fundamentals exam - facilitating hygiene (3/5)

how is hygiene defined?

actions/practices that decrease spread/transmission of pathogens and promote comfort, dignity, and overall health

what does hygiene consist of?

bathing body/hair, hands, nail care, oral care, foot care, perineal care

what’re the main factors that influence hygiene practices?

privacy

culture/religion

developmental

physiological

describe how privacy influences hygiene

always maintain privacy. close doors/privacy curtain, consider the number of staff members that are truly needed

how does culture/relgion influence hygiene?

is the client comfy with the person providing the care?

are there any rituals or routines the client practices/prefers?

how does developmental stage impact hygiene?

young adults may not be used to needing assistance with daily tasks, older adults may have trouble completing tasks alone

how do physiological factors influence hygiene?

stroke - paralysis/weakness

visual impairments - safety concerns

bariatric challenges - skin folds

dementia

amputations

assessment in hygiene

determine the patients ability to performs tasks, identify where help is needed

she how they feel about hygiene and if they have the correct supplies to do so

most common diagnosis in hygiene

self-care deficit w

what’re other common nursing diagnoses in hygiene

risk for infection

risk for impaired skin integrity

planning & implementation in hygiene

develop goals for the patient, what do we want to see change

then carry out the interventions while encouraging the patients to help as much as they can

what are the types of bathing?

bed bath

bag bath

basin and water

shower

what’s a bed bath?

most common method of cleaning skin

bucket with soap and warm water

what’s a bag bath

pre packaged warmed wipes, no rinse/dry. fresh wipe per area

what’s a basin and water bath?

disposable basin with warm water, wash clothes, and no rinse soap

what’re some things to consider about bathing?

CNA/PCT scope of practice, typically performed in the morning

complete a skin assessment

what are chlorhexide gluconate wipes (CHG)?

antimicrobial wipes used for infection prevention. not to be used on face, genitals, or open wounds

how to clean Foley catheter during perineal care?

clean around it daily and after soiling. start at the top and work down

how to do perineal care with condom catheters?

remove and cleanse penis daily. after skin dries, apply new one

how to do perineal care with external female catheter (PureWick)?

perform regular hygiene, replace afterwards

what are some important things to remember about linen changes?

never place used linens on floor

use gloves always

change daily as needed

patient safety with an occupied bed?

maintain alignment and support, communicate throughout, and manage pain before turning

ergonomics and safety for staff with an occupied bed?

raise bed to proper working height and use additional personal when needed

lines, drains, and devices with an occupies bed

protect IVs, catheters, tubes, and drains. avoid pulling or kinking

skin and comfort when doing linen changes on an occupied bed?

smooth out lines, reduce wrinkles as these can cause skin breakdown

what does oral care consist of

brushing 2x day

mouthwash

dentures if needed

what to assess during oral care?

moist and pink gums

loose, missing, or decaying teeth

sores/bleeding gums

how to deal with oral care with unconscious patients

use side lying position and have suction near, use oral swabs. put moisture on their lips frequently

how to deal with dentures?

store in labeled denture cup w water or denture soak

use denture specific paste and soft bristled tooth brush

rinse w cool water, place washcloth or plastic pan in sink in case of dropping it

washing hair hygiene?

dependent on hair type/client preference

use shampoo/conditioner or no rinse shampoo cap

what should you assess when looking at a patients scalp during hygiene care?

redness, areas of breakdown, dandruff, or lice

what are the different methods of shaving?

electric razor - preferred

safety razor

nursing considerations with shaving during hygiene care?

assess for bleeding risk

use warm water and shaving cream

shave in direction of hair growth

who is foot care especially important for?

those with diabetes and other disorders that alter circulation and sensation

what to assess during foot care?

cuts, blisters, cracked skin, or redness

pay attention to the heels

what’re the do’s/dont’s in foot care hygiene?

new socks, lotion if needed, toes=dried

soaking repeatedly, no lotion between toes, no trimming of toenails

what’s the process of eye care hygiene?

inner canthus to outer canthus using warm moist wash cloth, NOT bag bath wipes

what should you assess during ear care in hygiene?

drainage, swelling, tenderness, redness

evaluation of hygiene care consists of?

was the patients care performed, how did it help, was it completed safely and properly? did they want to help at all and are they satisfied?

revise plan of care if needs weren’t met