unit three

Question 1

what are the 2 types of baths?

Answer 1

cleansing and therapeutic

Question 2

what are the 6 types of cleansing baths?

Answer 2

1. complete bed bath
2. partial bed bath
3. sponge bath at sink
4. tub bath
5. shower
6. bed bath with disposable wipes

Question 3

what are the 2 types of therapeutic baths?

Answer 3

sitz and medicated

Question 4

what are you assessing during bathing?

Answer 4

• room safety
• fall risk status
• bathing tolerance
• cognitive function
• visual status
• ability to sit
• extremity ROM
• presence of external medical devices/equipment
• bathing preferences
• skin problems
• skin condition
• risk for skin impairment

Question 5

what are the principles and guidelines of bathing?

Answer 5

• clean skin regularly and at time of soiling
• maintain privacy and comfort
• move from distal to proximal, avoid force/friction
• accomodate preferences and culture
• consider normal hygiene routine
• involve family when possible
• keep care items within reach
• use clean gloves (non intact skin, mucous membranes, drainage, secretions/excretions, blood)
• wash from cleanest to dirtiest
• test water temp to prevent burns
• focus on dignity, comfory, safety, autonomy, and self esteem (dementia patients)
• assess and evaluate patient before and after hygienic care

Question 6

what is the order of bathing?

Answer 6

1. face
2. upper extremities
3. chest
4. hands
5. abdomen
6. lower extremities
7. back
8. buttocks and anus
9. peri area

Question 7

what is perineal (peri) care? when is it done more often?

Answer 7

• cleaning of the external genitalia and surrounding skin
• done for patients with incontinence, indwelling catheters, and recent genital/rectal surgery

Question 8

what is included in oral care?

Answer 8

• brushing
• flossing
• rinsing reeth/mouth
• denture care

Question 9

what are the benefits of oral care?

Answer 9

• prevents and controls oral disease/infection
• promotes comfort
• makes swallowing easier = better food intake
• improves verbal communication

Question 10

what are you assessing during
oral care?

Answer 10

• room safety
• oral cavity (lips teeth, buccal mucosa, gums, palate, tongue)
• common oral problems
• risk for oral hygiene problems
• regular oral care practices
• ability to perform oral care

Question 11

what are common oral problems?

Answer 11

• dental caries: chalky white discoloration of tooth
• gingivitis: gum inflammation
• peridontitits: receding gum lines, inflammation, gaps between teeth
• halitosis: bad breath
• cheilosis: cracking lips
• stomatitis: mouth tissue/structure inflammation
• mucositis: oral mucous membrane inflammation

Question 12

what are unconscious patients at risk for when it comes to oral care?

Answer 12

• alterations of oral cavity
• infection
• aspiration

Question 13

why is nail and foot care important?

Answer 13

prevents infections, odor, pain, and soft tissue injury

Question 14

who is at increased risk for foot and nail problems?

Answer 14

• diabetes
• peripheral vascular disease

Question 15

what should you assess in the extremities?

Answer 15

• dryness, inflammation, cracking
• between toes and fingers, and soles of feet
• circulation: skin color and temp, peripheral pulses, cap refill

Question 16

what are the normal assessment findings of urinary elimination?

Answer 16

• greater than or equal to 30 mL/hr
• clear, amber/straw colored
• faint smell

Question 17

what are normal assessment finding of fecal elimination?

Answer 17

• brown
• soft but formed
• passing flatus

Question 18

what are the 7 types of feces?

Answer 18

1. separate hard lumps, hard to pass
2. sausage shaped but lumpy
3. like a sausage but with cracks on surface
4. like a sausage or snake, smooth and soft
5. soft blobs with clear cut edges, passes easily
6. fluffy pieces with ragged edges, a mushy stool
7. watery, no solid pieces, entirely liquid

Question 19

patient position:
sitting

Answer 19

• provides full expansion of lungs
• better visualization of symmetry
• physically weakened/developmentally challenged patients may sometimes be unable to sit

Question 20

supine

Answer 20

• most normally relaxed position
• used to promote blood flow to brain for hypotensive patients
• for patients with vertebral injuries and in cervical traction

Question 21

prone

Answer 21

• good position for assessing posterior area and certain joint ROM
• patients with respiratory difficulties do not tolerate well

Question 22

dorsal recumbant

Answer 22

• good for assessment of anterior areas
• helps relax abdominal muscles
• patients with painful disorders are more comfortable with knees flexed

Question 23

lithotomy

Answer 23

• provides maximum exposure of genitalia
• uncomfortable, patients with arthritis or other joint deformities may be unable to tolerate this position

Question 24

lateral recumbant

Answer 24

• good for assessing heart murmurs
• patients with respiratory difficulties do not tolerate well

Question 25

modified lateral recumbant

Answer 25

• helps improve exposure to rectal/genitourinary areas
• joint deformites hinder ability to bend hip and knee

Question 26

knee-chest

Answer 26

• provides maximum exposure to rectal area
• embarassing and uncomfortable
• patients wiht arthritis or other joint deformities may be unable to assume this position