1. Mosby items and derived items © 2005 by Mosby, Inc. Chapter 38 Hygiene

2. Mosby items and derived items © 2005 by Mosby, Inc. Skin Function –Protection –Secretion –Excretion –Temperature regulation –Sensation Structure and appearance

3. Mosby items and derived items © 2005 by Mosby, Inc. Feet, Hands, and Nails Function –Mobility –Weight bearing Structure and appearance: nails

4. Mosby items and derived items © 2005 by Mosby, Inc. Oral Cavity Function/appearance –Mucous membranes –Salivary glands –Teeth –Gums

5. Mosby items and derived items © 2005 by Mosby, Inc. Hair Growth Distribution Pattern

6. Mosby items and derived items © 2005 by Mosby, Inc. Eyes, Ears, and Nose Structure and function –Prevention of injury and discomfort during hygienic care

7. Mosby items and derived items © 2005 by Mosby, Inc. Individual Factors Social practices Personal preferences Body image Socioeconomic status Health beliefs and motivation Cultural variables Physical condition

8. Mosby items and derived items © 2005 by Mosby, Inc. Assessment Physical examination –Integument: skin, hair, nails –Oral cavity –Eyes, ears, and nose

9. Mosby items and derived items © 2005 by Mosby, Inc. Common Skin Problems Dryness Acne Rashes Contact dermatitis Abrasions

10. Mosby items and derived items © 2005 by Mosby, Inc. Common Foot and Nail Problems Callus Corns Plantar warts Tinea pedis (Athlete’s foot) Ingrown nails Ram’s horn nails Paronychia Odors

11. Mosby items and derived items © 2005 by Mosby, Inc. Hair and Scalp Problems Dandruff Ticks Lice –Pediculosis capitis –Pediculosis corporis –Pediculosis pubis Alopecia

12. Mosby items and derived items © 2005 by Mosby, Inc. Risk Factors for Skin Impairment Immobilization Reduced sensation Nutrition and hydration alterations Secretions and excretions on the skin Vascular insufficiency External devices

13. Mosby items and derived items © 2005 by Mosby, Inc. Developmental Changes Condition of the integument and hygienic practices –Infant –Toddler –Adolescent –Adult –Older adult

14. Mosby items and derived items © 2005 by Mosby, Inc. Use of Sensory Aids Eyeglasses Contact lenses Artificial eyes Hearing aids

15. Mosby items and derived items © 2005 by Mosby, Inc. Assessment Self-care ability Hygiene practices Cultural factors Clients at risk for problems Special considerations Client expectations

16. Mosby items and derived items © 2005 by Mosby, Inc. Nursing Diagnoses Ineffective health maintenance Impaired mobility Bathing/hygiene self-care deficit Risk for impaired skin integrity

17. Mosby items and derived items © 2005 by Mosby, Inc. Planning Goals and outcomes –Client’s skin is clean, dry, and intact –Client tolerates bathing without excessive fatigue Setting priorities Continuity of care

18. Mosby items and derived items © 2005 by Mosby, Inc. Implementation Teaching hygiene techniques –Relevant to client’s situation –Adapted to client’s bathing facilities –Incorporating injury prevention and infection control measures

19. Mosby items and derived items © 2005 by Mosby, Inc. Bathing and Skin Care Complete bed bath Partial bed bath Tub bath or shower Bag bath

20. Mosby items and derived items © 2005 by Mosby, Inc. Guidelines for Bathing Provide privacy Maintain safety Maintain warmth Promote independence Anticipate needs

21. Mosby items and derived items © 2005 by Mosby, Inc. Additional Hygienic Care Considerations Perineal care –Self-care ability of client –Reduction of embarrassment –Asepsis Back rubs –Benefits –Contraindications

22. Mosby items and derived items © 2005 by Mosby, Inc. Foot and Nail Care Guidelines Careful inspection Lukewarm water temperature No soaking Cutting of nails, if indicated Application of lotions Proper socks, stockings, and shoes

23. Mosby items and derived items © 2005 by Mosby, Inc. Oral Hygiene Brushing and flossing Clients with special needs –Presence of stomatitis –Use of oxygen therapy –Unconscious state Denture care

24. Mosby items and derived items © 2005 by Mosby, Inc. Hair and Scalp Care Brushing and combing Shampooing Shaving Mustache and beard care

25. Mosby items and derived items © 2005 by Mosby, Inc. Eye Care Basic eye care Eyeglasses Contac lenses Artificial eyes

26. Mosby items and derived items © 2005 by Mosby, Inc. Ear Care Cleansing Cerumen removal Hearing aid care

27. Mosby items and derived items © 2005 by Mosby, Inc. Nasal Care Cleansing Special care for clients with nasal oxygen or GI tubes

28. Mosby items and derived items © 2005 by Mosby, Inc. Client’s Room Environment Maintaining comfort – Temperature, ventilation, noise, light Room equipment – Chairs, beds, other equipment – Bed making

29. Mosby items and derived items © 2005 by Mosby, Inc. Evaluation Client care Client expectations