Personal Hygiene

Question 1

Discuss approaches used in maintaining clients’ comfort and safety during hygiene care.

Answer 1

Introduce yourself
Verify client identification
Explain procedure to patient
Evaluate clients tolerance for activity
Assess for allergies
Assess for bathing preferences
Provide privacy

Question 2

Explain the purpose of bathing and perineal care.

Answer 2

Bathing removes sweat, oil, and micro-organisms from the skin. Perineal care is the cleaning of the buttocks, anus, thighs, vagina and or penis and is included in bathing.

Question 3

Compare and contrast the different types of bed baths.

Answer 3

Complete bed baths are for totally dependent clients and it goes over the complete body.
Where; Partial bed baths are for clients who needs one area bathed or for clients that must remain in bed and cannot reach all over body their self.

Question 4

What are the steps for performing a complete bed bath?

Answer 4

Gather supplies.
*Introduce yourself to the client.
*Verify client identification.
Explain the procedure to the client.
Assess the client’s activity tolerance for bathing. *Assess the client for allergies.
Assess for any bathing preferences (specific hygiene products, time of bathing, and cultural or personal beliefs)
*Provide privacy as needed.
*Perform hand hygiene and put on appropriate PPE if indicated.
Assess the client’s skin for any abnormalities.
*Adjust height of bed to comfortable working level. Place bath blanket or top sheet over client.
Remove gown or clothing from client and top covers. Fill a basin with warm water and cleansing agent.
Add the appropriate cleanser per agency policy.
Apply clean gloves.
Wash the client’s eyes: With a clean washcloth with only water, wash the client’s eyes. Wipe each eye from the inner corner outward.
Wash the client’s face, neck and ears.
Wash the client’s upper extremities. ● Form a mitt with a washcloth on your hand. ● Uncover the client’s arm closest to you. Wash the arm from fingers to axilla. Rinse and dry. ● Apply lotion and or deodorant if necessary or if client desires. ● Raise the siderail. Move to the opposite side of the bed and repeat the steps above with the other arm.
Wash the client’s chest and abdomen. ● Cover the client’s chest with a bath blanket. Lower the bath blanket to the client’s umbilicus, exposing the chest and abdomen. ● Wash the client’s chest and abdomen, covering it in between washing, rinsing, and cleaning.
Wash the lower extremities. ● Expose the leg closest to you. ● Wash leg, rinse, and dry, moving from the ankle to the knee and then knee to groin. ● Apply lotion if necessary or if client desires. ● Wash the foot, especially between the toes. ● Thoroughly dry foot and apply lotion if necessary or client prefers. ● Place the siderail up and move to the other side of the bed. Repeat the above steps with the other lower extremity. Change bath water at this time, if not done already. Wash the client’s back. ● Have a second person assist you if client cannot. ● Turn client to a side-lying position, with their back toyou. ● Wash, rinse, and dry the client’s back. Use firm strokes from the neck to the buttocks. ● Give the client a backrub if not contraindicated. ● Wash the buttocks and anus area. Always wash front toback.
Place the client back in the supine position.
Ensure clientsafety.
Remove gloves, perform hand hygiene, and put on a new pair of clean gloves.
Change the bath water at this time.
Perform perineal care (separate checklist).
Ensure client safety.
Remove gloves and perform hand hygiene.
Place a new gown or clean clothing on the client. Groom the client’s hair if necessary.
Change the client’s bed linens.
*Ensure that the client is in a safe position prior to leaving the room and has the call light within reach.

Question 5

What are the steps for performing a partial bed bath?

Answer 5

Gather supplies.
*Introduce yourself to the client.
*Verify client identification.
Explain the procedure to the client.
Assess the client’s activity tolerance for bathing. *Assess the client for allergies.
Assess for any bathing preferences (specific hygiene products, time of bathing, and cultural or personal beliefs)
*Provide privacy as needed.
*Perform hand hygiene and put on appropriate PPE if indicated.
Assess the client’s skin for any abnormalities.
*Adjust height of bed to comfortable working level. Place bath blanket or top sheet over client’s affected area.
Remove gown or clothing from client affected area and top covers. Fill a basin with warm water and cleansing agent.
Add the appropriate cleanser per agency policy.
Apply clean gloves.
Wash affected area while covering surrounding areas, while drying and moisturizing.

Question 6

What are the steps for performing a packaged bath?

Answer 6

Same steps for the complete bed bath but you will use a prepared package instead of the basin with warm water and cleanser.

Question 7

What is a therapeutic bath or when is it used?

Answer 7

Part of a treatment plan for conditions (e.g., skin disorders, burns, elevated body temperature, and muscular injuries) Oatmeal, cornstarch, and other bath products are added to the water to relieve skin irritation. This needs a prescripton.

Question 8

Demonstrate how to assist a client with a tub bath or shower.

Answer 8

A tub bath involves immersing the client in a tub of water to provide more of a washing and rinsing experience. A shower is for the ambulatory or those able to sit in a shower chair.

Question 9

Assess the client’s response to bathing and perineal care.

Answer 9

Of course if tolerable self care is encouraged but if not make patient as comfortable as possible.

Question 10

Why is oral hygiene important?

Answer 10

You may explain that brushing teeth prevents the development of plaque related disorders as well as remove debris and food particles that cause plaque and bacteria.

Question 11

Identify the supplies necessary for providing oral hygiene.

Answer 11

Water, A toothbrush, toothpaste, floss, towels, mouthwash if preferred

Question 12

Describe oral hygiene needs for dependent clients.

Answer 12

Introduce yourself
Verify pt identity
Confirm privacy
Perform hand hygiene
Don gloves
Inspect mouth, teeth and tongue
Cover pt chest with towel
Moisten toothbrush with water
Apply toothpaste
Brush inner and outer teeth starting from gumline to crown of teeth using circular motions
Brush under teeth and sides towards the back
Brush the tongue carefully, surface and both sides
Have pt swish water to rinse
Have them spit into basin and wipe around mouth
Floss each tooth, in between and around
Have patient swish around again
Spit into basin
Wipe mouth
Offer mouthwash
Have them swish for 30 seconds
Spit into basin.
Place basin down.
Remove towel from patient and discard properly
Position pt back to comfortable position
Practice hand hygiene
Dispose of items

Question 13

Describe oral hygiene needs for independent clients.

Answer 13

Introduce yourself
Verify pt identity
Confirm privacy
Determine pt help level
Bring pt to upright position
Perform hand hygiene
Don gloves
Inspect teeth, gums and tongue
Cover pt chest with towel
Set up station for pt
Observe technique and teach if necessary
Instruct pt to rinse
Instruct pt to spit
Instruct pt to wipe mouth
Instruct pt to floss
Observe technique and teach if necessary
Instruct pt to swish and spit into basin
Offer mouthwash
Instruct pt to swish for 30 sec
Instruct to spit into basin
Remove towel from chest
Perform hand hygiene
Assist pt to comfortable position
Clean basin and toothbrush
Store in safe place
Dispose of all waste

Question 14

Describe oral hygiene needs for unconscious clients.

Answer 14

Place pt on side lying position
Secure pt
Make sure suction equipment is near
place waterproof pad down
Place basin under cheek and chin
Using tongue blade and pen light to inspect mouth
Moisten toothbrush with water
Apply toothpaste
Brush inner and outer teeth starting from gumline to crown of teeth using circular motions, while using a tongue blade to keep the mouth open.
Brush under teeth and sides towards the back Brush the tongue carefully, surface and both sides
Draw up 10mL of water and slowly inject it into pt side of mouth
Allow water to drain out into basin use suction as needed.
Use chlorhexidine to swab as ordered
Remove basin and place on table
Remove pad from underneath patient
Wipe around pt’s mouth
Perform hand hygiene
Apply some lip moisturizer to pt’s lips
Reposition pt
Perform hand hygiene
Lower bed
And replace items back to home

Question 15

Identify the steps involved in providing denture care.

Answer 15

*Provide privacy as needed.
*Introduce yourself to the client.
*Perform hand hygiene and put on appropriate PPE if indicated.
*Verify client identification.
*Determine whether the client has allergies.
*Provide client education.
Using gauze, apply gentle pressure to upper dentures and remove.
Place in denture cup.
Repeat for lower dentures.
When washing dentures in sink, place washcloth or paper towels in sink to prevent damage to dentures if dropped.
Using toothbrush and paste, brush as you would with oral care.
Rinse thoroughly with water.
If using a denture soak, then soak dentures first as brush as described above.
Use toothbrush and toothpaste to clean gums and tongue, rinsing well.
When ready to replace dentures, apply adhesive to upper dentures and press firmly to upper gums. Repeat for lower dentures and have client bite down to secure adhesive to gums.
Ask client if dentures feel comfortable and secure.
If not being worn, dentures may be stored in cold water in denture cup.
*Ensure that the client is in a safe position prior to leaving the room and has the call light within reach.
Perform hand hygiene
Dispose of items
Replace items
Perform hand hygiene

Question 16

Assess a client’s response to oral hygiene.

Answer 16

You want the pt to be as independent as possible but will take over if and when necessary.

Question 17

Demonstrate the procedure for making an occupied bed.

Answer 17

Gather needed supplies.
*Verify client identification.
*Perform hand hygiene and put on appropriate PPE if indicated.
*Provide client education.
Place supplies on a surface within reach. Provide for privacy.
Ask a second person for assistance if needed.
Disconnect any call bell or equipment from linens.
Apply clean gloves.
Raise the bed to a comfortable working height. Lower the siderail on the side of the bed that you are working on.
Remove all of the top linens except for the top sheet or bath blanket, which should cover the client.
Assist client to turn towards the opposite side of the bed.
Use a second person if necessary. Loosen all bottom linens from the bed on the side that you are on.
Roll or fold bottom linens toward the client’s back, getting the linens as close to the client as possible.
Place the clean fitted sheet on the bed and place the corners on the head and foot of the bed on the side that you are on.
Push the rest of the clean sheet toward the middle of the bed and tuck it under the dirty linens.
If using a draw sheet or water-absorbent pad, place it on the bed with the vertical fold tucked in with the bottom sheet, against the client’s back.
Tuck the excess draw sheet under the mattress.
Raise the siderail.
Assist the client to roll over the tucked linens an on to their opposite side.
Move to the other side of the bed and lower the siderail.
Gently pull out the clean linens.
Secure the corners of the fitted sheet at the head and foot of the bed.
Pull the draw sheet or water-absorbent pad taut and tuck under the mattress if necessary. Assist the client back to their back.
Apply clean pillowcases to any pillows. Apply clean top sheet and blanket.
Tuck in the sheet and blanket at the foot of the bed and miter each corner.
Cuff the top sheet and blanket at the client’s shoulders
Raise siderail.
Remove gloves and perform hand hygiene. *Ensure that the client is in a safe position prior to leaving the room and has the call light within reach.

Question 18

Demonstrate the procedure for making an unoccupied bed.

Answer 18

Gather needed supplies.
*Verify client identification (if client is present in room).
*Perform hand hygiene and put on appropriate PPE if indicated.
*Provide client education.
Place supplies on a surface within reach. Provide for privacy.
Lower the siderails and adjust the bed to a comfortable working height.
Disconnect any tubes or equipment from the bed linens.
Apply clean gloves if linens are soiled. Loosen bottom lines around bed.
Roll linens into a ball and remove them from the bed, holding them away from your uniform.
Place directly in hamper or laundry bag. Wipe mattress with approved antiseptic if required by agency.
Remove gloves if necessary.
Attach bottom sheet to one half of the bed and then move to the opposite side and do the same.
If using a draw sheet or waterproof pad, place it on the middle of the bed where it will be located under the midsection of the client. Tuck sides under the mattress if necessary. Place the top sheet with the vertical centerfold with the hem at the head of the bed.
Unfold the top sheet.
Repeat the last two steps with a blanket or bedspread.
Tuck the sheet and blanket or bed spread under the mattress at the foot of the bed. Make a modified mitered corner at each corner of the foot of the bed.
Make a cuff at the head of the bed by folding down the edge of the top sheet over the blanket.
Place clean pillowcases on pillows and place them back on the bed.
*Ensure that the client is in a safe position prior to leaving the room and has the call light within reach.