fundamentals of nursing lesson 8 hygiene and care of the patient’s environment
TRANSCRIPT
FUNDAMENTALS OF NURSING
LESSON 8HYGIENE AND CARE OF THE PATIENT’S
ENVIRONMENT
VOCABULARY
ALOPECIA ASPIRATION AXILLA BEDPAN CANTHUS CERUMEN CHUX CIRCUMORBITAL DANDRUFF DENTURE DRAWSHEET ERYTHEMA FLATUS GAG REFLEX GINGIVITIS HALITOSIS
HYGIENE LABIA MAJORA LABIA MINORA MEDICAL ASEPSIS MITERED CORNER ORAL HYGEINE PEDICULOSIS PERINEAL CARE PERIODONTITIS PRONE SANGUINEOUS SYNCOPE UMBILICUS URINAL VERTIGO
FACTORS THAT INFLUENCE HYGIENE
HYGIENE: – Science of the preservation of health & healthy living
INFLUENCING FACTORS:– SOCIAL PRACTICE– BODY IMAGE– SOCIOECONOMIC STATUS– KNOWLEDGE– PERSONAL PREFERENCE– PHYSICAL CONDITION– CULTURAL VARIABLES– AGE
FACTORS THAT INFLUENCE HYGIENE
DAILY CARE:– SELF HYGIENE AS A ROLE
MODEL– RESPECT OF PRIVACY– ATTITUDE OF ACCEPTANCE– ENCOURAGEMENT TOWARD
SELF CARE– INSTRUCTION ON TEACHING– SENSITIVITY FOR PERSONAL
BELIEFS
FACTORS THAT INFLUENCE HYGIENE
ROOM ENVIRONMENT
EQUIPMENT HYGIENE CARE
SCHEDULE
FACTORS THAT INFLUENCE HYGIENE
EQUIPMENT:– Safety factors– Bedside stand– Bed– Over table– Chairs– Lights
FACTORS THAT INFLUENCE HYGIENE
HYGIENE CARE SCHEDULE:– Early AM– After breakfast– Afternoon– PM care
PURPOSE OF HYGIENE
MAINTAIN SKIN INTEGRITY PREVENT SKIN IMPAIRMENT PROMOTE ADEQUATE CIRCULATION PROMOTE HYDRATION PROMOTES COMMUNICATION
INTACT SKIN
DEFINITION– DEFENSE AGAINST INFECTION– DEFENSE OF AWARENESS– CONTROLS BODY TEMPERATURE
MEDICAL ASEPSIS REVIEW
KNOWN AS CLEAN TECHNIQUE
INHIBITS GROWTH & SPREAD OF PATHOGENIC MICROBES
INTACT SKIN
ASSESSMENT– COLOR– TEXTURE– THICKNESS– TURGOR– TEMPERATURE– HYDRATION
NURSING GOAL– PREVENT COMPLICATIONS OR SKIN IMPAIRMENT
GOOD TO KNOW
THE PATIENT SHOULD BE ENCOURAGED TO ASSIST IN PERSONAL HYGIENE IF POSSIBLE TO PROMOTE INDEPENDENCE AND SELF-ESTEEM.
DAILY SKIN INSPECTION AND DOCUMENTATION IS AN IMPORTANT PART OF SKIN CARE AND PREVENTION OF DECUBITUS ULCERS.
•FRICTION•SHEARING FORCE•PRESSURE
PRESSURE SORES: CAUSES
PRESSURE SORES
PROLONGED PRESSURE OVER BONY PROMINENCES IS #1 FACTOR IN CAUSING A DECUBITUS ULCER.
THE BEST TREATMENT FOR PRESSURE ULCERS IN THE INITIAL STAGE IS FREQUENT TURNING.
PRESSURE SORES: RISK FACTORS
POOR NUTRITION IMMOBILITY AGE INCONTINENCE IMPAIRED CIRCULATION SENSORY DEFICIT UNDER OR OVER WEIGHT
FIGURE 18-4 A, Stage I pressure ulcer.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
PRESSURE SORES:STAGE 1
FIGURE 18-4 B, Stage II pressure ulcer.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
PRESSURE SORES: STAGE 2
FIGURE 18-4 C, Stage III pressure ulcer.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
PRESSURE SORES: STAGE 3
FIGURE 18-4 D, Stage IV pressure ulcer.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
PRESSURE SORES: STAGE 4
PRESSURE SORES: TREATMENT
ASSESSMENT– SIZE– DEPTH– COLOR– EXUDATE– PAIN
SURGICAL ASEPSIS DURING WOUND CARE
PROMOTE NUTRITION AND HYDRATION
REPOSITIONING
USE PRESSURE RELIEVING DEVICES
COMMON SKIN PROBLEMS
DRY SKIN ACNE HIRSUTISM RASHES ABRASIONS
I am a female
COMMON SKIN PROBLEMS
CONTACT DERMATITIS
BATHING & HYGIENE
PURPOSE– CLEANSE THE SKIN
– STIMULATE CIRCULATION
– PROMOTE ROM
– DECREASE BODY ODORS
– INCREASE SELF IMAGE AND COMFORT
BATHING THE PATIENT
BATHING SHOULD BE INCREASED WHEN:– Pt is incontinent– Excessive wound drainage– Pt is diaphoretic
ELDERLY CONSIDERATIONS:– Frequency is decreased because
Thinner and drier skin Less vascular Fragile Age related changes
BATHING THE PATIENT
Skill 18-1 Step 8e(1) Bathing the Patient/Administering a Back Rub,Step 8e(1): Bed bath—Remove patient’s gown, all undergarments, and jewelry. (Facilitates a more effective bed bath.) If an extremity is injured or has reduced mobility begin removal of the gown from the unaffected side.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Skill 18-1 Step 8e(2) Bathing the Patient/Administering a Back Rub, Step 8e(2): Bed bath—If the patient has intravenous (IV) tube, remove gown from the arm without IV first, then lower IV container or remove tubing from pump.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Skill 18-1 Step 8e(3) Bathing the Patient/Administering a Back Rub, Step 8e(2): Bed bath—Remove gown from the arm without IV first, then lower IV container or remove tubing from pump and slide gown covering down over the affected arm, over tubing and container.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Skill 18-1 Step 8e(4) Bathing the Patient/Administering a Back Rub, Step 8e(4): Bed bath—Rehang IV container and check flow rate or reset pump. Do not disconnect tubing. (Undressing the unaffected side first allows for easier manipulating of gown over body part with reduced range of motion [ROM] [normal movement that any given joint is capable of making.])
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Skill 18-1 Step 8h Bathing the Patient/Administering a Back Rub, Step 8h: Bed bath—Form mitt with bath cloth around your hand; dip mitt and hand into bath water. Squeeze out excess water. (Facilitates handling of bath cloth and prevents corners from brushing against patient. Do not place soap in bath water—too many suds will prevent adequate rinsing.)
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
BATHING THE PATIENT
BATHING THE PATIENT
FEMALE BATH
Front
Back
MALE BATH
Always replace foreskin
PHLEBITIS: Inflammation of vein
Do Not
Massage
OUCH!
TOWEL BATH
Towel bath.
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
METHODS OF BATHING
Shower Tub Bath Tepid Sponge Bath Medicated Bath Sitz Bath
ORAL HYGEINE
Administering oral hygiene.
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
ORAL PROBLEMS
Dental Caries
Gingivitis
ORAL PROBLEMS
Halitosis Periodontitis
DENTURE CARE
Administering oral hygiene.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
HAIR CARE AND SHAVING
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
HAIR CARE AND SHAVING
Dandruff
HAIR CARE AND SHAVING
Pediculosis (tinea capitus)
HAIR CARE AND SHAVING
Pediculosis Corporis
HAIR CARE AND SHAVING
Pediculosis Pubis
FOOT & NAIL CARE
Risk Factors:– Poor foot care– Poor fitting shoes– Biting nails
Pt’s with peripheral vascular disease Joint Mobility Elderly
Palpate pulses Assess color and warmth Assess cap refill Assess for edema
– in feet and ankles
Assess between toes
FOOT & NAIL CARE
Problems:– Callus– Corns– Planter warts– Athletes foot– Ingrown toenails– Ram’s horn nails– Fungal Infection
FOOT & NAIL CARE
BACKRUBS
PURPOSE:– Increase relaxation– Increase circulation– Decrease muscle tension
Not for pt’s w fx of ribs or vertebra, burns, open wounds, or pulmonary embolism
CATHETER CARE
CATHETER CARE
Avoid tension or pulling & perform care BID Cleanse from urinary meatus down tube Never raise catheter bag above bladder
BEDMAKING: OCCUPIED BED
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
BEDMAKING—OCCUPIED BED
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
BEDMAKING—OCCUPIED BED
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
POST-OP BED
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
BEDMAKING—MITERED CORNER
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
BEDMAKING—MITERED CORNER
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
BEDPAN/URINAL
Selected equipment and supplies for elimination.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
BEDSIDE COMMODE
The bedside commode has a toilet seat with a container underneath.
ASSISTING WITH BEDPAN
Positioning the bedpan.
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
THE END