Beruflich Dokumente
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College of Nursing
Medical surgical Nursing
Module 4 -122
:Prepared By
Lecturer/ Magda Bayoumi
:Definition of Hygiene
Hygiene is the science of health and its maintenance. Personal hygiene is the self-care by
which people attend to such functions as bathing, toileting, general body hygiene, and
.grooming
Hygiene is a highly personal matter determined by individual values and practices. It involves
care of skin, hair, nails, teeth, oral and nasal cavities, eyes, ears, and perineal-genital areas
.
It is important for nurses to know exactly how much assistance a client needs for hygienic
care. Client may required help after urinating or defecating, after vomiting
Benefits
Cleansing the skin: removal of perspiration, some bacteria, sebum, and dead skin cells
.minimizes skin irritation and reduces the chance of infection
Stimulating circulation: muscle activity, warm water, and stroking extremities enhance
.circulation
Reducing body odors: secretions and excretions from axillae and perineal areas result in
.body odors that are eliminated by bathing
Improving self-image: promotes relaxation and feeling clean and comfortable. Care of hair
.and teeth enhances appearance and sense of well-being
:Intervention
Bathe less frequently; rinse away all soap or use a waterless cleanser
.rather than soap; increase fluid intake; use moisturizing lotion
Wash hair daily. Wash skin twice daily with warm water and soap to
remove oils and cosmetics (if used.); cosmetics that can accumulate in pores
should be used sparingly. Topical antibiotics, if prescribed, may minimize
.problems
Shaving is safest method; electrolysis and laser permanently remove hair
by destroying hair follicles; tweezing and bleaching are temporary measures;
depilatories may remove unwanted hair but may cause infection, rashes, or
.dermatitis
Wash thoroughly; apply antiseptic spray or lotion to prevent further
.itching and aid in healing process; warm or cold soaks relieve inflammation
Identify and avoid contributing agents; provide linens rinsed and
.sterilized to minimize irritation
Wash with mild soap and water; observe dressings for retained moisture,
.which can increase risk of infection
Early morning care: is provided to clients as they awaken in the morning. The care consists
of providing a urinal or bedpan to the client confined to bed, washing face and hands, and
giving oral care, making bed is part of morning care Afternoon care: often
includes providing bedpan or urinal, washing the hands and face, assisting with oral care to
refresh clients
Hours of sleep (HS) care is provided to clients before they retire for the car, and giving back
.massage
As-needed (prn) care is provided as required by the client. For example, a client who is
diaphoretic (sweating profusely) may need more frequent bathing and a change of clothes and
. .linen
:Function of Skin
The skin is the largest organ of the body. It serves five major functions 1-
It protect underlying tissues from injury by preventing the passage of microorganisms (the
(body's first line of defense
It regulate body temperature -2
It secretes sebum, an oily substance that a) softens and lubricates the hair and skin. -3
B) prevents the hair from becoming brittle c) decrease water loss from the skin when the
Bathing removes accumulated oil, perspiration, dead skin cells, and some bacteria. The
nurse can appreciate the quality of oil and dead skin cells produced when observing a
person after the removal of the cast that have been on for 6 weeks. Applications of oil
over several days are usually necessary to remove debris. Excessive bathing, however,
can interfere with the intended lubricating effect of sebum, causing dryness of the skin.
This an important consideration, especially for older adults who produce less sebum.
Bathing also produces a sense of well-being, it is refreshing and relaxing and frequently
improves morale, appearance, self respect.
Bathing offers an excellent opportunity for the nurse to assess all clients. The nurse can
observe the condition of the client's skin physical conditions such as sacral edema or
rashes.
:Bath Categories
Two categories of bath are given to clients: Cleaning and therapeutic
:Cleaning baths are given chiefly for hygiene purposes and include these types
Therapeutic baths: are given for physical effects, such as to soothe irritated skin or treat area
(e.g; the perineum). Medications may be placed in the water. The client remains in the bath for
a designated time, often 20-30 minutes.
:Nursing Diagnosis
Bathing/Hygiene Self-Care Deficit is appropriate when the focus of care is helping the client
move toward independence in bathing. The client may be unable to wash body parts, to obtain
or have access to a water source, or to regulate water temperature or flow. Contributing factors
may include impaired physical mobility in which range of motion (ROM) or muscle strength
is limited or an alteration in mental state. Shortness of breath with activity or excessive fatigue
.when bathing may also be contributing factors
Risk for Impaired Skin Integrity should be considered when the client has reduced
sensation, immobility, impaired circulation, incontinence, inadequate nutrition, or fragile skin
.associated with advancing age
Impaired Skin Integrity is an appropriate diagnosis for the client who has actually
experienced a loss in skin integrity. Pressure ulcers, vascular ulcerations, and blistering are
Imbalanced Nutrition: Less Than Body Requirements should be considered when a client's
appetite and intake are diminished because of altered mucous membranes, and the aim is to
.increase oral intake by improving oral hygiene
Dressing/ Grooming Self-Care Deficit is appropriate when the focus is to improve a client's
.ability to provide self-care with oral hygiene or hair care
Disturbed Body Image is often appropriate when the client loses interest in grooming or
experiences hair loss. This should also be considered when the client displays a lack of
.interest in appearance, especially when medical treatment alters body appearance or function
Ineffective Health Maintenance is appropriate when client teaching related to foot care is the
.focus of care for a diabetic