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MNA Mosby’s Long Term Care Assistant Chapter 20 Hygiene
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Hygiene Promotes comfort, safety and health
Prevents body and breath odors Relaxing and increases circulation
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Daily Care Most people have hygiene routines or habits
Routine care is given during day and evening Assist whenever needed.
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Before Breakfast Am care Assist with: elimination
face and hand washing Oral hygiene Dressing and hair care Changing incontinent residents Positioning for meals Straightening unit and making bed
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After Breakfast Morning Care Assist with: elimination Bath
Oral hygiene Dressing Hair care Shaving ROM
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Afternoon Care After lunch and the evening meal Assist with:
elimination Oral hygiene Activities Changing incontinent residents Changing wet or soiled linen
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Evening Care HS Care Assist with: elimination Oral hygiene
Changing into sleepwear Changing incontinent residents Changing wet or soiled linen
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Follow Standard Precautions and Bloodborne Pathogen Standards:
Oral Hygiene Keeps mouth and teeth clean Prevent mouth odors and infections Increases comfort Increases appetite Reduces risk of cavities and gum disease Residents with dry mouth (those using O2) will need frequent oral care. Follow Standard Precautions and Bloodborne Pathogen Standards: Wear GLOVES
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Oral Hygiene Flossing: Removes plaque and tarter Done after brushing
If done only once a day – do at bedtime Equipment: Toothbrush Toothpaste Mouthwash Emesis Basin Denture Cup Toothette Water Gloves
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Oral Hygiene for the Unconscious Resident
Use Toothette Lateral position to prevent aspiration Use padded tongue blade to keep mouth open Q2H
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Denture Care Cleaned as often as natural teeth Slippery
Easily broken when dropped Line sink or basin with paper towel Hot water causes warping Store in cool water if not worn Use gauze to grasp teeth if assistance is needed with removing Mouthwash for rinsing
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Due to dry skin: Older persons usually need a complete bath 2x week.
Bathing Due to dry skin: Older persons usually need a complete bath 2x week. Cleans the skin Refreshing and relaxing Stimulates circulation Opportunity to make observations
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Bathing Total care provided by CNA
Complete Bath Partial Bath (bath with assistance) Partial Bath Shower Tub Resident can assist. Will usually need assist with back and feet. Essentials: Face, hands, armpits, peri-care Provided by CNA Provided by CNA
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Rules for Bathing Follow Care plan Allow personal choice when possible
Practice Standard Precautions Provide privacy Cover for warmth and privacy Protect from falling
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Rules for Bathing Use good body mechanics Check water temperature
Wash from clean to dirty Encourage resident to help Rinse thoroughly Dry between skin folds Observe
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Observations to make Skin color Rashes Bruises Open skin areas
Pale or red skin Drainage or bleeding Swelling C/o pain
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Complete bed bath Use Bath blanket Make a bath mitt
Eyes Face Far arm, Near arm Chest Abdomen Change water Far leg, near leg Feet Back Peri-care Use Bath blanket Make a bath mitt Use lotion and deodorant ROM Soak hands and feet prn Report and record
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Partial bed bath Use Bath blanket Make a bath mitt
Resident is too ill to have complete bath Resident had complete bath day before Resident is having procedure or tests done soon Face Hands Arm pits Peri-care Use Bath blanket Make a bath mitt Use lotion and deodorant Report and record
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Partial Bath (Bath with Assistance)
Resident is capable of completing much of own bath Set resident up with all equipment needed. Assist with areas resident could not get to, usually: back and feet. May be done on SOB or in BR Make a bath mitt Use lotion and deodorant Report and record
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Shower TUB Prevent slipping, falls, chills and burns
A chair is usually used Protect privacy Water temp 105 F Prevent slipping, falls, chills and burns Last no longer then 20 minutes Clean before and after use Bath mat Fill tub before getting in Protect privacy Water temp 105 F
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Back Massage Do not massage reddened areas:
can lead to further tissue damage Relaxes muscles Stimulates circulation After bath and with HS care Last 3-5 minutes Use lotion to reduce friction Side lying Firm strokes Upward
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Perineal Care Peri-care Cleaning the genital and anal area QD and prn
Use common terms Standard Precautions: GLOVES
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Perineal Care Male: Retract foreskin if uncircumcised
Clean the tip using a circular motion Repeat as needed working down the shaft Rinse, Dry, replace foreskin if needed Clean around and under the scrotum Rinse, dry Clean rectal area Rinse, Dry
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Perineal Care Female: Separate the labia
Clean front to back using a different part of the wash cloth with each stroke Repeat until clean Rinse, Dry Clean rectal area from vagina to anus
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Reporting and Recording
Report bleeding stat Report Care given Record on ADL Flowsheets ADL Flow Sheet Oral care Skin care Hygiene Peri-care Back Massage ROM
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Review Hs care is given ? At bedtime
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Review Hygiene measures decrease circulation. True False
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Review Cleansing the genital and anal area is called Peri-care
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Review When is the best time to floss? At bedtime
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Review The unconscious resident needs oral care _______________. Q2H
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Review How will you know what the residents hygiene needs are? Care plan
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Review What can be used to provide oral care to the unconscious resident? Toothette
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Review The unconscious resident is at risk for _____________ during oral care. aspiration
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Review Older persons need a complete bath at least 2x week. True or False
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Review Residents who take tub baths and showers are at risk for Burns and falls
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Review When providing male peri-care which part is cleaned first? Tip of the penis
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Review Residents who take tub baths and showers are at risk for Burns and falls
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Review When transporting the resident from room to shower be sure to Keep the resident covered
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Review If you notice that a resident is incontinent when you begin his bath you should A. Start the bath as usual, with the eyes Provide peri-care first, change water and begin the bath Pad the area with dry towels, begin the bath as usual Doesn’t matter, begin as you choose.
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Review When providing peri-care
A. Use upward strokes, rectal area to urethra Use bath oil to ensure adequate cleaning Wash the rectal area first Use a clean part of the wash cloth for each stroke.
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Review The far arm is washed before the near arm . True or False
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Review Before meals AC S C C/O HS OOB TID BID without with
Complains of bedtime Out of bed 3X day 2X day
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Questions??
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