hygiene and care of the patient’s environment chapter 18 mosby items and derived items © 2011,...
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Hygiene and Care of the Patient’s Environment
Chapter 18Chapter 18
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 2Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Hygiene and Care of the Patient’s EnvironmentHygiene and Care of the Patient’s Environment
• Personal Hygiene The self-care measures persons use to maintain their
health
• Hygiene The science of health Includes care of the skin, hair, hands, feet, eyes, ears,
nose, mouth, back, and perineum
• Conscientious personal hygienic practices are essential for the nurse; nurses are role models.
Slide 3Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
• Factors Influencing Personal Hygiene Social practices Body image Socioeconomic status Knowledge Personal preference Physical condition Cultural variables
Hygiene and Care of the Patient’s EnvironmentHygiene and Care of the Patient’s Environment
Slide 4Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Patient’s Room EnvironmentPatient’s Room Environment
• Maintaining Comfort Room temperature: 68° to 74° F Good ventilation Bedpans and urinals that are emptied and rinsed
promptly Monitored noise level Proper lighting
Slide 5Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Figure 18-1Figure 18-1
A typical hospital room.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Slide 6Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Patient’s Room EnvironmentPatient’s Room Environment
• Room Equipment Bedside stand
• Used to store the patient’s personal articles and hygienic equipment
Overbed table• On wheels; is adjustable to various heights over the bed
or a chair Chairs
• Straight chairs and lounge chairs
Slide 7Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Patient’s Room EnvironmentPatient’s Room Environment
• Room Equipment (continued) Lights
• Lights provide comfort, safety, and ease.
• Call light signal indicates that a patient needs assistance.
Bed• Bed is designed for comfort, safety, and adaptability to
position changes.
• It has a number of safety features.
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BathingBathing
• Sitz Bath Cleanses and aids in reducing inflammation of the
perineal and anal areas of the patient who has undergone rectal or vaginal surgery or childbirth
Water temperature 98° to 102° F
• Cool Water Tub Bath May be given to relieve tension or lower body
temperature Water temperature tepid, not cold—98.6° F
Slide 9Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Figure 18-2Figure 18-2
The sitz bath.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Slide 10Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
BathingBathing
• Warm Water Tub Bath Given to reduce muscle tension Water temperature 109.4° F Observe s/s of dizziness/fainting
• Hot Water Tub Bath Given to assist in relieving muscle soreness and
muscle spasms Water temperature 113° to 115° F
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Slide 12Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
BathingBathing
• Other Baths Complete bed bath
• For patients who are totally dependent and require total assistance
Tepid sponge bath• Administered to reduce an elevated temperature
Medicated bath• May include agents such as oatmeal, cornstarch,
Burow’s solution, and soda bicarbonate
• To reduce tension and relax the patient and to relieve pruritus caused by certain skin disorders
Slide 13Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Skill 18-1: Steps 8h & 8iSkill 18-1: Steps 8h & 8i
Bed bath.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Slide 14Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Skill 18-1: Steps 8r & 8uSkill 18-1: Steps 8r & 8u
Bed bath.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Slide 15Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Skill 18-1: Steps 10d(1) & 10d(4)Skill 18-1: Steps 10d(1) & 10d(4)
Towel bath.
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Skill 18-1: Step 10e2Skill 18-1: Step 10e2
Towel bath.
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
Slide 17Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
BathingBathing
• Back Care/Back Rub Usually administered after the patient’s bath Promotes relaxation, relieves muscular tension, and
stimulates circulation Nurse massages for 3 to 5 minutes Contraindicated if the patient has such conditions as
fractures of the ribs or vertebral column, burns, pulmonary embolism, or open wounds
Slide 18Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Skill 18-1: Steps 14e & 14fSkill 18-1: Steps 14e & 14f
Back rub.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Slide 19Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Care of the Skin When a person’s physical condition changes, the skin
often reflects this through alterations in color, thickness, texture, turgor, temperature, and hydration.
As long as the skin remains intact and healthy, its physiological function remains optimal.
Slide 20Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 21Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Care of the Skin (continued) Collection of data
• Normal skin has the following characteristics: Intact without abrasions Warm and moist Localized changes in texture across surface Good turgor; generally smooth and soft Skin color variations from body part to body part
Slide 22Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Care of the Skin (continued) Impaired skin integrity
• A patient who stays in one position without relief of pressure can develop a pressure sore.
• Patients especially at risk are the chronically ill, debilitated, older, disabled, or incontinent patient and the patient with spinal cord injuries, limited mobility, or poor overall nutrition.
Slide 23Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Pressure sore stagingPressure sore staging
Slide 24Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Figure 18-5Figure 18-5
Thirty-degree lateral position to avoid pressure points.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Slide 25Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Figure 18-6Figure 18-6
Using a rolled bath blanket as a pressure-reducing device.
Slide 26Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Care of the Skin (continued) Impaired skin integrity
• Pressure ulcers occur when there is sufficient pressure on the skin to cause the blood vessels in an area to collapse.
• The flow of blood and fluid to the cells is impaired, resulting in ischemia to the cells.
• When the external pressure against the skin is greater than the pressure in the capillary bed, blood flow decreases to the adjacent tissue.
• If the pressure continues for longer than 2 hours, cell necrosis may occur.
Slide 27Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 28Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Care of the Skin (continued) Impaired skin integrity
• Shearing force The tissue layers of skin slide onto each other, resulting
in kinking or stretching of subcutaneous blood vessels; this results in an interruption of blood flow to the skin.
• Friction Rubbing of skin over a surface produces friction, which
may remove layers of tissue.
Slide 29Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 30Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Figure 18-3Figure 18-3
Diagram of shearing force exerted against sacral area.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Slide 31Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Care of the Skin (continued) Stages of pressure ulcers
• Stage I: nonblanchable erythema of the skin
• Stage II: partial-thickness skin loss; epidermis
• Stage III: full-thickness skin loss, damage or necrosis of subcutaneous tissue
• Stage IV: full-thickness skin loss with
extensive destruction, tissue necrosis,
or damage to muscle, bone, or
supporting structures
Slide 32Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Figure 18-4, AFigure 18-4, A
A, Stage I pressure ulcer.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Slide 33Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Figure 18-4, BFigure 18-4, B
B, Stage II pressure ulcer.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Slide 34Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Figure 18-4, CFigure 18-4, C
C, Stage III pressure ulcer .
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Slide 35Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Figure 18-4, DFigure 18-4, D
D, Stage IV pressure ulcer .
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Slide 36Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Stable eschar of heelSStable eschar of heelS
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Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Care of the Skin (continued) Nursing interventions
• Assess improvement.
• Assess size and depth of the ulcer, the amount and color of any exudate, the presence of pain or odor, and the color of the exposed tissue.
• Specific interventions are determined by the stage of the ulcer.
Slide 38Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Oral Hygiene Care of the oral cavity Helps maintain a healthy state of the mouth, teeth,
gums, and lips Brushing the teeth removes food particles, plaque,
and bacteria; massages the gums; and relieves discomfort resulting from unpleasant odors and tastes.
Slide 39Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Skill 18-2: Steps 9a & 9cSkill 18-2: Steps 9a & 9c
Administering oral hygiene.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
Slide 40Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Oral Hygiene (continued) Dentures
• A set of artificial teeth not permanently fixed.
• Should be stored in an enclosed, labeled cup for soaking or when they are not worn
• Should be cleaned as often as for natural teeth to prevent infection and irritation
• Oral care provided on a regular basis
Slide 41Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Skill 18-2: Step 10cSkill 18-2: Step 10c
Administering oral hygiene.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Slide 42Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Hair Care Combing, brushing, and shampooing are basic
hygiene measures for all patients. Patient may shampoo in the shower or tub, use a
portable chair in front of a sink, or in bed.
• Shaving the Patient Patient may prefer to shave at the time of bathing. Patients who have a bleeding disorder or are taking
anticoagulants should use electric razors. Do not allow a disoriented or depressed patient to use
a razor with a blade.
Slide 43Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Skill 18-3: Steps 9a & 10eSkill 18-3: Steps 9a & 10e
Care of the hair, nails, and feet.
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Slide 44Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Hand, Foot, and Nail Care Hands and feet often require special attention to
prevent infection, odors, and injury. Assessment
• Examine all skin surfaces.
• Carefully assess between the toes.
• Observe for adequate circulation.
Slide 45Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Eye, Ear, and Nose Care (continued) Care of the eyes
• Cleansing of the circumorbital area of the eyes is usually performed during the bath.
• Case involves washing with a clean washcloth moistened with clear water.
• The use of soap is omitted because it may cause burning and irritation.
• The eye is cleansed from the inner to the outer canthus.
• Patient may need assistance with care of eyeglasses or contact lenses.
Slide 46Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 47Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Eye, Ear, and Nose Care (continued) Care of the ears
• The ears are cleansed by the nurse during the bed bath.
• A clean corner of a moistened washcloth rotated gently into the ear canal works best for cleaning.
• A cotton-tipped applicator is useful for cleansing the pinna.
• The nurse should teach patients never to use bobby pins, toothpicks, or cotton-tipped applicators to clean the internal auditory canal.
Slide 48Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Eye, Ear, and Nose Care (continued) Care of the ears (continued)
• Hearing aids This involves routine cleaning, battery care, and proper
insertion technique. When not in use, the hearing aid should be stored where
it will not become damaged.
Slide 49Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Figure 18-8Figure 18-8
Hearing aid.
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
Slide 50Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Eye, Ear, and Nose Care (continued) Care of the nose
• The patient can usually remove secretions from the nose by gently blowing into a soft tissue.
• Teach the patient that harsh blowing causes pressure capable of injuring the tympanic membrane, nasal mucosa, and even sensitive eye structures.
• If the patient is not able to clean the nose, the nurse will assist, using a saline-moistened washcloth or cotton-tipped applicator; for excessive secretions, suctioning may be required.
Slide 51Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Perineal Care Care of the genitalia Part of the complete bed bath Assess for signs of vaginal or urethral exudate, skin
impairment, unpleasant odors, complaints of burning during urination, or localized tenderness or pain of the perineum.
Catheter care is to be performed twice daily on all patients with indwelling catheters.
• Includes cleansing of the meatal-catheter junction with a mild soap and water and sometimes application of a water-soluble microbial ointment
Slide 52Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Skill 18-4: Step 9bSkill 18-4: Step 9b
Female perineal care.
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
Slide 53Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Skill 18-4: Steps 9e & 9gSkill 18-4: Steps 9e & 9g
Female perineal care.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Slide 54Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Skill 18-4: Step 10c/10dSkill 18-4: Step 10c/10d
Male perineal care.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Slide 55Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Bed Making The patient’s bed is usually made in the morning after
the bath. When possible, the bed is made while it is not
occupied; when the patient is unable to be out of bed, the nurse will make an occupied bed.
The patient’s safety is always foremost in the nurse’s mind; comfort and privacy are also important.
• Use side rails, keep the call light within easy reach, and maintain the bed in the proper position.
Slide 56Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Skill 18-5: Step 8iSkill 18-5: Step 8i
Bed making: occupied bed.
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
Slide 57Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Skill 18-5: Step 8jSkill 18-5: Step 8j
Bed making: occupied bed.
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
Slide 58Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Skill 18-5: Step 8mSkill 18-5: Step 8m
Bed making: occupied bed.
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
Slide 59Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Skill 18-5: Step 8oSkill 18-5: Step 8o
Bed making: occupied bed.
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
Slide 60Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Skill 18-5: Step 8qSkill 18-5: Step 8q
Bed making: occupied bed.
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
Slide 61Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Skill 18-5: Step 8rSkill 18-5: Step 8r
Bed making: occupied bed.
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
Slide 62Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Bed Making (continued) It is the nurse’s responsibility to keep the bed as clean
and comfortable as possible. This may require frequent inspections to make sure
the bedding is clean, dry, and wrinkle free. Check the linens for food particles after meals and for
urine incontinence or involuntary stool. Use proper body mechanics; raise bed to a working
level.
Slide 63Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Figure 18-9Figure 18-9
The postoperative bed.
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
Slide 64Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Figure 18-10Figure 18-10
Selected equipment and supplies for elimination.
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Slide 65Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Figure 18-11Figure 18-11
The bedside commode has a toilet seat with a container underneath.
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Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Assisting the Patient with Elimination Bedpan
• A device for receiving feces or urine from either male or female patients confined to the bed
Urinal• A device for collecting urine from male patients; urinals
for females also available Bedpans or urinals are used when a patient is unable
to get up to go to the bathroom for the purpose of urination or defecation.
Slide 67Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Assisting the Patient with Elimination (continued) The nurse should offer the bedpan or urinal
frequently, because patients may accidentally soil bedclothes if their elimination needs are not met.
Report any abnormalities and record in the nurse’s notes.
Flow sheets are usually provided for documentation of normal voidings and stools.
Slide 68Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Skill 18-6: Steps 11b & 11cSkill 18-6: Steps 11b & 11c
Positioning the bedpan.
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St. Louis: Mosby.)
Slide 69Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Care of the Incontinent Patient Incontinence is a very common problem, especially
among older adults. Incontinence occurs because pressure in the bladder
is too great, sphincters are weak, or the innervation has been compromised due to illness or injury.
Incontinence may involve a small leakage of urine when the person laughs, coughs, or lifts something heavy.
Slide 70Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Components of the Patient’s HygieneComponents of the Patient’s Hygiene
• Care of the Incontinent Patient (continued) Care requires the use of disposable adult
undergarments or underpads. Cleansing the skin thoroughly after each episode of
incontinence with warm soapy water and drying it thoroughly help to prevent skin impairment.
When urinary incontinence results from decreased perception of bladder fullness or impaired voluntary motor control, bladder training can be helpful.
Slide 71Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Nursing ProcessNursing Process
• Nursing Diagnoses Oral mucous membranes, impaired Mobility, impaired physical Skin integrity, impaired Self-care deficit—bathing/hygiene, dressing/grooming