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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