Hygiene
The Skin
The skin serves several functions:
• Protection
• Secretion
• Excretion
• body temperature regulation
• cutaneous sensation.
• It consists of two primary layers: the epidermis and the
dermis.
• Just beneath the skin lies the subcutaneous tissue (hypodermis),
which shares some of the protective functions of the skin.
• Epidermis shield underlying tissue against water loss and injury
and prevent entry of disease-producing microorganisms.
• The innermost layer of the epidermis generates new cells to
replace the dead cells that the outer surface of the skin
continuously sheds.
• Bacteria commonly reside on the outer epidermis. These
resident bacteria are normal flora that do not cause disease
but instead inhibit the multiplication of disease causing
microorganisms.
• Bundles of collagen and elastic fibers form the thicker
dermis that underlies and supports the epidermis.
• Nerve fibers, blood vessels, sweat glands, sebaceous
glands, and hair follicles run through the dermal
layers.
• Sebaceous glands secrete sebum, an oily, odorous fluid, into
the hair follicles. Sebum softens and lubricates the skin and
slows water loss from the skin when the humidity is low.
• Sebum has bactericidal action. The subcutaneous tissue
layer contains blood vessels, nerves, lymph, and loose
connective tissue filled with fat cells. The fatty tissue
functions as a heat insulator for the body.
The skin often reflects a change in physical condition
by alterations in color, thickness, texture, turgor,
temperature, and hydration.
As long as the skin remains intact and healthy, its
physiological function remains optimal. Hygiene practices
frequently influence skin status and can have both beneficial
and negative effects on the skin.
For example, too-frequent bathing and use of hot water
frequently leads to dry, flaky skin and loss of protective oils.
The Feet, Hands, and Nails:
• Any condition that interferes with movement of the hand impairs a
patient’s self-care abilities.
• Foot pain often changes the patient’s gait, causing strain on
different joints and muscle groups. Discomfort while standing or
walking limits self-care abilities.
• The nails grow from the root of the nail bed, which is located in the
skin at the nail groove, hidden by the fold of skin called the cuticle.
• A scalelike modification of the epidermis forms the visible part of the
nail (nail body), which has a crescent-shaped white area known as the
lunula. Under the nail lies a layer of epithelium called the nail bed. A
normal healthy nail appears transparent, smooth, and
convex, with a pink nail bed and translucent white tip.
Disease causes changes in the shape, thickness, and curvature
of the nail.
The Oral Cavity
• It consists of the lips, the cheeks, the tongue and its muscles, and the
hard and soft palate. The mucous membrane, lines the oral cavity. The
floor of the mouth and the undersurface of the tongue are richly
supplied with blood vessels.
• Normal oral mucosa glistens and is pink, soft, moist,
smooth, and without lesions.
• Several glands within and outside the oral cavity secrete saliva. Saliva
cleanses the mouth, dissolves food chemicals to promote taste,
moistens food to facilitate bolus formation, and contains
enzymes that start breakdown of starchy foods. The effects of
medications, exposure to radiation, dehydration, and mouth breathing
impair salivary secretion in the mouth.
• Strong sympathetic nervous system stimulation almost
completely inhibits the release of saliva and results in
xerostomia or dry mouth.
• A normal tooth consists of the crown, neck, and root. The
enamel-covered crown extends above the gingiva or gum,
which normally surrounds the tooth like a tight collar. The
root is embedded in the jawbone.
• Healthy teeth appear white, smooth, shiny, and
properly aligned.
• Regular oral hygiene helps to prevent gingivitis (i.e.,
inflammation of the gums) and dental caries (i.e., tooth
decay produced by interaction of food with bacteria
The Hair:
Hair growth, distribution, and pattern indicate a person’s
general health status.
Hormonal changes, nutrition, emotional and physical
stress, aging, infection, and some illnesses affect hair
characteristics. The hair shaft itself is lifeless, and
physiological factors do not directly affect it. However,
hormonal and nutrient deficiencies of the hair follicle
cause changes in hair color or condition.
Factors Influencing Hygiene:
Social Practices. Social groups influence hygiene preferences and practices,
(type of hygiene products used, the nature and frequency of personal care
practices). Family customs play a major role during childhood in determining
hygiene practices such as the frequency of bathing, brushing, the time and no of
times these are performed.
Personal Preferences. Patients have individual desires and preferences about
the timings and products used for hygiene and grooming. Knowing patients’
personal preferences promotes individualized care. Help the patient develop new
hygiene practices when indicated by an illness or condition. For example, you
need to teach a patient with diabetes proper foot hygiene.
Body Image. Body image is a person’s subjective concept of his or her body,
including physical appearance, structure, or function. Body image affects the way
in which individuals maintain personal hygiene. Surgery, illness, or a change in
emotional or functional status often affects a patient’s body image.
Socioeconomic Status. A person’s economic resources
influence the type and extent of hygiene practices used.
Health Beliefs and Motivation. Knowledge about the
importance of hygiene and its implications for well-being
influences hygiene practices. Motivation also plays a key role in a
patient’s hygiene practices.
Cultural Variables. Cultural beliefs and personal values
influence hygiene care. People from diverse cultural backgrounds
frequently follow different self-care practices.
Developmental Stage. The normal process of aging influences the
condition of body tissues and structures. A patient’s developmental
stage affects the ability of the patient to perform hygiene care and the
type of care needed.
Skin. The neonate’s skin is relatively immature at birth. The
epidermis and dermis are loosely bound together, and friction causes
easy bruising. A toddler’s skin has a greater resistance to infection and
skin irritation.
When an adult bathes frequently or is exposed to an environment with
low humidity, it becomes dry and flaky.
Feet and Nails. With aging and continued exposure the
patient is more likely to develop chronic foot problems as a result of
poor foot care, improper fit of footwear, and systemic disease.
The Mouth. the teeth and gums remain healthy if a person
follows healthy eating patterns and dental care. In addition, regular
brushing help to prevent caries and periodontal disease.
Hair. Throughout life changes in the growth, distribution, and
condition of the hair influence hair hygiene. As males reach
adolescence, shaving becomes a part of routine grooming.
Eyes, Ears, and Nose. There are changes in hearing, vision,
and olfaction across the life span as a result of growth and
development. Alterations in sensory function often require
modifications in hygiene care.
Physical Condition. Patients with certain types of physical
limitations or disabilities associated with disease and injury lack the
physical energy and dexterity to perform hygiene self-care safely.
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