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Chapter 38

Hygiene

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Skin

• Function– Protection– Secretion– Excretion– Temperature regulation– Sensation

• Structure and appearance

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Feet, Hands, and Nails

• Function– Mobility– Weight bearing

• Structure and appearance: nails

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Oral Cavity

• Function/appearance– Mucous membranes– Salivary glands– Teeth– Gums

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Hair

• Growth

• Distribution

• Pattern

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Eyes, Ears, and Nose

• Structure and function– Prevention of injury and discomfort

during hygienic care

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Individual Factors

• Social practices

• Personal preferences

• Body image

• Socioeconomic status

• Health beliefs and motivation

• Cultural variables

• Physical condition

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Assessment

• Physical examination– Integument: skin, hair, nails– Oral cavity– Eyes, ears, and nose

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Common Skin Problems

• Dryness

• Acne

• Rashes

• Contact dermatitis

• Abrasions

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Common Foot and Nail Problems• Callus• Corns• Plantar warts• Tinea pedis (Athlete’s foot)• Ingrown nails• Ram’s horn nails• Paronychia• Odors

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Hair and Scalp Problems

• Dandruff

• Ticks

• Lice – Pediculosis capitis – Pediculosis corporis– Pediculosis pubis

• Alopecia

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Risk Factors for Skin Impairment

• Immobilization

• Reduced sensation

• Nutrition and hydration alterations

• Secretions and excretions on the skin

• Vascular insufficiency

• External devices

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Developmental Changes

• Condition of the integument and hygienic practices– Infant– Toddler– Adolescent– Adult– Older adult

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Use of Sensory Aids

• Eyeglasses

• Contact lenses

• Artificial eyes

• Hearing aids

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Assessment

• Self-care ability

• Hygiene practices

• Cultural factors

• Clients at risk for problems

• Special considerations

• Client expectations

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Nursing Diagnoses

• Ineffective health maintenance

• Impaired mobility

• Bathing/hygiene self-care deficit

• Risk for impaired skin integrity

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Planning

• Goals and outcomes– Client’s skin is clean, dry, and intact– Client tolerates bathing without

excessive fatigue

• Setting priorities

• Continuity of care

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Implementation

• Teaching hygiene techniques– Relevant to client’s situation– Adapted to client’s bathing facilities– Incorporating injury prevention and

infection control measures

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Bathing and Skin Care

• Complete bed bath

• Partial bed bath

• Tub bath or shower

• Bag bath

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Guidelines for Bathing

• Provide privacy

• Maintain safety

• Maintain warmth

• Promote independence

• Anticipate needs

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Additional Hygienic Care Considerations

• Perineal care– Self-care ability of client– Reduction of embarrassment– Asepsis

• Back rubs– Benefits– Contraindications

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Foot and Nail Care Guidelines

• Careful inspection

• Lukewarm water temperature

• No soaking

• Cutting of nails, if indicated

• Application of lotions

• Proper socks, stockings, and shoes

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Oral Hygiene

• Brushing and flossing

• Clients with special needs – Presence of stomatitis – Use of oxygen therapy – Unconscious state

• Denture care

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Hair and Scalp Care

• Brushing and combing

• Shampooing

• Shaving

• Mustache and beard care

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Eye Care

• Basic eye care

• Eyeglasses

• Contac lenses

• Artificial eyes

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Ear Care

• Cleansing

• Cerumen removal

• Hearing aid care

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Nasal Care

• Cleansing

• Special care for clients with nasal oxygen or GI tubes

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Client’s Room Environment

• Maintaining comfort– Temperature, ventilation, noise,

light

• Room equipment– Chairs, beds, other equipment

– Bed making

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Evaluation

• Client care

• Client expectations