Hygiene

MEETING NEEDS OF CLIENT- HYGIENE

1. HYGIENE -KHYATI CHAUDHARI

2. Personal Hygiene It Affects patient’s comfort, safety & well-being. Hygiene care includes cleaning & grooming activities that maintain body cleanliness & appearance. It is the nurses responsibility to provide the patient with the opportunity for hygiene. The skill may be delegated but not always, depends on facility policy.

3. Personal Care And Grooming: Relationship To Self-Esteem

4. Introduction Personal grooming is important for a positive self-image and every effort should be made to encourage and assist the resident to maintain a pleasing and attractive appearance. Provide for the patient’s personal care and grooming needs and identify the role of the nurse aide in meeting these needs.

5. Daily Hygienic Needs Bathing Skin care Back care Oral hygiene Shaving Shampooing hair Hair care Nail care Perineal care Dressing and undressing

6. Factors that affects hygiene practice

7. Factors : Culture Family Practices Illness Individual preferences Bath in morning or before going to bed Frequency of bathing, shaving Shampooing hair daily or weekly

8. Factors : Economics Unable to afford deodorant, shampoo, etc. Unable to afford utilities

9. Personal Care and Grooming: Role of the Nurse

10. Nurses Role Assist to follow their personal hygiene practices. Encourage to do as much of their daily care as possible. Assist residents to select their own clothing  . Promote independence and self esteem. Encourage use of deodorant, perfume, aftershave lotion, and cosmetics. Be patient and encouraging

11. Oral Hygiene Is measures used to keep mouth and teeth clean and free of microorganisms.

12. Purposes : To Prevent odors. To Prevent infections. To Prevent tooth decay and loss of teeth. To Prevent gum disease. To Increase comfort. To Enhance taste of food.

13. Oral hygiene is provided: Before breakfast After meals At bedtime Other times as requested or necessary

14. Observations to report: Foul mouth odors Bleeding Loose or broken teeth or dentures Sores in or around mouth Coated tongue Complaints of pain

15. 7 Principles For Brushing Teeth Hold brush at 45 degree angle Use circular motion to brush teeth Brush well where teeth and gums meet Brush all surfaces Brush upper teeth first Brush gently Offer diluted mouth wash

16. Special Mouth Care Products Swabs Toothettes : usually soaked in mouthwash or plain water hydrogen peroxide, salt water solution if specified on care plan Petroleum jelly for dry lips

17. Denture Care Handle carefully – expensive to replace Clean as often as natural teeth Protect from loss or breakage Store safely, when out of mouth, in labeled container Never use hot water, which can warp dentures

18. Continue … Store dry, in water or in special solution For long term storage, put container holding dentures in bedside stand

19. Oral Hygiene procedure

20. Definition Oral hygiene cleaning the teeth and the oral cavity of the patient. It includes the measures to prevent the spread of disease from mouth and increase the comfort of the patient.

21. Purposes To maintain the healthy state of mouth, gums, teeth and lips. To remove food particles from and between the teeth. To stimulate appetite. To provide a sense of well-being. To remove dental plaque. To prevent sores and infection of the oral tissues.

22. Purposes To relieve discomfort resulting from halitosis and taste. To prevent gum inflammation and infection. To prevent the mucous membrane from becoming dry. To prevent sordes, which results in ulceration. To maintain the intactness and health of the lips and oral cavity.

23. Sordes   A dark brown or blackish crust like deposit on the lips,  teeth , and gums of a person with dehydration resulting from a chronic debilitating disease.

24. Purposes To prevent oral infections . To clean and moisten the membranes of the mouth and lips.

25. Indications Seriously ill patient. Patients with fever. Postoperative patients. Unconscious patients. Paralyzed patients.

26. Patients breathing through mouth. Patients with infections and disease of mouth. Patients under anesthesia.

27. Article used for conscious patient

28. Articles needed for conscious patients- A tray containing the following articles :- Face towel. Mackintosh with draw sheet or towel. Disposable gloves(clean). Toothbrush .

29. Toothpaste . Log of tepid water. Emollients (liquid paraffin, coconut oil, boroglycerine Vaseline. Cotton applicator.

30. Articles used for unconscious patient

31. Face towel. Mackintosh with draw sheet. Disposable gloves(clean) Artery forceps Dissecting forceps. Tongue depressor

32. Mouth gag Potassium permanganate(1gm:5000ml) Gauze piece Emollients (liquid paraffin, coconut oil, boroglycerine Vaseline Cotton applicator

33. Mouth Gag

34. For unconscious

35. Steps Assess patient’s oral hygiene. Test for presence of gag reflex by placing tongue blade on back half of tongue. Check the Dr.’s orders for specific precautions regarding the movement & positioning of patient. Explain the procedure to the client.

36. Pull curtains. Raise bed to comfortable working level. Arrange articles by bedside. Position the patient on side, head turned towards you. Place towel & mackintosh under the patients head & spread one towel over chest & an emesis basin under the chin. Raise side rails of bed on both side.

37. Do not pour water into the mouth of unconscious patient. Separate the upper & lower teeth with padded tongue depressor by inserting it quickly & gently if required. Take gauze piece with dissecting forceps. Wrap the gauze piece around the artery forceps covering its tip. Moisten the gauze piece with normal saline or dip in the cleaning agent.

38. Swab each tooth gently but firmly & clean all the sides of the tooth. Clean chewing surface first & then, inner & outer surface from gum to crown. Clean lower teeth on both sides followed by upper teeth on both sides. Gently swab roof of the mouth, gums & inner side of cheeks. Clean the tongue from back to front using artery forceps covered with gauze.

39. Clean the teeth & tongue in similar way using the plain water. Apply emollient to the lips using cotton applicator. Position the patient in comfortable position. Lower the bed. Replace the article after discarding the waste, remove gloves, discard it & wash hands. Record date, time & solution used, condition of mouth & any abnormalities, like bleeding/inflammation.

40. After procedure Apply emollient over the lips. Remove and dispose off equipment appropriately. Remove and discard the gloves. Remove kidney tray, mackintosh and towel. Make the patient comfortable. Tidy up the unit.

41. In unconscious patient, if there is collection of secretions in mouth, apply suction. Take all the articles to treatment room. Discard the waste as per protocol of biomedical waste management and clean the articles with soap and water. Wash hands.

42. Record the time and nature of treatment and condition of the mouth on nurse record. Document assessment of the teeth, tongue, gums, and oral cavity.