HygieneHygiene

Hygiene Schedule In Acute Care

Hygiene Schedule In Acute Care

Early Morning or A.M. Care

Morning or After Breakfast Care

Afternoon Care

HS Care

Early Morning or A.M. Care

Morning or After Breakfast Care

Afternoon Care

HS Care

Skin CareSkin Care

Assessment- Inspection/ Palpation Determine need for hygiene Observe color (Table 32-9,pg 689),

texture, thickness, turgor, temperature, hydration

Skin Lesions (Box 32-8, pg.692) Recognize common skin problems

(Table 38-2, pg.1009)

Assessment- Inspection/ Palpation Determine need for hygiene Observe color (Table 32-9,pg 689),

texture, thickness, turgor, temperature, hydration

Skin Lesions (Box 32-8, pg.692) Recognize common skin problems

(Table 38-2, pg.1009)

Skin CareSkin Care

Nursing Diagnoses Impaired Skin IntegrityAltered Peripheral Tissue PerfusionBathing/Hygiene Self-Care Deficit

Planning Goals- Cleanliness, stimulation of

circulation, range of motion, improved self-esteem, and reduction of body odors

Nursing Diagnoses Impaired Skin IntegrityAltered Peripheral Tissue PerfusionBathing/Hygiene Self-Care Deficit

Planning Goals- Cleanliness, stimulation of

circulation, range of motion, improved self-esteem, and reduction of body odors

Skin CareSkin Care

Implementation Bathing

Perineal Care

Back Rubs

Implementation Bathing

Perineal Care

Back Rubs

Perineal CarePerineal Care

Assessment- Listen for problems, smell, know at risk clients

Indications for Care- Urinary or fecal incontinence, excessive secretions, skin irritation, clients at risk because of indwelling catheters, perineal surgery, or childbirth

Goal of Care- Comfort, promote healing, prevent or eliminate odor or infection

Assessment- Listen for problems, smell, know at risk clients

Indications for Care- Urinary or fecal incontinence, excessive secretions, skin irritation, clients at risk because of indwelling catheters, perineal surgery, or childbirth

Goal of Care- Comfort, promote healing, prevent or eliminate odor or infection

Back RubBack Rub

Goal- Promote relaxation and stimulate circulation

Cautions Contraindications Never massage arms and legs

Goal- Promote relaxation and stimulate circulation

Cautions Contraindications Never massage arms and legs

Nail and Foot CareNail and Foot Care

Assessment Circulation Abnormalities or problems (Table 38-3,pg

1011)

Gait Pulses Nails Special considerations- diabetic clients

Assessment Circulation Abnormalities or problems (Table 38-3,pg

1011)

Gait Pulses Nails Special considerations- diabetic clients

Nail and Foot CareNail and Foot Care

Nursing Diagnoses Pain Impaired Skin Integrity Self-Care Deficit

Plan and Implementation Foot and nail care given during bath

Nursing Diagnoses Pain Impaired Skin Integrity Self-Care Deficit

Plan and Implementation Foot and nail care given during bath

Diabetic Client Foot CareDiabetic Client Foot Care

Need meticulous care daily Do not cut corns or calluses or use

commercial removers Always dry well between toes, use

powder when necessary Avoid doing or wearing anything that

impairs circulation Wear clean socks daily Well fitting shoes, no bare feet

Need meticulous care daily Do not cut corns or calluses or use

commercial removers Always dry well between toes, use

powder when necessary Avoid doing or wearing anything that

impairs circulation Wear clean socks daily Well fitting shoes, no bare feet

Hair CareHair Care

Assessment Examine condition of hair and scalp Determine ability to do self care Problems/ abnormalities (Table 38-4,

pg.1012) Dandruff Ticks Pediculosis Capitis Pediculosis Corporis Pediculosis Pubis Alopecia

Assessment Examine condition of hair and scalp Determine ability to do self care Problems/ abnormalities (Table 38-4,

pg.1012) Dandruff Ticks Pediculosis Capitis Pediculosis Corporis Pediculosis Pubis Alopecia

Hair CareHair Care

Diagnosis Dressing/ Self-Care Deficits Impaired Skin Integrity Pain Body Image Disturbance

Planning and Implementation Brushing and combing Shampooing Shaving Mustache and beard care

Diagnosis Dressing/ Self-Care Deficits Impaired Skin Integrity Pain Body Image Disturbance

Planning and Implementation Brushing and combing Shampooing Shaving Mustache and beard care

Eye CareEye Care

Assessment Scaliness underlying eyebrow Eyelids- edema, lesions, secretions Eyelashes- styes, irritating lashes

(entropian,ectropian)

Lacrimal Sac- Sclera or conjunctiva Pupil- Size, shape, light response Eye movement Contacts, eyeglasses, or artificial eye

Assessment Scaliness underlying eyebrow Eyelids- edema, lesions, secretions Eyelashes- styes, irritating lashes

(entropian,ectropian)

Lacrimal Sac- Sclera or conjunctiva Pupil- Size, shape, light response Eye movement Contacts, eyeglasses, or artificial eye

Eye CareEye Care

Implementation Basic care Unconscious client Eyeglasses Contact lenses Artificial eyes

Implementation Basic care Unconscious client Eyeglasses Contact lenses Artificial eyes

Ear CareEar Care

Assessment Exam external ear

Implementation Clean during bath Cautions Assess gross hearing

Assessment Exam external ear

Implementation Clean during bath Cautions Assess gross hearing

Nose CareNose Care

Assessment Exam nasal mucosa Position of nasal septum Difficulty breathing from nose

Implementation Nasal secretions Suctioning

Assessment Exam nasal mucosa Position of nasal septum Difficulty breathing from nose

Implementation Nasal secretions Suctioning

Client’s roomClient’s room

Maintain comfortable room environment Temperature, ventilation, noises, lighting, controlling stimuli

Room equipment Overbed table, night stand, chairs, bed, lights, special equip.

Common bed positions Know common bed positions (Table 38-6, page 1054)

Room accessories Water pitcher, glass, tissue, lotion, toothpaste, wash basin, etc

Bed-making Basic principles of asepsis- Keep linen away from uniform, never fan

linen, place nothing on the floor, if clean linen touches floor get new linen

Use good body mechanics Be able to make occupied and unoccupied beds (open/closed)

Maintain comfortable room environment Temperature, ventilation, noises, lighting, controlling stimuli

Room equipment Overbed table, night stand, chairs, bed, lights, special equip.

Common bed positions Know common bed positions (Table 38-6, page 1054)

Room accessories Water pitcher, glass, tissue, lotion, toothpaste, wash basin, etc

Bed-making Basic principles of asepsis- Keep linen away from uniform, never fan

linen, place nothing on the floor, if clean linen touches floor get new linen

Use good body mechanics Be able to make occupied and unoccupied beds (open/closed)

SummarySummary

Evaluation of client’s hygiene is based on the client’s expression of a sense of comfort, relaxation, well-being, and an understanding of personal hygiene techniques

Evaluation of client’s hygiene is based on the client’s expression of a sense of comfort, relaxation, well-being, and an understanding of personal hygiene techniques