perform pericare
every 8 hr (2 times a day) | 3 times a day with catheter
60
how to perform with catheter in
-wash urethral opening first & then 4 inches of catheter
61
how much fluid should someone with a catheter have
2000-2500ml
62
ways to prevent catheter association UTI
- aseptic technique with sterile equipt - secure to reduce urethra trauma - closed urinary drainage system - maintain an unobstructed flow - avoid tubing loops - drainage bag not on floor - don't allow spigot to touch anything - empty bag when half full - need to be below bladder - samples with sterile syringe from port
63
who is a condom catheter good for?
-incontinent or comatose men who still have a complete spontaneous emptying bladder
64
What are the conservation management methods to promote continence?
1) Lifestyle modification (less smoking, less caffeine, obesity) 2) Pelvis floor exercise and training 3) bladder training 4) prompted voiding 5) self catheterization
65
what are some plaque forming foods
pop, bread, starch
66
how does ill-fitting dentures effect digestive system
enjoyment of food, nutritional status
67
how often to replace tooth brush
every 3 months
68
why are unconscious patients susceptible
- unable to drink or eat - dryness - thick saliva - mouth breathers - oxygen therapy - can't swallow - bacteria that'll cause pneumonia if aspirated
69
what are dental caries
chalky white discolouration (or brown in later stages) its a cavity
70
what is gingivitis
inflammation of the gums
71
what is periodontitis
receding gums, inflammation between teeth
72
what is halitosis
bad breath
73
what is cheilosis
cracking of lips
74
what is stomatitis
inflamed oral tissue
75
what are u looking for in each part of oral assessment
- color - texture - hydration - contour - lesions
76
what is leukoplakia
precancerous lesions found in smokers
77
nursing history for mouth & pharyngeal assessment
- if pt. wears dentures, if they are comfy - recent change in appetite or weight - if they use tobacco products - if they use smokeless tobacco - alchohol consumption - dental hygiene practices - any pain - any lesions

N143 !!!! (4 decks)

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