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Oral care
Includes care of a patients mouth and teeth, also known as oral hygiene
Benefits of oral care
Stimulates appetite, provides comfort, prevents any diseases and tooth decay and bad breath
Caries
Decay and crumbling of tooth
Halitosis
Bad smelling breath
How many times should oral care be done?
At least 3 times daily for most
Who may require oral care every 2 hours?
Those who are unconscious, vomiting, dehydrated, tube-fed, etc.
Precautions for mouth care
May require PPE, store patients toothbrush away from other personal items
Toothbrush
To brush teeth, soft-bristled ones are often recommended for sensitive gums
Toothpaste
Use fluoride toothpaste unless specified otherwise
Mouthwash
Is optional and based on patients need
What to observe and report?
Any pain, bleeding, excessive saliva, swelling of tongue, infections, any blockage of the airway
For special mouth care
Use specialized oral suction devices to clear secretions, report these secretions to the nurse
When brushing teeth make sure
Patient is sitting up right, they need to be in the fullest upright position
Why do patients need to be in an upright position?
To ensure that they do not aspirate (choke on the water or toothpaste)
When brushing teeth start from:
Back of the teeth to the front
Aspiration
Breathing fluid, food, vomitus, or an object into the lungs
What is an important principle in dentures?
CNAs cannot put dentures in and they cannot take them out, it is a safety measure for both you and the patient
Why can't you put dentures inside a patient?
For the safety of you and the patient. Trying to "pop" dentures from the lower jaw causes the CNA to place downward pressure on the lower jaw, which can dislocate the jaw. Patients may also accidentally bite down on the CNAs fingers
What if the patient cannot take their own dentures?
They will not wear dentures and we will puree their food so that it is easier to eat without chewing.
Full plate denture
It is a replacement of all of the patient's teeth on either the upper or lower jaw
Partial denture
A type of denture that replaces most of the patient's teeth, but will have holes where the plate fits around some of the patient's natural teeth
Bridge denture
Used when a patient has most of their natural teeth, but needs a few replacements for missing teeth. This will be a small section of artificial teeth that fits into a slot between natural teeth.
What happens if dentures get dropped?
They may break and the facility may be responsible for reimbursing the patient for new dentures. It's important to protect the dentures by placing something in the bottom of the sink (like a washcloth) and keep the dentures over the sink.
Why should dentures be stored in cool water?
It is to prevent them from drying out and becoming brittle
How are the sides of a denture brush used?
The smaller side is used to clean the channel part of the dentures (the part that goes over the gums) and the larger brush is used like a toothbrush to clean the teeth part of the dentures.
Toothettes
Soft, disposable sponges on sticks. Used to clean dentures, especially for patients who are unable to handle a brush or need to clean in a sensitive manner
Chain of infection
explains how pathogens (viruses/bacteria) can pass from person to person.
Pathogen
First step to the chain infection
Where the pathogen lives inside of
Reservoir or host
Is a pathogen inside a reservoir dangerous?
No but the person it is inside of is
How do pathogens move?
Pathogens have to rely on some other medium (like a fluid) to get out of the host. Most often happens when liquids flow out of wound or incision
What does wearing gloves do?
This blocks you to come in contacr with body fluids. This blocks the pathogen by interfering with the mode of transmission and prevents access into any of your portals of entry
Leaves method
To wash and prevent contamination. This allows you to use one leaf to wipe a body opening, then fold that leaf forward to confine any pathogens inside the fold and use the second "leaf" for the next cleaning stroke.
Most effective method of cleaning non-intact skin while preventing any pathogen invasions
Leaves method
Incontinence
Means that the patient cannot ontrol his or her bladder and/or bowels
Can people be incontinent of urine and fences?
Yes, people can be incontinent of both
All blood is filtered through
the kidneys which removes waste products and creates urine
Urine is created continuously as little drops and what happens to them?
These drops descend tubes called ureters and collect in a hollow sac called a bladder
Bladder
Holds all of these urine drops until enough has been accumulated to fill the bladder
What happens when urine is accumulated to the bladder?
The bladder will signal to the brain that it needs to be emptied and you go to the bathroom, then the process starts all over again
When a patient is incontinent of urine
the bladder does not hold the drops of urine; instead they continue to flow out of the body
Chucks
Known as absorbent underpads which allows air to circulate and draws the urine away from the skin, while in bed
The care plan will contain specific information on the frequency of cleaning for each patient, but is often done
Every 2 hours around the clock (even when sleeping)
Normal temperature for urine
90-100 F
To prevent infection
Wipe from the front to the back
Clitoris
Located at the junction of the labia minoriajaids in arousal and vaginal lubrication
Bartholin's glands
Secrete fluid for lubrication during intercourse
Perineum
Area between the labia majora and anus, may also refer to entire pelvic floor in female
Testes (male gonads)
produce sperm and testosterone. Found in the scrotum, located outside the body to maintain a lower temperature for sperm development
Penis
External reproductive organ located in front of the scrotum. Encloses the urethra, which carries urine and semen.
For uncircumscribed patients
retract the foreskin gently to clean underneath it. Rinse thoroughly and ensure the foreskin is replaced
bath water temperature
105 F (40.6 C)
complete bed bath (CBB)
a bath in which all parts of a patient's body are bathed while the patient is confined to bed
Tub bath
Involves immersion in tub, allowing more thorough washing and rinising. Patients may require nurse's help.
Partial bed bath
Bath consists of bathing only body parts that would cause discomfort if left unbathed (hands, face, axilla, perineal area) and includes washing back and providing back rub.
