Ch.40 P&P, Hygiene, Part 2

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

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Ch.40 P&P, Hygiene, Part 2

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	Created by Michelle Arlotto almost 8 years ago