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Hygiene & Personal Care, Link Title - Coggle Diagram
Hygiene & Personal Care
Briefly describe the Ethical, Legal, and Professional Principles associated with providing hygienic care.
Identify some health assessment questions you can ask while performing daily hygiene.
Do you have anyone at home who helps you with your ADL
Do you have any concerns about your health/diagnosis/condition
How confident do you feel with your home hygiene routine
What does your home hygiene routine look like
Do you have the right equipment at home to help you with your ADLs
Describe alterations and functions that may affect hygienic care
Overly dry skin, excoriation, pressure ulcers, open wounds, and incision
Any interruption in the skin: Areas of the body that have been affected by skin to skin chafing, contact and moisture such as abdominal creases/folds, groin, under arms and under the breasts. These areas are prone to degeneration of skin tissue and can be havens for bacterial growth and infection.
Knowledge of an individual's medical diagnosis and ensuring safety to both the staff and patient.
Pediculosis: lice
Gingivitis
Halitosis
Age: Infants/young children dependent on hygienic needs, as well as elderly.
Patient disabilities that affect the patients such as range of motion difficulties, or individuals with partial or full paralysis which require more than one individual to perform personal care.
The level of cognitive functioning the patient is displaying
Cultural and spiritual beliefs
For patients who are unable to care for their own hygienic needs, a nurse’s ethical response is to provide care to that patient with competence and compassion. The ANA code of ethics for nurses stated that the principle underlying nursing practice is the respect for dignity, worth, and human rights of a person. This respect of a patient’s dignity becomes apparent when the nurse cares for a patient’s basic hygienic needs
Identify what areas of the body are assessed during a bed bath:
During a bed bath the nurse has a great opportunity to assess the patient's cognitive functioning, range of motion, the condition of the patient's skin, as well as how well they practice their own hygienic practices. The patient’s hygiene and how they practice their hygiene directly correlates to the upkeep of the integumentary system. The nurses can gather objective data regarding the effects of the patient's hygiene practices
Denture care:
Gather equipment, perform hand hygiene, don gloves, introduce yourself, ensure patient privacy, confirm patient identity, and raise bed to comfortable working height.
Place towel over patients chest, remove upper and lower dentures with gauze pad, and place dentures in denture cup.
Take dentures over to the sink, place a towel in the sink, and clean all surfaces of the dentures with tepid water, stiff bristle toothbrush, and toothpaste. Inspect dentures for any rough, worn, or sharp edges. Place them back into the dentures cup with water, place adhesive if the patient prefers, and place them back into the patient's mouth.
Remove and dispose of your gloves and perform hand hygiene. Don gloves.
Remove towel, clean the equipment and store the supplies in a safe place. Remove and dispose gloves, perform hand hygiene, and document care and assessment.
Oral care on an unconscious patient:
Gather equipment, perform hand hygiene, don gloves, introduce yourself, ensure patient privacy, confirm patient identity, and raise bed to comfortable working height.
Inspect mouth for abnormalities with tongue depressor and light.
Moisten soft bristle toothbrush, apply toothpaste, open mouth with depressor and plush inner and outer surfaces of teeth, and then gently brush sides and surface of tongue.
Rinse the mouth with a 10 ml syringe filled with water. Allow the water to drain into the emesis basin and use suction as needed.
Clean mouth: cheeks, gums, and roof of mouth with a foam swab.
Remove the emesis basin, towel, and waterproof pad from under patients cheek and chin. Use the towel to wipe patient’s mouth.
Remove and dispose of your gloves and perform hand hygiene. Don gloves.
Apply lip moisturizer with cotton swab. Reposition the patient.
Remove and dispose of your gloves and perform hand hygiene. Don gloves.
Lower the bed and raise the head no more than 30 degrees.
Clean the emesis basin, rinse the toothbrush, and store the supplies in a safe place. Remove and dispose gloves, perform hand hygiene, and document care and assessment.
Place the patient in a side -lying position with the head of the bed lowered. Place pillows behind the patient to help them stay in the side lying position. Make sure suction equipment is set up and working properly. Place a waterproof pad, towel, and emetics basin under the patient's cheek and chin.
Assistive medical device that can be used to help bathe patients in a shower.
shower commode:
oral care products: toothbrush, toothpaste, emetics basin, oral swabs, mouthwash, water, cup, suction, tongue depressor, flashlight, chapstick, towels, and gloves.
PICTURE
PICTURE
Identity factors influencing personal hygiene practices:
Explain how personal hygiene relates to health and well being:
3 NCLEX style questions:
2) What position should an unconscious patient be while receiving mouth care?
Side-lying position
3) As the nurse, you have just received two new admissions. Your first patient is bedridden, confused, and incontinent. Your other new admission is comfortable, alert, and awaiting your arrival to introduce yourself. Who should the nurse see first?
The incontinent patient.
1) A patient who is bedridden and cannot move with assistance was just admitted into your care. The patient has not been turned in the past 2 hours. As the nurse, what would be your main concern?
Repositioning the patient and assessing for skin breakdown
Discuss delegation of hygiene activities
Collaboration with colleagues is necessary when a patient needs or is more comfortable with a caregiver of the same sex for personal care. This could be for religious, cultural, or personal reasons
The patient should always be an active participant in their hygiene care to the best of their abilities
Some aspects of hygiene care can be delegated to a UAP after the assessment of the patient. Specific instructions should be given.
It is sometimes necessary to collaborate with a physical therapist for the assessment of a patient’s physical abilities to perform ADLs
Personal hygiene helps to keep us clean as well as lowering our risk for infections. “The presence of skin, scalp, or oral infections may indicate poor hygiene” (Yoost, 2020, p. 503). Personal hygiene can help to make someone feel more comfortable and better about themselves and their appearance.
Some factors influencing personal hygiene may include “personal habits, cultural beliefs, ethnic customs, and age.” (Yoost, 2020, p. 500).
A patient recently paralized (quadriplegic) from a motor vehicle collision states, “Why do I need a bed bath every day while I am in the hospital?” Provide a therapeutic response to this question:
“I know it can feel excessive, but having regular personal hygiene care is important. It can boost your self esteem, plus it is good for your circulation.
Discuss safety measures when providing personal hygiene care:
-Always make sure bed is at a comfortable working height to prevent back injury
-Ensure side rail is up opposite to side you are working if you are alone
-Ensure wheels are locked
-Ensure oxygen and suction are working properly in case needed
-Never trim a patient's nails or toenails
-Never soak the feet of a diabetic patient
-Use an electric razor if available, if not a single blade razor
-Wipe from the inner canthus to the outer and always use a clean section of the cloth for each eye
-Never insert cotton swabs into a patient’s ear
-Use proper PPE
-For oral care have the patient sit up if they are able to do so, for unconscious patients prop them on their side
How does the RN assess 'Self-Care Abilities' or ADLs?
The RN can assess ADLs by using the Katz scale of Index of Independence which keeps score of basic everyday living activities or observing patient to see what they can do
Describe cultural considerations of importance when conducting personal hygiene on a patient:
Bathing differences
How often they cleanse
What to use while assisting
Male vs female
Some religion requires same sex
Personal preference
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