hygienic care.pptx full eplanation for all

hygienic care

1. HYGIENE, CARE AND GROOMING By Mr. Abraham A.( BScN,MScN ) 1

2. Bed bath Is a bath given to a patient who is unable to give care for him/her self. Purposes To promote comfort, relaxation and cleanliness To stimulate circulation To prevent bad body odors feel To prevent pressure sores To relax and refresh the patient Maintain muscle tone & joint mobility 2

3. To improve self image To give an opportunity for the nurse to assess patients To prevent multiplication of pathogenic micro organisms on the skin surface. 3

4. Indication: Patients who are weak seriously ill and for pt that has certain heart conditions unconscious, paralyzed or confused patient 4

5. Precautions Avoid scratching the skin with jeweler or long sharp fingernails. Avoid harsh scrubbing, use of rough towel or wash clothes. Assess the status & level of mobility. Maintain adequate privacy and warmth throughout the procedure and drape appropriately. Identify if there are limitation of movements or position for pt. 5

6. Bath water must be warm enough and change throughout the procedure when it becomes cool, too soapy, dirty or after washing the genital area Always wash from clean to dirty. Determine allergies to soap and other cream lotion. Clean the eyes with water from the inner to the outer cantus. 6

7. Giving tub bath Type of bath that allow direct washing and rinsing by using shower Shower: - The pt is assisted to the bathroom, sits or stands and spray of water is usually directed on to the body. 7

8. Purpose To promote comfort relaxation and cleanliness To stimulate circulation To prevent bad body odors To relax and refresh the patient Maintain muscle tone & joint mobility To prevent multiplication of pathogenic micro organisms on the skin surface. 8

9. Precautions Adjust temperature and flow of the water Avoid chilling Always keep bath room un locked Check pt frequently for sign of exhaustion. Make sure that the tub shower clean and functioning Place disposable rubber or plastic materials on the floor of the shower Instruct patient not to use oil during bath If sensation is normal, ask client to test water, and adjust temperature if water is too warm 9

10. Giving back care Is purpose full manipulation (massage) of the muscle and tissues. It is also known as back message, back rub. Purpose Provide psychological & physical comfort (reduce tension, anxiety stress, stimulate and relax muscles) Increase general and local circulation 10

11. Improves muscle and skin functioning Prevent bedsore. To relieve insomnia (inability to sleep) It provides opportunity for the nurse to assess the patient condition . 11

12. Precautions 1.Massage pressure areas gently, massage the back by using appropriate technique.-duration of massage should not exceed 20 minutes 2. Repeated back massage may possibly cause subcutaneous tissue degeneration. 3. Frequent positioning is preferable to back massage 4. Inspect skin areas of pressure points for whitened or reddened areas that do not disappear after rubbing. 12

13. 5 . Covering areas not being massaged & prevent unnecessary exposure 6. Lubricating palms to decreases friction on skin during massage. 7. Identify location of bony prominences to avoid direct pressure NB- Circular movement should be used on bony prominences. 13

14. Mouth care Mouth care: - Care of the mouth which includes brushing the teeth, mouth and tongue with mouth wash solution and rinse it with water Routine mouth care:- is providing oral care at least three times a day for hygienic purpose. Special mouth care: - Is a care given to entire mouth, teeth, tongue and gum in an increased frequency using mouthwash solution for helpless patient. 14

15. Purpose Keep the mouth clean and fresh, which provide the pt sense of well being. Stimulate appetite Prevent dental decays & halitosis (bad breath) Remove food particles, dead epithelial cells, microorganisms from around and b/n the teeth tongue & lips. Prevent inflammation of tongue, gums & oral mucous. 15

16. Prevent spread of infection to other parts of the body Indications for special mouth care Is un conscious Is not taking oral food or fluid Has mouth infection or inflammation e.t.c . 16

17. Equipment Solutions Sodium bicarbonate solution ½ Tsp in 250 ml, of water Hydrogen per oxide solution Glass of Clean water Normal saline solution Lemon juice Other mouth wash solution if a specially ordered. 17

18. Mouth gag Emesis basin Glycerin/petrolatum Cotton tipped application Receiver Towel Tissue paper or piece of gauze Denture care cup 18

19. Toothbrush and paste Forceps Sputum mug Tongue depressor wrapped with gauze bandage Lubricate (liquid paraffin or mineral oil, cold cream, glycerin , Vaseline) Drinking tube (straw) 19

20. Procedure 1. Explain procedure to the patient and wash your hands 2. Have all equipment read on the bed side table 3. Set on the semi sitting position and up the head of the bed 4. Place towel under patient’s chin across his/her chest 5. Turn patient’s head to the side and arrange basin at corner of the mouth 20

21. 6. Dip applicator in mouth washes solution and cleans the inside of the mouth, the tongue, and the teeth gently and carefully. 7. Discard the swab. 8. If the teeth are difficult to clean, a larger swab can be used. This is done by Wrapping several turns of cotton around a tongue depressor. 21

22. 9. If the tongue or lips are dry and cracked, moisten an applicator with lubricant and gently wipe them with mineral oil, liquid paraffin, Vaseline or any suitable cream. A mixture of lemon and glycerin is also good. 10. If he/she is unconscious, hold the mouth open with a tongue depressor padded with gauze. 22

23. 11. This care should be done in the morning, at night and after each meal if possible. 12. Wait at least ten minutes after patient has eaten to prevent nausea. Do not go far back on the patient’s tongue as it may gag him. 13. Chart – procedure, time and observation. 23

24. Care of dentures it is a care for artificial teeth . Purpose To Freshens mouth and facilitates intake of solid food. To remove microorganisms 24

25. Assist client with denture removal: Top denture: With tissue, grasp the denture with thumb and forefinger and pull downward. Place in denture cup. Bottom denture: Place thumbs on the gums and release the denture. Grasp denture with thumb and forefingers and pull upward. Place in denture cup After cleaning assist client in replacing dentures 25

26. Giving bedpan and urinals Giving bedpan and urinals is the process of giving bedpan or urinal for pts in bed. Purpose To provide receptacle for elimination of waste material for clients confined to bed. To obtain specimen of urine or stool for laboratory examination. To obtain an accurate measurement or assessment of the client’s urine or stool. 26

27. Indication Bed ridden patients Patient with problem of the spine Patient with cast or fracture For critically ill patients Post operative patients 27

28. Type of bed pans Regular bed pans-made of metal or hard plastic ,has a curved smooth upper end and tapered lower end A fractured pan- designed for clients with body or legs casts or clients restricted from raising their hips 28

29. Type of urinals: Males Females Time Early morning, after each meal and at bed time-PRN (when required). For maternity patients four hourly during the day. For patients with diarrhea or dysentery-PRN (when ever necessary). In case of frequency of urine-PRN 29

30. Perineal care Perineal care:- is a cleaning procedure prescribed for cleansing the perineum and genitalia of male or female patient. It can be clean or sterile procedure. Routine Perineal care: - Is done for hygienic purposes routinely twice a day and more frequently during menstruation and excess vaginal discharge . 30

31. Special Perineal care: - Is a care given after various procedures for therapeutic and preventive purpose using strict aseptic technique. Purpose To remove normal perinea secretions and odors To prevent infection To promote client comfort To facilitate healing 31

32. To prevent irritation and ulceration of the genitalia Indication Infection on the genital and perineum Surgery of the genitalia and perineum Post delivery Incontinent patients pts with indwelling catheter Abnormal or un pleasant discharge from the genitalia 32

33. Equipment 1. Pitcher or container with warm water 2. Prescribed solution 3. Sterile forceps or glove 4. Protecting materials ,draw sheet 5. Gauze swabs 6. Perineal pad 7. Bowl or kidney basin 8. Bed pan/urinals 9. Screen 33

34. Procedure 1. Prepare tray or trolley with the above equipment, cover & take to patient’s room. 2. Explain procedure to patient. 3. Assist patient to use bedpan. 4. Remove soiled pad and place in bowel or kidney basin. 5. Move tray or trolley near bed. 6. Fold the blanket to foot of the bed 34

35. 7 . Flex patient’s knees and cover with top sheet. 8. Take the sterile cotton swabs with forceps, pour solution on the cotton and clean perineum using downward strokes. Use only one cotton swab for each strokes. 9. Repeat cleansing the perineum pouring the solution over the genitalia. 10. Avoid hurting the perineum with the forceps. Be careful with episiotomies stitches 35

36. 11. Dry perineum and genitalia thoroughly using cotton swabs. If patient has episiotomy observed for any signs of infection – swelling, discharge etc. medicated powder or solution may be applied according to the orders. 12. Remove bedpan 13. Turn patient on one side and dry anal area. 14. Place perineal pad across perine um. 36

37. 15. Avoid contaminating the inner side of pad 16. Apply T – Binder ( as needed) 17. Straighten bed and leave patient comfortable 18. Remove soiled article, clean and return to their proper places. Perineal swabbing should be done at least three times daily and each time following bowl movement. 37

38. Sitz bath A sitz bath can refer to a bath where the pelvic region is immersed in warm water Purpose To cleanse perineal area To soothe perineal area To reduce sign of inflammation of perineal ,vaginal area after child birth 38

39. Cleanse and soothe and reduce inflammation after vaginal or rectal surgery Hemorrhoids or fissures Indication Following surgery in anorectal region Following incision in the perineal (episiotomy) Swollen painfull hematoma 39

40. Contraindication DM Impaired peripheral sensory function Immediate post hemorroidioctomy 40

41. Equipment 1. Large Basin 2. Fenestrated chair ( sitz bath chair) 3. Glove 4. Bath thermometer 5. Tissue paper or towel 6. Common Medication (Common salt,KMnO4, Betadine solution) 41

42. Procedure 1. Check for specific order 2. Assemble equipment and take to the bath room ( may be given in the room in mobile sitz bath chair if available) 3. Clean tub and fill half – full. 4. Check temperature of water (must be as patient can bear). 5. Close windows and explain procedure to patient 42

43. 6. Take patient to the bathroom and assist to undress as necessary. 7. Assist patient to sit in a big bowl of warm water or in a tub. 8. Observe patient’s condition and check pulse. Discontinue treatment if patient feels dizzy. 9. Avoid chilling, drape shoulders with bath towel. 10. Allow pt to stay in the water for about 20 – 30 minutes, check patient frequently. 43

44. 11. Assist patient to dry, dress and return to room. 12. Clean bowl or tub and discard used linen. 13. Apply dressing if needed. 44

45. Hand and foot care Feet and nail often need special attention. Assess the appearance of feet & nail to identify existing problems or clients at risk of developing foot or nail problems. Purpose: To prevent the client’s hands and feet odour To have soft, hydrated skin. To maximized functional ability of hands and feet. 45

46. To make client comfort and relax. Indication: Paralyzed client and geriatric . People with diabetic mellitus and clients with poor circulation are at high risk for foot difficulties/ problems. 46

47. Facial hair shaving facial hair removal of male client that un able to complete self-care . Purpose : to well groomed the client. To keep skin integrity 47

48. Assisting individuals to dress Purpose: 1. To maintain client self esteem 2. To providing protection 3. To promote the client’s dignity Equipment 1. Suitable clothes 2. Mirror 3. Screen 48

49. Procedure 1. Assist the client to select suitable clothes. This may be their own personal clothing or clothing from the clinical area’s supplies. 2. Ensure privacy 3. Assist client to remove soiled clothing, outer garments first. If necessary assist in cleansing prior to redressing. 49

50. 4 . Have clothing available and ready to use. If client has limited mobility or limb injuries as identified during their mobility assessment remove clothing from unaffected side first. 5. Be aware of wounds, drains and indwelling catheters when removing clothing and re-dressing client. 6. Give the client time, and encourage them to perform as much of the activity as possible. 50

51. 7. Remove clothing in a systematic way, e.g. top to bottom, replacing with clean clothing as each item is removed. 8. Choose clothing with easy fitting fastenings. 9. Give client access to mirror to check overall appearance 10. Ensure client is left comfortable. Record any changed care needs in nursing record. 51

52. Giving hair Care Hair care is an important part of daily hygiene care it includes brushing and combing of the hair. Purpose To stimulate scalp circulation To maintain cleanliness of the hair & scalp To prevent the presence of lice & nits To provide pleasure and feeling of self-stem. 52

53. Equipment Brush and comb Towel & oil or Vaseline Procedure 1. Place patient in comfortable position 2. Place towel on top of pillow under patient’s head and shoulder. 3. If hair is badly tangled, comb small part at a time. Oil or Vaseline may be applied to untangle the hair. 53

54. 4. If the hair is long, it should be braided and fastened with rubber band. 5. Observe carefully for pedicli or nits 6. Remove towel and leave patient comfortable. 7. Remove hair from comb & brush, wash and dry. 54

55. Hair shampoo Hair shampooing is the washing of the hair in bed or out of bed Purpose To remove dirty To prevent offensive odour To stimulate circulation of the scalp To keep the hair and scalp cleaned and healthy To treat condition of the hair and scalp 55

56. To provide comfort and good appearance Precaution Determine the facilities available for the procedure and the pts condition (pt may have their hair shampoo during a bath or a shower. If pt is bed ridden the shampoo may be performed with the pt in bed or lying on a trolley) Use devices to protect neatness of the bed and pts gown Observe condition of the pt. throughout the procedure. 56

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58. Giving pediculosis treatment Pediculosis is a condition in which the hair is infested with lice or pedicles . pediculosis treatment: - is an application of pesticides such as gamma benzene hexachord (BHC) Purpose To kill and remove pedicles and nits from head and hair To prevent transmission of pedicles. To make patient comfortable 58

59. Precaution Avoid treatment from interring the eyes, nose and throat Apply Vaseline on the fore head to prevent irritation Instruct the pt not to wash before 12 – 24 hrs Contact family member of the pt and treat them as well. Teach the pt and pts relative the importance of keeping the hair and the body clean. Hands must be washed after scratching the hair. 59

60. Equipment 1. Gown and cap (for the nurse) 2. Rubber sheet and cover 3. Bowel with swabs - 4. Gauze or cotton 5. Bowel with Vaseline 6. Bowel with medicine to be applied 7. Kidney tray 8. Comb or fine-toothed comb 9. Dustbin 10. Cape to cover patient after treatment 60

61. Procedure 1. Position patient conveniently 2. Wear gown and cap to protect yourself. 3. Place towel and rubber sheet over pillow. 4. Apply Vaseline to forehead and around the edges of hair to prevent skin reaction. 5. Apply medication on entire head 61

62. 6. Wrap head with head cover or clean scarf and leave for several hours (12-24hrs) wash hair. 7. Comb hair with fine tooth comb to remove dead lice. 8. Chart – treatment, time and observation 9. Repeat treatment as needed. 10. Collect used rubber and cover, Send to the laundry separately. 62

63. Care of eyes a care given for eyes with aseptic technique Purpose To prevent infection To remove foreign bodies Indication client’s with artificial eye Comatose patients 63

64. Equipment 1. Sterile eye-dressing packs 2. Sterile 0.9 per cent sodium chloride 3. Tray for equipment 4. Clinical waste bag 5. Gloves (if risk of contact with blood or body fluids). 6. Apron 64

65. Procedure 1. Explain procedure to client 2. Apply apron and wash hands 3. Gather all equipment 4. Ensure privacy for the client 5. Ensure good light source 6. Assist the client into a comfortable position 7. Prepare equipment, wash hands 8. Cover the client’s chest using the towel from dressing pack 65

66. 9. Instruct client to close their eyes 10. Moisten swab in the solution and gently swab from the inner canthus outwards, using one wipe. Repeat in the same direction until the eye is free from crusts/discharge. Repeat on the other eye, all the time observing the general condition of the eyes 11. If the client has an infection, wash hands before moving from one eye to the other and always swab the non-infected eye first 66

67. 12. If the eye is to be touched to remove a foreign body, a cotton bud should be used 13. Gently dry the client’s eyelids 14. Remove and dispose of equipment safely 15. Leave the client comfortable. Remove apron and wash hands 16. Evaluate care delivery, document and report any change in client’s condition 17. Update care plan as necessary 67

68. Ear care/irrigation Ear irrigation is the process of flushing the external ear canal with sterile water or sterile saline. Purpose To remove ear wax or foreign object lodged in the ear canal. Less invasive than using an instrument 68

69. Precautions The ear canal should be examined with an otoscope prior to ear irrigation Ear irrigation is contraindicated if the eardrum is ruptured, because the procedure may force bacteria through the perforation into the inner ear 69

70. Ear irrigation is also contraindicated in patients with fever and ear pain, as these symptoms may indicate an inner ear infection. If a foreign object is made of vegetable matter (e.g., a bean or pea), irrigation is contraindicated because the water will cause the object to swell and complicate extraction of the object. 70

71. Equipments Irrigating solution at room temperature: Example Luke water A container for the solution. A syringe or bulb suction(50–60-cc syringe (20–30-cc syringe for children) or ear irrigation set) A small basin/kidney dish as receiver 71

72. A towel cotton ball Hydrogen per oxide solution Procedure 1. Wash your hands 2. Wipe out the ears with a clean wash cloth and remove the excess wax. Usually you can loosen the wax by pulling the ear lobe downward. 72

73. 3. If the wax can still not be dislodged, you may need to irrigate the ear canal. 4. To irrigate ear a) Fill the syringe or bulb suction with the irrigating solution b) Gently pull the ear lobe up and back to straighten out the ear canal, so that the solution can flow through the whole canal. 73

74. c) Put towel on shoulder at the side of ear to be clean d) Insert the tip of the syringe or bulb suction into the ear and very gently direct the solution into the canal. e) Let the solution drip out with the kidney dish at the ear side and be sure the syringe does not block it 74

75. 5. When you have finished, wipe the outside of the ear and ask the patient to turn onto one side with the ear down. 6. Put a towel under the ear to keep the bed d ry. 75