Chapter 38
Hygiene
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Skin
• Function
– Protection
– Secretion
– Excretion
– Temperature regulation
– Sensation
• Structure and appearance
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Feet, Hands, and Nails
• Function
– Mobility
– Weight bearing
• Structure and appearance: nails
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Oral Cavity
• Function/appearance
– Mucous membranes
– Salivary glands
– Teeth
– Gums
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Hair
• Growth
• Distribution
• Pattern
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Eyes, Ears, and Nose
• Structure and function
– Prevention of injury and discomfort
during hygienic care
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Individual Factors
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Social practices
Personal preferences
Body image
Socioeconomic status
Health beliefs and motivation
Cultural variables
Physical condition
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Assessment
• Physical examination
– Integument: skin, hair, nails
– Oral cavity
– Eyes, ears, and nose
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Common Skin Problems
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Dryness
Acne
Rashes
Contact dermatitis
Abrasions
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Common Foot and Nail Problems
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Callus
Corns
Plantar warts
Tinea pedis (Athlete’s foot)
Ingrown nails
Ram’s horn nails
Paronychia
Odors
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Hair and Scalp Problems
• Dandruff
• Ticks
• Lice
– Pediculosis capitis
– Pediculosis corporis
– Pediculosis pubis
• Alopecia
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Risk Factors for Skin Impairment
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Immobilization
Reduced sensation
Nutrition and hydration alterations
Secretions and excretions on the skin
Vascular insufficiency
External devices
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Developmental Changes
• Condition of the integument and
hygienic practices
– Infant
– Toddler
– Adolescent
– Adult
– Older adult
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Use of Sensory Aids
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Eyeglasses
Contact lenses
Artificial eyes
Hearing aids
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Assessment
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Self-care ability
Hygiene practices
Cultural factors
Clients at risk for problems
Special considerations
Client expectations
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Nursing Diagnoses
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Ineffective health maintenance
Impaired mobility
Bathing/hygiene self-care deficit
Risk for impaired skin integrity
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Planning
• Goals and outcomes
– Client’s skin is clean, dry, and intact
– Client tolerates bathing without
excessive fatigue
• Setting priorities
• Continuity of care
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Implementation
• Teaching hygiene techniques
– Relevant to client’s situation
– Adapted to client’s bathing facilities
– Incorporating injury prevention and
infection control measures
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Bathing and Skin Care
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Complete bed bath
Partial bed bath
Tub bath or shower
Bag bath
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Guidelines for Bathing
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Provide privacy
Maintain safety
Maintain warmth
Promote independence
Anticipate needs
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Additional Hygienic Care
Considerations
• Perineal care
– Self-care ability of client
– Reduction of embarrassment
– Asepsis
• Back rubs
– Benefits
– Contraindications
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Foot and Nail Care Guidelines
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Careful inspection
Lukewarm water temperature
No soaking
Cutting of nails, if indicated
Application of lotions
Proper socks, stockings, and shoes
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Oral Hygiene
• Brushing and flossing
• Clients with special needs
– Presence of stomatitis
– Use of oxygen therapy
– Unconscious state
• Denture care
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Hair and Scalp Care
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Brushing and combing
Shampooing
Shaving
Mustache and beard care
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Eye Care
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Basic eye care
Eyeglasses
Contac lenses
Artificial eyes
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Ear Care
• Cleansing
• Cerumen removal
• Hearing aid care
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Nasal Care
• Cleansing
• Special care for clients with nasal
oxygen or GI tubes
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Client’s Room Environment
• Maintaining comfort
– Temperature, ventilation, noise, light
• Room equipment
– Chairs, beds, other equipment
– Bed making
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Evaluation
• Client care
• Client expectations
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