CARE OF HAND AND FEET.pptx

CARE OF HAND AND FEET

1. CARE OF HAND AND FEET

2. Purpose To keep clean To prevent skin injury (% scratching) To prevent infection To promote comfort To improve grooming To promote self-esteem To detect or examine the abnormalities To prevent worm infestations

3. CARE OF THE NAILS Inspect the feet daily including the top and soles of the feet and the area between the toes. Wash and soak the feet using lukewarm water (37 degree celcius ) If the feet perspire ,apply a foot powder. If dryness is noted along the feet ,apply soft oil and rub gently into the skin File the toe nails straight across the square. Avoid wearing elastic stockings Wear clean socks daily.

4. Do not walk bare foot Wear properly fitted shoes. Exercise regularly to improve circulation to the lower extrimities Immediately wash minor cuts and dry them thoroughly , mild antiseptics may be applied to the skin .

5. COMMON FOOT AND NAIL PROBLEMS CALLUS It is a thickened portion of the epidermis caused by local friction or pressure CORNS It is caused by friction and pressure from shoes . It is seen mainly on toes ,over bony prominence.

6. CORNS AND CALLUS

7. ATHELET’S FOOT( Tinea pedis ) It is a fungal infection of foot mainly induced by wearing of constricting foot wears. INGROWN NAILS Toe nails or finger nails grow inward into soft tissue around nail resulting from improper nail trimming PARONYCHIA It is the inflammation of tissue surrounding nails following an injury . It is common among diabetic patients

8. ATHELET’S FOOT

9. INGROWN NAILS

10. PARONYCHIA

11. FOOT ODOR It is the result of excessive perspiration promoting microorganism growth.

12. PURPOSES To keep the feet clean and dry To trim nails and keep them short to prevent injury To teach the patient in proper way to inspect the feet and hands for any dryness and signs of infection.

13. ARTICLES REQUIRED A tray containing , A pair of scissors or a nail clipper Wet swabs in a small bowl A jug with water for washing hands A kidney tray with Dettol 1 in 40 solution A paperbag A towel Wash basin Was cloth Mat, Mackintosh and Drawsheet

14. PROCEDURE STEPS RATIONALE Check the client’s identification and doctor’s order Explain to the client about the purpose and procedure Gather all the required equipments to the bedside Provides privacy and assist the client to a comfortable upright position In sitting position, Soaking Put a mackintosh with covering towel on the bed Put the basin with warm water over mackintosh Soak the client’s hands in a basin of warm water and apply mild soap. Scrub and wash them up. Dry hands by using towel To assess needs It fosters cooperation To prevent spread of infection and to promote effective care To make nails soft , there by you can cut nails easily and safely

15. CUTTING Trim the client’s nails with nail clippers Wipe all fingernails from thumb to 5 th nail side by side by wet cotton ball . One cotton ball is used for one nail finger. Shape the fingernails with a filer , rounding the corners and wipe both hands by a sponge towel CARE OF FINGERNAILS Apply lotion or cream to hands Position patient on chair, place disposable mat under patient’s feet if possible and provide patient with privacy. Fill the basin with warm water (100- 110 deg fahreheit ) To prevent dryness To provide comfort To make nails soft , thereby you can cut nails easily and safely

16. Place the basin on a disposable mat and help the patient to place feet into basin . Soak feet for 15-20 minutes. CARE OF FEET Cut toe nails straight across and do not round off the corners , do not shape corners Apply lotion or cream to feet Make the client comfortable and replace equipment and discard dirty water and swab Perform hand hygiene and record the procedure If the nails tend to grow inward at the corners , place a wisp of cotton under the nail to prevent toe pressure . A notch cut in the centre will pull in edges and corners . Sometimes, very thick ,hard toe nails require surgical removal To prevent dryness To prepare equipment for the next procedure

17. SPECIAL INSTRUCTIONS FOR CARE OF FEET Notice and feel your feet daily for blisters, open sores , cuts and color changes or ingrown toe nails.

18. Cut toe nails straight across

19. Wash your feet daily with soap and lukewarm water .Take care to wash between toes

20. Wear clean soaks which must fit well and have no holes or tears

21. Examine your shoes everyday for pebbles ,nails or any irritating object

22. Keep your feet dry especially between toes . Use powder, if needed.

23. Keep your skin soft , put lotion on top and bottom of your feet ,do not apply between the toes.

24. CARE OF EYES EARS AND NOSE

25. CARE OF EYES PURPOSES To clean the eye of discharge and crusts Prior to eye drop instillation To soothe eye irritation To prevent abrasion in the unconscious patients To prevent from corneal damage

26. ARTICLES REQUIRED A tray containing , Sterile gauze swabs or cotton balls Sterile 0.9% Nacl Paperbag Sterile gloves Disposable gloves Appropriate eye ointment if prescribed.

27. PROCEDURE Explain the procedure to the patient and make sure that the bed area is clear of any obstructions Provide a comfortable position to the patient Ensure patient’s privacy Make an assessment of the patient’s eyes Wash hands and put on gloves Place disposable towel around the patient’s neck Ask the patient to close their eyelids to avoid damage to the cornea With a gauze swab dampened in the saline 0.9% gently clean the eye from the inner canthus to outer canthus .Do not apply direct pressure over the eyes

28. Repeat the procedure for both eyes Exudate from the eyes should be removed carefully and as often as necessary to keep the eyes clean. An unconscious patient need frequent special eye care,the physician may order lubricating eye drops ,in some cases the eyes may be medicated and covered to prevent further irritation Eyeglasses can be used Dry the patient’s eyelids gently to remove excess fluid Replace the equipments

29. Ensure the patient is comfortable Wash hands thoroughly Document the procedure .

30. CARE OF EARS

31. PROCEDURE The ears are cleaned during bed bath A clean corner of the moistened washcloth rotated gently into the ear is used for cleaning Also a cotton tipped applicator is helpful for cleaning the pinna The care of hearing aid is also involves routine cleaning, battery care and proper insertion techniques . The specialist must assess the knowledge and routine for cleaning and caring the hearing aid The hearing aid should be turned off when its not in use.The outside of hearing aid should be cleaned with clean cloth. Proper care of hearing aid is essential.

32. CARE OF NOSE

33. PURPOSES To clean the mucus from the nose To clean allergens and irritants To decrease swelling in the nose and increases airflow

34. PROCEDURE Secretions in the nose can be removed by having the patient to blow into a soft tissue . The specialist must teach the patient that harsh blowing can cause pressure capable of injuring the eardrum ,nasal mucosa and even sensitive structures. If the patient is not able to clean his nose ,the specialist will assist using a saline moistened washcloth or cotton tipped applicator . Do not insert the applicator beyond the cotton tip. Suctioning may be necessary if the secretions are excessive

35. When patient’s receive oxygen per nasal cannula or have a nasogastric tube , you should cleanse the nares every 8 hours. Use a cotton tipped applicator moistened with saline . Secretions are likely to collect and dry around the tube ; therefore you will need to cleanse the tube with soap and water.

36. PERINEAL CARE

37. DEFINITION Perineal care is a clean procedure, cleansing of the patient’s external genitalia , perineum , anus and the surrounding area which routinely done during bed bath, after urination and bowel movement.

38. Patient who require special attention to perineal area . 1. Patient who are unable to do self-care . 2. Patient with genito -urinary tract infection . 3. Patient with incontinence of urine and stool . 4. Patient with indwelling catheters.

39. 5. Postpartum patients . 6. Patients after surgery on the genitor-urinary system . 7. Patients with injury, ulcer or surgery on perineal area.

40. Preliminary Assessment 1. Assess the condition of perineal skin-any itching, irritation, ulcers, oedema, drainage etc. 2. Assess the need and frequency of perineal care. 3. Assess whether perineal care should be done under an aseptic technique or a clean technique.

41. . Check the physician’s order for any specific instructions . 5. Assess the patient ability for self care. 6. Assess the patient’s mental state to follow instructions. 7. Check the articles available in patients unit.

42. Preparation of Articles : A Tray containing Mackintosh       Purpose: To protect the bed. Wet cotton ball or rag pieces in a bowl.       Purpose: To clean perineum .  

43. A jug with warm water or antiseptic solution.       Purpose: Gauze or rag pieces in a container. Long artery forceps in kidney tray.       Purpose: To hold swabs for cleaning. .

44. Paper bag.       Purpose: To receive wastes. Clean linen, pads, dressing etc as needed.       Purpose: To keep patient clean. Bed pan.       Purpose: if the patient is in need to passing urine or stool

45. Preparation of Patient: 1. Explain procedure to the patient. 2. Provide privacy by screens and drapes. Drape the patient as for vaginal examinations. 3. Remove all articles that may interfere with the procedure e.g. air cushion. 4. Give extra pillows to raise the head.

46. 5. Roll the draw sheet to opposite side to prevent soiling when bedpan is placed under buttocks, over draw sheet. 6. Offer bed pan. Keep the clean bed-pan on the bed on your working side. 7. Untie the pads, if any and observe the discharges its color , odor , amount etc. 8. Leave the patient for sometime so that she may pass urine or stool if necessary. 9. Get the toilet tray and arrange the articles conveniently on bed side table

47. Steps: 1. Wash hands        Reason: To prevent cross infection. 2. Pour water over perineum.        Reason: To wash off the discharge from the perineal area. 3. Clean the perineum using the wet swabs.        Reason: To prevent the entrance of bacteria from the colon into urinary tract. 4. Hold the swabs with forceps and clean from above.

48. . Use one swab for one swabbing. 6. Clean perineum from the midline outward in following order            a.  The vulva            b. The labia            c. Inside of labia on both sides.            d. Outside of labia on both sides.  

49. 7. Clean the perineal region and anus thoroughly. 8. Remove the bed pan by supporting the hip as before. Turn the patient to one side and dry the buttocks with dry rag piece.

50. After Care : 1. Apply the medicine and pad if necessary. 2. Remove the mackintosh if extra one is used. 3. Change linen if necessary straighten the bed clothes. Arrange the bed linen. 4. Make patient comfortable.

51. 5. Take the bed pan to sanitary annex. Remove cotton swabs, and empty the contents into toilet. 6. Clean all articles. 7. Boil forceps. 8. Replace articles