Personal Hygiene

Tina Handayani Nasution/FN III

*What is it???Hygiene : Health

Personal hygiene : the self care measures people use to maintain their health

Is it important for nurse???Why???Lets discuss!!!*

*PURPOSE OF NURSE PROVIDED HYGIENERemove microorganismsDo physical assessmentIncrease circulationDistal to proximalReturn to heartImprove self imageProvide comfort

Factor Affecting Personal Hygiene ???

Tina Handayani Nasution/FN III

*SOCIOCULTURAL FACTORSBathe daily; not all cultures doEconomicsSome cultures wear items not to be removed in bathexamples: wigs, head dressings, medals or shawlsMale nurse only or female nurse only may be necessary in some cultures

*SOCIOCULTURAL FACTORSMale relative may not allow male nurse alone with woman patientAutonomy of patient is paramount; in others, family makes decisions for careLevel of educationNurse accepts all who lovingly participate

*KNOWLEDGE May need teaching regarding:Front to back perineal careSpecial foot care for circulatory problemsSkin inspections by dermatologist

*DEVELOPMENTAL LEVEL:NEWBORNSDo not place under running faucetDo not submerge until umbilical cord drops off Dry carefully, especially the head Place cap after bath

*YOUNG CHILDRENChildren can drown in 2 inches of water; never leave alone during bathingNo milk or juice bottles in bedWipe off teeth after eating with soft clothDemonstrate on teddy bear

*CHILDRENChildren may have natural parents, stepparents, four sets of grandparents

For decision making, some cultures must ask father, some must ask grandmother

*ADOLESCENTSModesty essentialNormal clothes, not gownsBed pans not acceptableAllow decision making

*OLDER ADULTSHeat insensitivity; can burn easily

Foot care

Skin very fragile

*Personal PreferencesIn providing hygiene, may find very personal detailsReport on need to know basisDecide together on what to take furtherMust break personal preferences if signs of abuse

*Physical ConditionPatient receiving chemotherapy

Patient receiving radiation therapy

Unconscious patient

*Hygiene Care ScheduleEarly morning care: Urinal/bedpan, wash hands and face, brush teethMorning care: After breakfast, complete bath or shower, hair care, nail care, oral care, back rub, linen changeAfternoon care: straighten linen, offer urinal/bedpan/commode, wash hands/face Evening care: Elimination, wash hands and face, oral care, linen straightening, back rub

*HYGIENE includes:Care of the skinCare of the feet and nailsOral hygieneHair careCare of the eyes, ears, and noseClients room environment

Diskusi kasusNy. A usia 50 tahun di rawat di RS terkena hipertensi dan stroke. Ny. A tampak kotor dan pergerakan terbatas. Kulit tampak kemerahan terutama bagian yang terdapat penekanan..Berdasarkan kasus diatas:Pengkajian fokus apa yang saudara lakukan terkait personal hygiene klienDiagnosa keperawatan apa yang munculIntervensi apa yang saudara lakukan untuk pemenuhan personal hygiene klien*

tugasCarilah 1 jurnal setiap kelompok yang terkait dengan personal hygiene:Lakukan jurnal sharing:Topik/judul jurnalTujuan Hasil jurnal*

*Care of Skin

*SKINRegulates body temperatureFirst line of defense against harmAntibacterial and antifungalTransmits sensationsSigns of problemsRedness (erythema)WetNot intact

*PATIENTS AT RISK FOR SKIN PROBLEMSAltered level of consciousnessAltered nutritionImmobilityDehydrationAltered sensationSecretions on skinMechanical devices, restraintsAltered venous circulation

*Nursing DiagnosisImpaired skin integrity related to immobilization, exposure to chemical irritants

Hygiene self care deficit : bathing related to pain in hands, forced immobilization, musculoskeletal weakness

*NURSING INTERVENTIONSGoals : - Client will have intact skin- Client will be free of odors

Expected outcomes : - Skin will be without redness- Skin will be warm, soft, smooth, and well hydrated- Odors will be reduced or eliminated

*ContinueIntervention : Bathe client daily

Dry skin thoroughly after each cleansing

Apply lotion to skin after bathing

*NURSING ASSESSMENT WHILE BATHING

Color and condition of skinPain on movementLevel of consciousnessInjuriesScarsSkin turgorNeviWeight loss or gain

*PERINEAL CAREProfessionalism alwaysFemaleAlways sterile to contaminated (urethra to rectum)MaleAssess for circumcisionIf not, cleanse under foreskin and replace

*Care of the feet and nails

*Common Foot & Nail ProblemsCallusCornsPlantar wartsIngrown nailsRams horn nailsParonychiaFoot odors

*Nursing DiagnosisPain related to callus formation, ingrown toenails

Impaired physical mobility related to painful foot lesion

Impaired skin integrity related to improper nail-cutting practices, friction of shoes, injury to nail

*FOOT CARESoak feet as part of bathClean toes and toenailsTeach as you goRange of motion of legsFeet of diabetic patients and patients with vascular disease are inspected carefully; Never cut toenails of these patients

*NAIL CAREObserve circulation; color, capillary refill timeObserve color, sensation, and movement (CSM)Cut nails straight across and file smooth; Do not go down into cornersAssess for rings too tight or too loose

*Oral hygiene

*Oral HygieneCommon oral problems :Dental cariesPeriodontal diseases

Nursing Diagnosis :Altered oral mucous membrane related to radiation of oral cavity

*MOUTH CAREExamine with gloves and light, especially smokersUse only water soluble lubricantsUnconscious patient has no gag reflex, position on side for careTeach about brushing and flossing

*Hair care

*Hair and Scalp ProblemsDandruffPediculosis (Lice)Pediculosis Capitis (Head Lice)Pediculosis Corporis (Body Lice)Pediculosis Pubis (Crab Lice)Hair Loss (Alopecia)

*Nursing DiagnosisImpaired skin integrity related to scalp lacerationPain related to scalp lesion, accumulated secretions in hairBody image disturbance related to unkempt physical appearanceRisk for infection related to scalp laceration

*Nursing InterventionsBrushingCombingShampooingMustache and beard care

*Care of the eyes, ears, and nose

*Nursing DiagnosisSensory perceptual alterations (visual, auditory, or olfactory) related to obstruction in ear canal, nasal obstruction, inflammation of eyes or local eye infection

Risk injury related to decrease of visual, auditory, or olfactory function

*EYE CAREContact lenses usually removedStored in saline liquid; case labeledAlso label and safeguard glasses in drawerClean inner to outer canthus Patient must be able to blink to protect corneaNever use cotton near eyesTreat each eye separatelyEyes considered sterile

*EARSAllow nothing sharp in earsHearing aids now miniscule in size dont lose! Label caseCerumen in ears may need softening and removingSpeak directly to patients face

*Continue

*Clients room environment

*BEDMAKINGMake bed for patient comfortIf incontinent, wash, rinse, dry, change linenPosition as ordered

*

Procedure bed making*

*NURSE SAFETY IN BEDMAKINGRaise bed to working heightFace patientConserve stepsDont lift aloneSide rails as orderedLower bed and place call bell when leaving

*Any Questions ???