Comfort & Hygiene NURN 153 Lecture Exam 1

What is hygiene?

Hygiene is maintaining personal cleanliness and grooming to promote physical and psychological well-being. If a patient cannot meet their own hygiene needs, the nurse ensures those needs are met.

What is the nurse’s overall goal when helping a patient with hygiene?

Help the patient maintain health and comfort while encouraging them to do as much of their own care as safely possible. The nurse provides only the assistance the patient cannot or should not perform independently.

Why is assessing the patient before providing hygiene care important?

The assessment tells the nurse what care the patient actually needs, what the patient can do independently, and what parts of routine AM care may need to be changed for the patient’s condition, abilities, or preferences.

What factors can affect a patient’s hygiene practices and needs?

Culture, socioeconomic status, spiritual practices, developmental level, health state, and personal preferences.

How can the patient’s health condition change the normal hygiene routine?

The nurse may need to provide more assistance, shorten or modify the bath, perform only necessary hygiene tasks, or use a bed bath if the patient cannot safely perform normal self-care.

How should culture or spirituality affect hygiene care?

The nurse should ask about and respect the patient’s usual practices and preferences instead of assuming everyone performs hygiene the same way. This may affect hair care, shaving, bathing, privacy, or other grooming practices.

What should the nurse do if a patient can perform part, but not all, of their hygiene care?

Allow the patient to perform the parts they can safely do and assist only with the remaining tasks. This supports independence and patient-centered care.

What are the five scheduled types of hygiene care?

Early morning care, AM care, PM care, hour-of-sleep (HS) care, and PRN/as-needed care.

What is included in early morning care?

Basic care to refresh the patient for the day, such as toileting, washing the face and hands, mouth care, and comfort measures.

What is usually included in AM care?

AM care can include toileting, oral care, bathing, hair care, shaving/grooming, dressing, positioning for comfort, and refreshing or changing bed linens.

Does every patient automatically receive every part of the standard AM care routine?

No. AM care is individualized based on the patient’s assessment, abilities, health condition, preferences, and current needs.

What is PM care?

Hygiene assistance later in the day, such as toileting, handwashing, oral care, straightening linens, and helping the patient reposition or move.

What is HS care?

Care provided around bedtime to promote comfort, cleanliness, rest, and safety, such as toileting, face/hand washing, oral care, changing soiled clothing/linens, comfortable positioning, and placing needed items within reach.

What is PRN hygiene care?

Hygiene performed whenever the patient needs it, rather than at a scheduled time—for example, cleaning after incontinence, changing sweaty clothing or linens, or providing additional oral care.

What should the nurse assess when examining the skin during hygiene care?

Pain, cleanliness, color, temperature, turgor, moisture, sensation, vascularity, lesions, and areas affected by medical devices.

What questions can the nurse ask when assessing the patient's skin?

Ask about changes such as rash, dryness, itching, lumps, or lesions, and whether anything makes the symptoms better or worse.

Why is bathing more than just cleaning the patient?

Bathing cleans and conditions the skin, promotes circulation, provides movement/exercise, promotes muscle relaxation and comfort, provides sensory stimulation, improves self-image, and strengthens the nurse-patient relationship.

What is the difference between a complete bed bath, self-help bath, and partial bath?

Complete bed bath: nurse bathes the entire body of a dependent patient. Self-help bath: patient bathes themselves in bed with some assistance. Partial bath: only certain areas are washed, with the nurse helping where needed.

How does the nurse decide which type of bath a patient needs?

Base it on the patient’s mobility, strength, ability to perform self-care, health condition, safety, and individual hygiene needs.

What infection-control principle should be followed when bathing a patient?

Work from the cleanest areas toward the less clean areas and wear clean gloves when there may be contact with mucous membranes, secretions, excretions, blood, or other indicated body substances.

What safety and comfort measures are important during a bath?

Identify the patient using two identifiers, check water temperature, use safe body mechanics, maintain warmth and privacy, dry the skin thoroughly, and use emollients when appropriate.

Why should the patient be kept covered during a bed bath?

To maintain privacy, dignity, comfort, and warmth while exposing only the area being washed.

Why is thoroughly drying the skin important after bathing?

It helps protect skin integrity and prevents moisture from remaining on the skin, especially in areas where moisture can contribute to irritation or breakdown. The PowerPoint specifically stresses making sure the skin is completely dry.

What should the nurse assess about a patient’s hair and scalp?

Texture, hair loss, dandruff, infestations, lesions, and inflammation, while also asking about changes such as hair loss, scalp dryness, or itching.

Why must cultural and religious practices be considered during hair care?

Hair and grooming may have personal, cultural, or spiritual significance. The nurse should learn the patient’s usual hair-care and styling preferences before providing care.

What are important safety considerations when shaving a patient?

Wear gloves when using a disposable razor, shave in the direction the hair grows, use extra caution with patients at risk for bleeding, and assess cultural preferences. Patients prone to bleeding should use an electric razor.

Why is shaving especially important to assess before performing it on a patient taking anticoagulants?

Anticoagulants increase the risk of bleeding, so the nurse must use extra precautions and avoid causing cuts.

What should the nurse assess when examining the feet and nails?

Pain, cleanliness, color, temperature, swelling, sensation, pulses, capillary refill, skin integrity, and changes in the nails.

Why is foot care especially important for patients with diabetes?

Diabetes can increase the risk of foot injury, ulceration, infection, and possible amputation, so careful foot assessment and prevention are essential.

What special foot-care precautions are used for patients with diabetes, PVD, or immunosuppression?

Inspect feet daily, avoid clipping with scissors, use lukewarm water, dry thoroughly, do not soak the feet, and refer problems such as calluses, bunions, or blisters for appropriate foot care.

Why should a diabetic patient's feet not be soaked?

Their feet require extra protection from skin damage. The PowerPoint specifically identifies avoiding soaking as a safety measure for high-risk foot care.

What should the nurse assess when examining the eyes, ears, and nose during hygiene care?

Ask about changes in vision, hearing, or smell and assess for pain, symmetry/alignment, swelling, and discharge. Also determine whether the patient uses glasses, contacts, or hearing aids.

How should eyeglasses be cared for?

Keep them clean, handle them by the frames, never place the lenses face down, report damage or complaints, and store them in a labeled container.

How should hearing aids be cared for?

Protect them from heat, moisture, lotions, sprays, and shampoo; handle carefully; check the batteries; let the patient manage them when able; and store them in a labeled container.

How should the nurse clean a patient's eyes?

Use water or normal saline and clean from the inner canthus toward the outer canthus with a clean, warm cloth or compress.

What should the nurse avoid when cleaning the ears?

Do not use cotton-tipped swabs inside the ear. Clean the external ear with a washcloth-covered finger.

What should the nurse assess when examining the mouth?

Pain, color, teeth, symmetry, swelling, movement, odor, oral lesions/tender areas, and the presence of dental appliances.

What is the purpose of oral care?

Keep the lips and oral mucosa clean, soft, intact, and moist, reduce plaque and odor, and help reduce the risk of respiratory infection.

How should dentures be cared for?

Remove and rinse them after meals and at bedtime, follow infection-control principles, and store them in a labeled cup with water. Do not leave them on a tray table or meal tray.

What special precautions are used when providing oral care to an unconscious patient?

Use only a small amount of liquid, position the patient’s head toward the nurse, inspect the mouth, clean all areas of the oral cavity, follow facility protocol, and moisturize the lips.

What should the nurse assess before providing perineal care?

Ask about changes, discharge, swelling, itching, redness, special hygiene practices, and products used. Assess for pain, color, odor, discharge, lesions, masses, or other abnormalities.

What are the key principles of perineal care?

Maintain privacy, remove fecal material from the skin, and clean the perineal area from front to back to reduce contamination.

What environmental care should the nurse provide as part of hygiene and comfort?

Keep the room tidy and clean, maintain a comfortable temperature and ventilation, control unpleasant odors, and provide fresh linens.

After hygiene care, what safety checks should the nurse perform before leaving the patient?

Make sure the bed is low and safe, brakes are locked, bed controls work, the patient is comfortably positioned, the call light and needed items are within reach, and side rails are used when indicated.