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Ch.40 P&P, Hygiene, Part 2
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Ch.40 P&P, Hygiene, Part 2
Perineal care
- 1x day, more for urinary catheter
- Risk factors for skin break down
- Urinary/fecal incontinence
- Rectal & perineal surgical dressings
- Catheters
- Morbid obesity
Back rub
- Effleurage: long, slow, guiding strokes
- Follows bath, promotes relaxation
Foot and nail care
- Exception for Pts w/ diabetes Mellitus or vascular disease
- Risk for ulcer/infection
- Soaking causes skin softening or maceration of tissue. May need providers order in order to provide care
- May need Dr order to provide care
- Risk for ulcer/infection
- Prevents infection and promotes circulation
- Exception for Pts w/ diabetes Mellitus or vascular disease
Oral hygiene
- Inadequate oral care, some meds diminish saliva
- Less saliva= Reduction of fighting off pathogens
- Pts w/ stoke, trauma to oral cavity, endotracheal tube oral care every 1-2 hrs
- CHG rinse for increased risk Pts
- Older adults, Pts with cognitive impairments or immunocomprimised
- No wax floss for chemotherapy, radiation or anticoagulant Pts
- Prevents bleeding
- Inadequate oral care, some meds diminish saliva
Patients with special needs
- Diabetes mellitus, chemo, artificial airway
- Teeth cleaned 3-4x day
- Unconscious Pts
- Provide hygiene & CHG
- CHG protects from choking & aspiration
- Provide hygiene & CHG
- Stomatitis
- Burning, pain, change in food & fluid tolerance
- Chemo, immunosuppressive agents, head/neck radiation, nasogastric tubes= higher risk
- Denture care
- Avoids gingival infection, irritation
- Denture-induced somatitis
- Red, swelling under dentures
- Red sores on roof of mouth
- Yeast Candida albicans infection
- Diabetes mellitus, chemo, artificial airway
Hair and scalp care
- Brush, comb
- Distributes oil, prevents tangling
- Culture preferences
- Learn as much as you can about their hair practices and whether or not it's okay to cut Always ask permission before styling
- Lice shampoo
- May have severe neurological side effects. Use properly
- Shampooing
- May need order for Pt w/ limited mobility
- Can cause injury
- Pts who are ambulatory/weight bearing, or become tired/could faint
- Shower/tub chair
- Pt unable to sit, can be moved
- Transfer to stretcher to move to sink/shower w/ handheld nozzle
- Pt unable to sit, or be transferred
- Shampoo in bed
- May need order for Pt w/ limited mobility
- Pts prone to bleed need electric razor
- Brush, comb
Eyes, ears, nose
- Prevents infection, maintains normal sensory Fxn
- Clean under medical devices
- Wash eye with wet wash cloth, ONLY water
- Unconscious Pts
- May need eye patch and eye drops to prevent drying of cornea/irritation
- Contact lenses
- Must be removed periodically
- Prevents infection, ulcers resulting in pain, tearing, discomfort, refness
- If not removed, severe cornea injury can result
- Must be removed periodically
- Artificial eye removed & cleaned
- Ear cleaning
- Avoid history of perforated eardrum, assess red, swelling, drainage
- Bulb irrigating syringe/ water pik
- Ask Pt if dizzy, pain nausea, vertigo= solution too hot/too cold
- Nasal care
- Clean w/ suction, wash cloth, applicator
- Change tape frequently, watch for moisture
Pt room environment
- Clean, organize, all safety precautions
- Bed making
- Frequently, make sure clean, dry, free of wrinkles
Evaluation
- Encourage Pt to verbalize any discomfort by asking questions
- Were you please d with how we cared for your foot?
- Inspect if spiking/drainage removed
- Check rashes/ulcers
- Teach back
- If hygiene not met from Pt, ask how we can help or what kept them
- Encourage Pt to verbalize any discomfort by asking questions