Bathing

1
Bathing

• Provides opportunity to teach, give emotional
  support and provided opportunity for social
  interaction
  
• Cleanses the skin of microbes
• Prevents body odor (perspiration interact with
  bacteria)
  
• Removes dead skin (can lead to infection) and
  excessive oils
  
• Relaxes and refreshes the client
• Improves circulation
• Provides opportunity to teach, give emotional
  support provides opportunity for social
  interaction
  

2

• Provides for active passive exercises of
  extremities
  
• Creates a rapport with clients
• Helps with your assessment
• Cultural Considerations
• Middle Eastern, Eastern Asian avoid exposure of
  arms and lower torso
  
• Hindu, Orthodox Jewish, Muslim and Amish prefer
  gender-congruent care prefer care from family
  member
  
• Hindus Muslims left hand used for cleansing and
  right hand reserved for praying and eating
  

3

• Hindus irreverent to use negative nonverbal
  communication when washing feet
  
• Categories of baths
• Therapeutic
• Cleansing
• Principles of Bed Baths
• Infection control
• Personal choice
• Privacy and confidentially
• Comfort and safety
• Body mechanics

4

• Therapeutic Baths
• Sitz bath-used for clients who has had rectal ,
  perineal surgery, childbirth or irritation from
  hemorrhoids or fissures
  
• Medicated baths ( oatmeal, cornstarch, Aveeno,
  Burows solution, sodium bicarbonate) relieves
  skin irritation and creates an antibacterial
  drying effect
• Cooling bath- tub with tepid water to reduce
  temperature
  
• .

5

• Cleansing Baths Make sure to check temperature
  of water
  
• Complete bed bath- client totally dependent of
  staff
  
• Partial bath- face, axillae, hands, back and
  perineal area bathed by staff, the rest completed
  by client
  
• Shower- preferred if client is ambulatory
• Tub bath- ambulatory client or if needed
  assistance use Hoyer lift
  
• Sponge-done with bath basin or at sink, with
  assistance with hard to reach areas
  

6

• Bag Bath- pre-moistened cloths in a no-rinse
  cleanser emollient ( has number of wash cloths
  that are pre-moistened, placed in microwave and
  heated. With the cloths, client washes, rinses
  and dries with these wash cloths)
• Students bring from home
• 2 WASH CLOTHS, 2 LARGE TOWELS, HAND SOAP, TOOTH
  BRUSH, TOOTH PASTE, DENTAL FLOSS, 1 PILLOW CASE,
  2 TWIN SHEETS, 1 HAND SMALL BOTTLE OF HAND LOTION

7

• Equipment for lab class
• 2-3 Wash cloths, 2 towels, soap
• Tooth brush, tooth paste, mouthwash and dental
  floss
  
• Basin and emesis basin
• Toilet tissue
• Bedpan or urinal
• Clean gloves
• 2 sheets, 1 pillow case, draw sheet,
• I bedspread
• ( items listed above will be supplied from
  school)
  

8

• Procedure
• Explain procedure
• Ask if patient is allergic to any soaps or
  detergents
  
• Provide privacy
• Offer urinal or bed pan before bath
• Adjust height of bed for good body mechanics and
  safety of client
  
• Arrange equipment needed on overbed table
• Remove bedspread by folding (do not shake linen)
• Place bath blanket on top of sheet (make sure
  client is covered and not exposed) and have pt.
  hold top edge
  

9

• Remove top sheet out from under bath blanket
• Wash hands
• Fill basin ½ filled with warm water( not hot or
  cold) (WATER TEMPERATURE 110-115)
  
• Wear gloves if coming in contact with blood or
  body fluids
  
• Start with side closest to you
• Place towel across clients chest
• Fold wash cloth so no ends hang loose
• With plain water rinse face starting from inner
  canthus outward ( eyes from nose outwards)
  

10

• First one eye then the other eye
• With soap and water if agreeable with client wash
  face, ears, neck, then with 2nd wash cloth rinse
  and dry same area
  
• Remove gown from under bath blanket
• Place towel under arm closest to you, start
  washing hands to arm pit. Rinse with 2nd wash
  cloth and dry same
  
• Place arm under blanket
• Remove blanket to waist, wash, rinse and dry
  area
  

11

• Place towel on chest and move bath blanket down
  to pubic area
  
• Wash, rinse and dry this area
• Ask client to bend knees, place towel under leg
  closest to you
  
• Wash leg in long strokes watching not to knead
  clients calf
  
• Rinse with 2nd wash cloth and dry
• Place foot in basin, soak foot and wash
  thoroughly between toes and between toes
  
• Rinse with 2nd wash cloth and dry thoroughly

12

• Change water
• Proceed to other side of client, washing the same
  way from arms, legs and toes
  
• DO NOT CUT TOES NAILS ON ANY CLIENTS, ONLY
• PODIATRIST CAN CUT TOE NAILS OF CLIENTS
• DO NOT SOAK FEET OF CLIENTS WHO HAVE DIABETES OR
  PERIPHERAL VASCULAR DISEASE
  

13

• Bathing Male clients
• Change water
• Put on clean gloves
• If uncircumcised, gently retract foreskin
• Holding penis, clean the tip in circular motion
  starting at the urethral meatus and working
  outward. Wash, rinse and dry
  
• Gently replace foreskin
• Wash shaft of penis, rinse and dry
• If possible have patient or nurse lift scrotum
  wash, rinse and dry ( check for redness or
  irritation)
  

14

• Put up side rails and change bath water
• Ask client to lie on his side or prone position
  away from you
  
• Place towel lengthwise on bed
• Wash back from neck to buttocks, rinse with 2nd
  wash cloth and pat dry.
  
• Wash, rinse and pat dry buttock and anus area
• Remove gloves and empty basin
• Place lotion in hand and rub hands together to
  warm
  
• Message back from sacral area upward to neck
  using circular motion, to maintain integrity of
  skin
  

15

• Stroke from buttocks to shoulder, upper arms and
  over scapular using circulator motion doing it
  for 3-4 minutes
  
• When finished put a clean gown on client
• Put on top sheet and remove bath blanket
• Bathing Female
• Cover client with bath blanket
• Have client bend knees and spread legs if able
• With non-dominant hand expose labia, urethra and
  vagina.
  
• Wash downward from vaginal area toward anus,
  rinse with 2nd wash cloth and pat dry
  

16

• Check for redness, pain, swelling, discharge,
  irritation and skin breakdown
  
• With client on side wash, and rinse with second
  wash cloth, and pat dry going away from urethra
  to anus
  
• Personal hygiene includes
• Oral hygiene
• Hair care
• Foot care
• Perineal and genital care
• Eye care

17

• When you have completed the bath and made the
  clients bed, MAKE SURE THE BED IS IN LOW
  POSITION AND THE ONE SIDE RAIL IS UP (in the
  acute care setting, however always check the
  policy of your institution)