crflog78666
Hygeine
Describe factors that influence personal hygiene practices. Discuss conditions that place patients at risk for impaired skin integrity. Explain the importance of foot care for the patient with diabetes. Describe how hygiene care for the older adult differs from that for the younger patient. Assessment of hygiene needs & safety • Oral Care • Skin Care • Denture care • Care alterations for pts with sensory alterations Perineal Care
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Hygiene
actions clients take/ health practices/ that dec the spread of transmission of pathogens, therfor dec risk of illness
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(T/F) grooming is not considered hygenic
F, being welled groomed is a part of good hygiene (keeps body clean)
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Hygiene Practices Examples
Grooming
Handwashing
Brush teeth
Routine Bathing
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What can cause compromised skin integrity
Cuts
Irritation
Inflamation
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(T/F) changes in the integrity of the skin can increase the risks of infection, loss of a leg or arm, and death
True, leaves host susceptible to bacterial infestation
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Washing skin regularly keeps it healthy by
removing oil, dead skin cells, and bacteria that might cause skin breakdown
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major cause of skin breakdown
urine and fecal incontinence
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Urine and Fecal Incontinence inc risk of skim damage at:
Skin around hips, genitals, buttocks, and perineum
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It is recommended to clean the skin with:
pH balanced cleanser to dec skin irritation and dryness, thereby decreasing risk of impaired skin integrity.
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Preforming hand hygeine before a client...
decreases transmission of germs from nurse to client
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Preforming hand hygiene after a client...
decreases transmission of germs from nurse to other clients
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alcohol based hand sanitizer
A solution that can often be used in place of soap and water that contains 60% alcohol.
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Important times to wash hands with soap and water include:
After blowing nose, coughing, or sneezing
after using the restroom
before and after eating
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Health Promotion
Encourage wellness and inc control over and improvment of all aspects of general health
includes: creating awareness of health problems
whole person meaning mental, physical, spiritual, and social well being.
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Religion can influence caring for someone include:
Client privacy and modesty
beliefs regarding gender of the nurse caring for the client
reluctance to remove clothing and expose one's body during personal care
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(T/F) Infants should be sponge washed about 3 times a week untill the umbilical cord falls off (1-2 weeks after birth)
True, bathing the infant more than 3 times a week can dry skin
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When taking care of the residual umbilical cord after it has fallen off, Nurses must observe for
Infection
Infection signs include: foul smelling yellowish discharge, reddened skin at cord stump site, and crying when the cord or surrounding skin is touched.
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Diaper Dermatitis
skin becomes inflamed in response to various substances (urine, feces, fungal/bacterial infection) or an allergic reaction to something in the diaper
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Who can get diaper dermatitis?
Anyone who wears a diaper, however, most likely to occur in infants 9-12 months
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Important risk factor for Diaper Dermatitis
Increased Moisture, which results in skin becoming inflamed and soft which increases pathogen exposure
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Diaper Dermatitis Treatment
chnage diaper frequently to avoid skin exposure to urine and feces.
wash and clean skin with water and soap free cleanser
topical emollients to provide a barrier between skin and diaper
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Change in children and teengares skin is due in part to
Hormones, which will cause oily skin and increased sweating
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Good Hygiene for children and teens includes:
Bath daily and wash hair every other day (prvnt odor and build up of oily skin)
use deoderant or antiperspirant (BO)
Using a noncomedogenic cleanser and soap for oily forehead, nose, and chin
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noncomedogenic
Solutions that can hinder the clogging of pores.
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Reasons why older people resist taking showers
Illness/disease
pain with mobility
fear of water/ sound of water
fear of falling
fear of water temp (hot/cold)
dificulty getting in and out of tub
lacking energy to bathe
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(T/F) Ignoring a clients refusal to bathe can be considered abuse
True, but health should be prioritized so a nurse must find a work around to the issue
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Hemiparesis
minor loss of strength in the face or upper or lower extremity on one side of the body. clients with this have issue grasping objects, have reduced acuracy of movement, muscle fatigue, and decreased cordination
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Hemiplegia
paralysis that affects one side of the body
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(T/F) Having a high BMI can influence whether or not you need assistance with personal care needs.
True, bc inc comorbidities = dec functional ability
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How does inc weight affect skin integrity?
Skin folds can extend to knees and hamper the ability to perform hygiene care.
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areas susceptible to deep skin folds
groin
gluteus maximus
under breasts
behind knees
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Inc moisture and skin friction can cause rashes to form in skin folds leading to? Treated how?
infection
treated with proper hygiene ( skin folds cleaned with ph-balanced liquid soap and light dabing skin dry)
if fungal infection, notify provider, discuss nystatin powder for treatment on infection
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When dealing with someone who is obese and having challanges with perineal care, a nurse should
clean and dry the skin gently
use barrier creams to protect skin from iritants(stool, urine, other fluids from body)
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Usage of barrier products during perineal care requires care because
administering excessive amounts can cause skin cracking, discomfort, and hinder the nurse's ass-essment of the clients skin
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(T/F)Clients who have an increased BMI can experience a decreased ability to perform skin care after toileting due to their increased body build and shape. The inability to clean the skin after toileting can result in irritant dermatitis
true, due to buildup of moisture and rashes forming, irritation may form
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Bariatric=?
fat, obese (high bmi), has skin folds, cannot do cleaning by self bc very fat
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Individuals with dementia have an inability to independantly perform ADLs, including:
bathing, dressing, and grooming
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To maintain the client’s dignity, respect, and freedom of choice when assisting with ADLs, the nurse should incorporate the client’s personal abilities, likes, and dislikes into these processes such as:
offering choices and using basic verbal instructions in a safe setting
observe for signs of incontinence
schedule toilet times (ensure bathroom accessible)
discourage caffeine and fluid consumption later in day
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(T/F) individuals with dementia have a poorer hygeine
True, oral hygiene may be compromised by PTs inability to process information and dexterity decline, nurses must assist.
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Inadequate oral hygeine is a risk factor for
aspiration pneumonia
(bc food or other substances in back of throat get inhaled into lungs)
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Oral Hygeine interventions for amputated individual
use electric tooth brush (put in clients mouth and once on have them move it around with their mouth???)(i didnt make that up its in the ati page 5)
flossing using a tuning fork flossing tool (used with one hand)
electric razor( easy to manipulate)
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Bed Baths used when
pt who cannot get to the bathroom but can bath themselves, or if they cant bathe themselves
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when assisting a pt to the restroom, you should
inspect condition of clients skin and speak to any hygiene related issues
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bedbath can be completed using
disposable wipes or soap and water
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should wash basins be used in a bed bath
no, they harbor pathogens and can lead to tarnsfer of pathogens
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soap and water bed baths arent recomended bc?
they can dry skin
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(T/F) other methods of bathing that omit soap and water decrease the risk of skin deterioration and preserve skin integrity, which forms an essential barrier to infection
True, bc soap and water can inc risk of skin deterioration
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During footcare lotion should go where and where not
lotion on feet (especially heals), just not between toes
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why are individuals with diabetes mellitus having foot problems
due to nerve damage, they may feel a burning or stinging weakness in feet. they also have impaired peripheral circulation.
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diabetes mellitus with foot issues, have a inc risk for
increased risk for dec ability to fight infection
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when washinga diabetic persons feet, a nurse should
use warm water (not hot to avoid burning bc they have peripheral nerve damage)
refrain from soaking the foot as it can dry the skin
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Perineal area
located between the tail bone and pubic arch, between the anus and vulva in females and the scrotum and anus in males
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Perineal care can be preformed during:
during a bed bath, tub bath, or shower, or as needed, such as when clients are incontinent of urine or stool.
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Can you use soap for perineal care?
yes :)
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(T/F)When providing perineal care for a female client, wash from anterior to posterior (front to back) to decrease the risk of urinary tract infection
True, cleaning back to front can move bacteria closer to urethra
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Before beginning indwelling catheter care, nurse must
Perform hand hygiene and don clean gloves (The nurse can then use soap and water to perform this care)
First, clean the genital area. For men, pull back the foreskin and wash the area including the penis. For females, clean the area between the labia, going from front to back.
Next, clean the urethra, where the catheter enters the body.
Finally, clean the catheter, beginning from the meatus and moving down away from the client’s body.
Hold the catheter near the meatus when cleaning the catheter to avoid placing tension on this device
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When performing perineal care a nurse should use
waterproof pad
skin cleanser
skin protectant cream
washcloths
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(T/F)Oral hygiene involves keeping the mouth and teeth clean by brushing and flossing the teeth and using fluoride mouthwash to promote oral health
True
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how many times and how long should you brush your teeth for
twice a day for 2 mins
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(T/F) battery powered toothbrushes are better at decreasing plaque and mild gum disease (Gingivitis) than using a standard toothbrush
True
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(T/F) teeth should be flossed daily below the gum line, as well as a fluoride mouthwash
true, eliminates bacteria
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Routine use of mouthwash has several benefits, including
reduction or control of plaque, gingivitis, unpleasant breath, and tooth decay.
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(T/F)Manifestations of an unhealthy oral cavity include dry mouth and lips, chipped teeth, film on the tongue, plaque and cavities, and oral thrush.
True
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oral thrush on dentures means
they have suboptimal oral hygiene (dirty!!!)
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Ventilation can inc concentration of bacteria entering mouth/ lung. Nurses are responsible to:
perform oral hygiene for patient since they are unable to
mainly: applying mouth rinses and gels, brushing teeth, and suctioning secretions
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Inadequate oral hygiene can cause
tooth decay (dental caries, also called cavities)
periodontal (gum) disease
and has been linked to heart disease, cancer, and diabetes
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Tooth decay
condition in which teeth are permanently damaged and may develop dental caries
Such cavities may be caused by food, bacteria, and acid that form plaque on the teeth
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Acid breaks down the tooth enamel, which can then lead
to permanent harm of teeth (sensitivity, inc chippage)
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Gingivitis
gum inflamation
caused by plaque forming on teeth from poor oral hygiene
can progress to predontitis
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Denture care includes
removing food and other particles that get trapped under the dentures
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(T/F) dental care of dentures can inc risk of thrush
False, will dec
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can visual impairment affect oral hygiene? how/how not?
Can, through physical, social, and educational barriers related to disability, medical state, or insufficient education
to overcome, educational aids should be provided such as use of dental models, audio tapes, magnifying devices, and/or written info with large print, braile
