Personal Hygiene

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Chapter 16

• Personal Hygiene

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Chapter 16Personal Hygiene

• Personal hygiene promotes comfort, safety, and
  health. Hygiene and grooming are basic
  activities of daily living (ADL). The skin is
  the bodys first line of defense against disease.
  Intact skin prevents microbes from entering the
  body and causing an infection.
• Integumentary System Is the largest organ system
  of the body
• Skin
• Hair
• Nails

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Skin What does the skin do for our bodies?
Box 16-1 pg 313 -skin is the first line of
defense against injury and infection -absorbs
medication -regulates internal
temperature -acts as a sensor to heat, cold, and
pain -helps make vitamin D and store minerals
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1. General guidelines of hygiene and
(ADLS) -special requirements for older
residents (equipment, assistive devices) -use
proper body mechanics -allow resident to do as
much as possible for self -ensure safety and
privacy at all times -explain procedure -use
residents product as requested -follow
standard/universal of precautions -follow a plan
of care for the person
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2. Safety Guidelines place rubber or
non-skid mat in tub before resident enters Keep
bathroom floor dry to prevent falls Do not add
oil to bath water Be sure bath water is at a
temperature comfortable for resident
(95'-105') Remain with resident at all
times Bath or shower chair should be
locked Have resident use grab bars and
rails Assist resident in all transfers Residen
t with special treatments, be careful and do
not -do not put stress on tubes -do not
lower IV bottle below infusion site -do not
raise drainage tube above site
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3. Daily care Personal hygiene and grooming
routines and personal habits
?Let the person do as much on their own as
possible! Only Assist as needed Page 314
AM care providing personal care for resident
when they awaken before breakfast. 1. Assist
resident to the bathroom or offer the bedpan or
urinal 2. Help resident wash face and hands 3.
Assist resident with oral care 4. Assist
resident to dress and groom for breakfast 5.
Protect residents privacy
Morning care care given after
breakfast -Always assist resident to the
bathroom or offer the bedpan or urinal
-bathing, back massage, grooming, ROM,
exercise, ambulating
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Afternoon care care done after lunch and the
evening meal
HS or PM care given just before bedtime. Care
needs to be relaxing and comfortable 1.
Assist resident to the bathroom or offer the
bedpan or urinal 2. Help resident wash face
and hands 3. Assist resident with oral
care 4. Clean incontinent resident and change
any soiled linens 5. Provide peri
care 6. Assist resident to undress and put on
gown or pajamas 7. Offer back massage 8. Straigh
ten bed linens for residents comfort
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?keeps the mouth and teeth clean, ?? comfort,
?food tastes better, ?prevent mouth odor and
infection.
4. Oral Care
A. General guideline 2 x day 1. wear
gloves 2. position resident for safety - sitting
up 3. encourage resident to help when
possible 4. avoid placing fingers into
residents mouth 5. avoid vigorous cleaning
causes bleeding 6. use products requested by
resident
B. Observe and report to the nurse 1.
Mouth discoloration, irritation, redness,
bleeding, paleness, sores, lesions or
crack of mouth, gum or lips and swelling 2. Bad
breath that does not improve after mouth care 3.
Complaints of pain or discomfort of mouth
related to dentures a. damaged,
broken, ill-fitting or lost dentures 4.
Changes in residents ability to participate in
oral care
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5. Types of Oral Care
A. Conscious oral care (Real teeth) Page 318
1. Brush 2 x day, floss once, rinse with 1
part mouthwash to 4 part water. 2. Sit
resident up (fowler position) 3. Spread towel
across chest 4. Clean all surfaces in an up and
down/circular motion paying special attention
to gum line 5. Allow resident to expectorate
into a appropriate container 6. Assist resident
to rinse mouth, wiping lips and mouth 7. Offer
flossing and mouth wash if resident desires 8.
Moisturize lips (residents using oxygen NO
petroleum based products) 9. Report
abnormalities such as bleeding gums, sores
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B. Unconscious oral care/aspiration precautions
Page 320

• 1. Every 2 hours or as needed
• 2. Place towel under head and chin
• 3. Lateral side lying with head turned or
• supine position with head turned
• to prevent aspiration or choking
• or as residents medical condition
• indicates
• Insert swab/sponge tip - Do Not use
• toothbrush and toothpaste
• 5. Rotate against all tooth surfaces, mucous
  membranes and tongue
• 6. Clean and lubricate lips (on oxygen use KY
  Jelly)
• 7. Precaution use very small amounts of fluid
  to prevent aspiration

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• Dentures made from plastic/porcelain Page
  324
• 1. Line sink with towel or washcloth or fill
  with water
• 2. Brush dentures under running water with
  toothbrush and toothpaste
• 3. Water should be neither hot nor cold
  (warm water)
• 4. Place dentures in denture cup with water,
  adding cleaning tablet (if available)
• 5. Cover with lid and allow to soak
• 6. Perform mouth care while dentures are out
  of mouth
• 7. Remove at bedtime and place in soaking
  solution
• 8. If dentures are left in overnight, they
  must be removed for 10 to 20 minutes during the
  day.
• 9. Denture dont need to be flossed

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6. Lip care 1. Water base lubricate (KY
Jelly) use on patients with oxygen or everyone
2. Petroleum base (Vaseline, chap sticks,
carmex) do not use on patients with oxygen
7. Skin Care A. Principles of skin
care 1. Skin is fragile and easily
injured 2. Special care of bony prominence
(pressure points) 3. Soap must be completely
rinsed from skin and pat dry
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7. Skin Care
B. Skin care products pg 326 Box 16-1
AVOID use of SCENTED products
Soaps mild soap to prevent drying and
irritation of skin Creams/Lotions protect the
skin and help with dry skin Powders absorb
moisture and prevent friction -dont shake or
sprinkle powder onto the person -sprinkle a
small amount on hand or cloth -apply a thin
layer ?do not use powders near people with
respiratory problems. Inhaling powder irritates
the airway and lungs. ?Avoid using around tubes
oxygen, foley catheter, G- tube, suprapubic
catheter Deodorants can help to reduce body
odors Barrier cream may be used for prevention
of friction and pressure sores
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• Observe skin and REPORT problems to NURSE
• 1. Redness or irritation on skin
• 2. Breaks or cracks in skin especially between
  toes
• 3. Pale, bluish or gray discoloration of skin
• 4. Corns, calluses, ingrown nails, or other
  complaints of hands or FEET
• 5. Bleeding
• 6. Pain

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D. Back Rub/ Massage a. Stimulates
residents circulation. b. Prevents skin
breakdown c. Soothe, refreshing and promotes
relaxation d. May include areas other than the
back hands, scalp, feet e. Usually provided
after a bath, at bedtime, or to promote
relaxation F. Procedure 3-5 min or as
ordered 1. warm lotion in hands 2.
apply with gentle pressure, using both hands and
always keep your hands in contact with
the skin. 3. start at the buttocks up to
back of neck without pulling skin 4.
use long firm stroke 5. use shorter circular
strokes across the shoulders using both
hands 6. inspect for reddened area or any
skin condition ?Never massage a persons with
heart disease, back injuries, back surgery,
skin disease, and lung disorders
Never massage a red area
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8. Bathing (assisted and total care) Page
329 A. Bathing 1. Cleanses the skin allows
for observation 2. Provides activity
(ROM) 3. Increases circulation 4. Relaxes the
resident B. Guidelines for bathing
Bathing 2-3 x week Water temperature
95'-105' F 1. provide privacy only expose
area being washed 2. keep person warm at all
times 3. check water temperature ? with
bath thermometer ? with your wrist
?have patient feel the water 4. turn on cold
water first? then hot water 5. no longer than 20
minutes 6. lock wheels on shower chair 7. Good
time to observe the skin for problems 8. Remain
with resident at all times
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9. Types of baths Water temp 95'-105' F A.
Tub bath no longer than 20 minutes -fill tub
before person gets in drain the tub before
getting out -remain with the resident for the
entire bath -clean disinfect tub after each
use C. Whirl pool same as tub bath D.
Shower 1. Ensure residents modesty
(Closing door pulling shower curtain) 2.
Use a shower chair, and go as fast as you can to
prevent the resident from getting
cold. 3. The residents hair may be
shampooed during the showering process E.
Complete Bed bath Page 330-331 Unable to
bath by self or on complete bed rest
Privacy only exposing area being washed
Keep warm Wash front to back cleanest to
dirtiest Rinse and dry well Observe skin
for possible problems F. Partial bath water
temp. 95' -105'F ?face, ?hands, ?axillary, ?back
?perineal area and buttocks. Body parts
needs to be done every day. To take care of most
of their own bathing needs or have odor
problem
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10. Peri-care Provided any time the perineum
needs to be cleansed, especially after a BM,
urination, shower/bath, at bedtime, or when
moisture or secretions are present. Page
344-345 1. Done as part of bath, every time
they have a BM or urinate, or as needed. 2.
Resident should do their own perineal care, if
able 3. Follow standard precautions and the
rules of medical asepsis A. Circumcised
male per-care 1. Wash in a circular motion
from the tip of the penis to the base of the
penis 2. Clean scrotum and then the rectal
area from front to back 3. Rinse and gently
dry each area B. Uncircumcised male
per-care 1. Retract foreskin and wash as
above 2. Return foreskin to original
position C. Female 1. Open the labia
minora and wash the meatus and then sides 2.
Wash the labia majora and then the rectal area
from (FRONT TO BACK and clean to dirty)
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Complete Bed bath Page 330-331 Unable to
bath by self or on complete bed rest
1. Wash cloth or mitt
Chest and abdominal area
Arms and Hands
Eyes, face, ears and neck
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Back
Legs and Feet
Peri-Care Female
Peri-Care Male
Partial Bath
Body parts washed daily
Face
Hands
Buttocks
Back
Axillary
Perineal area