Hygiene

2. Objectives
 Define key terms
 Describe factors that influence hygiene
 Explain importance of foot care in the diabetic client
 Successfully perform hygiene procedures

3. Assessments
 Skin/Hair
 Feet and nails
 Oral cavity
 Eye, Ear and Nose

4. Risk Factors for Skin Impairment
 Immobilization
 Reduced Sensation
 Secretions & excretions
 Vascular insufficiency
 External devices

5. Developmental Changes
 Skin
 Feet & Nails
 The mouth
 Eye, ear, & nose
 Self-care Ability

6. Assessment of Hygienic Practices
 Preferred routine
 Preferred products
 Preferred method
 Dental care

7. CULTURAL FACTORS
 Chinese Americans
 Vietnamese Americans
 “What would make them feel most comfortable during
a bath?”

8. At Risk for Hygiene Problems
 Oral Problems
 Skin Problems
 Foot Problems
 Eye Care Problems

9. Special Considerations
 Footwear
 Eating Patterns
 Sensory Aids

10. Nursing Diagnosis
 Self-care deficit, bathing/hygiene
 Dentition, altered
 Fatigue

11. Planning
 Individual for each client & each nursing diagnosis
 Client’s condition influences care plan
 Plan around client’s schedule, needs
 Include family
 Community resources

12. Interventions/Implementation
 Pre-medicate if needed
 Health promotion
 Acute & restorative care, e.g.:
 Bathing & skin care
 Perineal Care
 Foot & nail care
 Oral hygiene

13. Bathing Times
 Am Care – before breakfast
 Complete AM Care – after breakfast
 Afternoon Care - afternoon
 PM Care – at bedtime, backrub

14. Bathing
 Complete Bed Bath
 Partial Bed Bath
 Bag Baths
 Perineal Care
 Back Rub
 Infant

15. Foot & Nail Care
 Soaking feet
 Teach proper technique, inspection
 High risk clients
 Diabetes
 PVD
 Peripheral neuropathy
 Vascular insufficiency

16. Peripheral neuropathy
 Muscle wasting
 Absent DTR’s
 Foot deformities
 Abnormal gait
 Decreased sensation

17. Vascular insufficiency
 Decreased hair growth
 Absent or decreased pulses
 Infection
 Shiny skin
 Blanching on elevation
 Thickened nails

18. ADA Guidelines for Foot & Nail care
 Inspect & wash daily
(check temp)
 Do not soak
 Podiatrist to TX
corns/calluses
 Unscented powder
 File toenails straight
across, do not cut
 Annual foot exam
 Do not walk barefoot
 Proper fitting shoes
 Break in new shoes
 Exercise regularly
 Avid hot water bottles
 TX minor cuts

19. Oral Hygiene
 Brushing 4 x a day
 Fluoride paste
 Soft brush
 Electrical
 Replace q 3 months
 Replace after a cold
 Soft rubber ball on
handle
 Foam rubber brush
 (Lemon-glycerin swabs
not recommended)
 Rinsing
 Mouthwash
 Don’t share brush
 Don’t drink from bottle
 Disclosure tabs/drops
 Flossing 1 x a day

20. Oral Care for Unconscious Clients
 Mouth care at least q 2 h
 Assess for aspiration
 Suction secretions
 Do not use fingers to hold mouth open

21. Clients with Cancer, NGT, Infection
& Diabetes
 Stomatitis (chemo,radiation,NGT, infection)
 gentle brushing & flossing
 avoid alcohol, mouthwash, stop smoking
 NS rinses 4x a day - q 2h
 Oral analgesic
 Diabetes- frequent periodontal disease
 Dentist q 3-4 months
 good oral hygiene

22. Denture Care
 Remove at night
 Keep covered in water when not worn
 Enclosed labeled cup in bedside stand
 Don’t place in napkin or tissue

23. Hair & Scalp Care
 Brushing & combing
 preferred hair practices
 braiding
 brush in sections
 Lice

24. Shampooing
 Shower/bath
 Shower or tub chair
 Sink/washbasin
 Stretcher to shower or sink
 In bed
 Dry shampoo

25. Grooming
 Shaving
 warm washcloth, shaving cream
 pull skin taught
 use short, firm strokes in direction of hair growth
 electric razors if risk for bleeding
 Mustache & beard

26. Care of Eyes
 Clean wet washcloth - no soap
 Eyeglasses - cool water, soft cloth
 Contact lenses
 rigid (hard)
 soft
 rigid gas permeable (RGP)
 daily wear, extended wear, disposable
 At risk for infection, corneal ulceration

27. Artificial Eye/prosthesis
 Enucleation
 Permanent implant or temporary
 To remove prosthesis:
 retract lower lip & put pressure below eye
 or use small bulb syringe or medicine dropper
 clean with NS, assess socket for infection
 Replace - retract upper & lower lids

28. Care of Ear
 End of wet washcloth
 Gentle downward retraction at entrance to ear canal to
remove visible cerumen
 No sharp objects
 No cotton tipped applicators

29. Hearing Aids
 Three types:
 in the canal (ITC)
 in the ear (ITE)
 behind the ear (BTE)

30. Irrigation of Ear
 To remove impacted cerumen
 Glycerin ( 3 gtts) at bedtime
 H2O2 BID
 250ml. Of warm water into ear canal
 Client sit or lies on side
 Water pik or bulb syringe
 Do not occlude canal

31. Care of Nose
 Teach client to blow nose gently
 Gentle suctioning
 Wet washcloth or cotton tipped applicator
 Only insert cotton tip of applicator
 NGT or endotracheal tubes through nose
 change tape QD
 hold tube & clean & dry nasal surface

32. Maintaining Comfort
 Temperature
 Good ventilation
 Noise level
 Proper lighting
 Room equipment
 Beds/bed making/linens

33. Evaluation
 Reassess condition of client’s skin
 Determine if comfort improves
 Ask client to demonstrate self-care skills
 Ask client if expectations are being met

34. Contact Us:-
011-25464531, 011-41425180, 011-66217387
+91-9818308353,+91-9818569476
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