Chapter 2: Bathing & Patient Care

Bathing Basics

• Opportunity to:

  • Assess skin condition

  • Check range of motion

• Type of bath depends on:

  • Patient mobility

  • Health condition

  • Provider orders

Supplies:

• Towels, washcloths

• Cleanser

• Gown

• Lotion, powder, deodorant

Bathing: Water Temperature

• Safe range: 98.6°F – 115°F (37°C – 46°C)

• Ideal routine: 105–110°F

• Always:

  • Let patient test water

  • Avoid extremes (burn risk)

Bathing: Privacy

• Close doors or curtains

• Use bath blanket when possible

• Respect dignity at all times

Bathing: Safety

• Prevent falls:

  • Non-slip mats/socks

• Never leave unsafe patient alone

• Keep call light within reach

• Bed bath:

  • Raise side rails

• Keep:

  • IV sites dry

  • Surgical sites protected

Bathing: Bathing Technique

• Wash clean → dirty areas

• Use long, firm strokes (stimulates circulation)

• Rinse thoroughly

• Dry with gentle patting (not rubbing)

• Adjust bed height to prevent caregiver injury

Bathing: Catheter Care

• Ensure enough slack in catheter tubing to prevent pulling during repositioning

• Secure drainage bag to the side of the bed (not bed rails)

• Prevents accidental catheter removal

Drainage Bag Safety

• Never raise the drainage bag above the level of the bladder

• Prevents backflow of urine into the bladder

• Backflow can lead to infection

Bathing: Perineal Care with Catheter

• Cleanse perineal area with soap and water

• May use provider-ordered antimicrobial/microbicidal ointment at insertion site

• Helps reduce infection risk

Frequency

• Unless otherwise ordered, catheter care is done twice daily

Bathing: Sitz Bath

• A cleansing method using warm water in a special basin placed over the toilet

• Soothes and cleans perineal and rectal areas

• Uses

  • Post-childbirth recovery

  • Hemorrhoids

  • Rectal surgery

  • Excessive drainage or irritation

  Benefits

  • Promotes healing

  • Reduces pain and swelling

  • Improves hygiene

Bathing: Monitoring & Reporting

• Report any new or unusual changes to the nurse, including:

  • Itching

  • Pain or discomfort

  • Changes in behavior

  • Signs of infection

  • New symptoms

Oral Care Basics

• Oral hygiene is essential for overall health but often overlooked

• Provide oral care:

  • Upon waking

  • After meals

  • Before bedtime

• Some patients need more frequent care, especially:

  • NPO patients

  • Patients on drying medications

• Always check with the nurse first (swallowing risk)

Oral Care: Patient Considerations

• Some patients may need assistance or full care

• Others can perform oral care with set-up help only

• Denture care is different from natural teeth care

• Always assess patient ability before starting

Oral Care: Oral Care for Natural Teeth

Positioning & Supplies

• Raise head of bed as tolerated

• Supplies:

  • Soft-bristle toothbrush

  • Toothpaste

  • Water

  • Emesis basin

  • Dental floss

  • Washcloth and towel

Oral Care: Brushing Technique

• Brush in a circular motion

• Hold toothbrush at a 45° angle to the gums

• Clean from back teeth to front teeth

• Be gentle to protect gums

Oral Care: After Brushing

• Allow patient to rinse mouth with water

• Spit into emesis basin

• Provide flossing after brushing

Oral Care: Denture Care (overview?)

• Patients may prefer to clean dentures themselves

• Dentures are:

  • Expensive

  • Fragile

  • Custom-made (hard to replace)

• Always ask the patient about their preferred cleaning method

Oral Care: Removing Dentures (Assisted Care)

If patient can remove them:

• Allow patient to remove dentures independently

• Place dentures in a washbasin with lukewarm water

• Avoid hot water (can damage dentures)

If patient needs assistance:

• Put on gloves

• Remove upper denture:

  • Break suction using thumb and forefinger

  • Use gauze and gently pull downward

• Remove lower denture:

  • Lift and gently twist side to side

Oral Care: Cleaning Dentures

• Use denture cleaner only (not toothpaste)

  • Toothpaste can scratch dentures

• Clean over a sink with a washcloth to prevent damage if dropped

• Brush all surfaces gently

• Rinse thoroughly with lukewarm water

Oral Care: Reinsertion & Storage

• Moisturize dentures before reinsertion to help suction

• When not in use:

  • Place in labeled denture cup (name + room number)

  • Store in lukewarm water or denture solution

• Prevents drying and warping

Oral Care: Denture Rule of Thumbs (what to use)

• Dentures do NOT replace oral care

• Clean:

  • Gums

  • Tongue

  • Cheeks

• Use:

  • Soft-bristle toothbrush

  • Foam swabs

  • Mouthwash (if appropriate)

• Rinse thoroughly

Oral Care: Unconscious Patients

• Position patient on their side facing you

• Prevent aspiration

• Place:

  • Towel under head

  • Emesis basin under chin

• Do NOT place fingers inside mouth

  • Risk of involuntary biting

• Explain procedure throughout care

  • Patients may still have partial awareness

Oral Care: Reporting Findings

Oral care is an opportunity to report concerns such as:

• Red, swollen, or bleeding gums

• Canker sores

• Pus or signs of infection

• Foul or fruity breath odor (possible underlying condition)