Anatomy physiology of integument system

Understanding the skin Crust Function of the skin Glands of the skin Nerves in the skin Blood vessels in the skin Skin tissue Skin pigmentation Skin appendages Physiology of the sense of touch White reaction Triple response Active hyperemia Various skin diseases

Dermatitis

Definition Cause Signs and symptoms Means of prevention

Getting treatment Askep dermatitis

The concept of nursing actions

Personal hygiene (skin care, nail the feet and hands, teeth and mouth, eyes, ears, nose, hair, and perineum) Environmental hygiene (sweeping, mopping, making beds, and melawa-lawa).

DISCUSSION

Anatomy physiology of integument system

Understanding the skin

The skin is a layer of tissue found on the outer cover and protect the surface of the body, associated with mucous membrane that lines the cavities of entrance holes. Boils on the skin surface and mucous glands sweat glands.

Crust

Epidermal

Stratum corneum.

This layer consists of many layers of horn (keratinasi), flat, dry, core, core cell is dead, and if you lack the substance keratin.

Stratum lusidum.

Flattened cells, the difference with the stratum granulosum are cells that have lost a lot of core and cell grains have become clear once and translucent light.

This layer is only found on the palms of hands and soles of the feet. In looks like a pipe layer of the cornea, the boundaries are not so visible cells called the stratum lusidum.

Stratum granulosum.

This layer consists of 2-3 layers of flattened cells like coil with middle nucleus and cytoplasm containing granules (granules) keratohiali or keratin combined with hyaline. The foreign object blocking layer, germ and chemical bahn into the body.

Stratum spinosum / akantosum stratum.

This layer is the thickest layer and can reach 0.2 mm consists of 5-8 layers. spinosum cells called because when viewed under a microscope, the cells consist of cells that form polygonal / many corners of having horns (spina). This layer serves to hold the friction and pressure from outside. Forms a thick and available in many areas of the body that come into contact or support the weight and pressure such as the heel and the heel of the foot.

Akantosum called because its cells spiked. Turns spine or horn is no relationship between other cells called intercelulair intercellular bridges or bridges.

Stratum Basal / germinativum.

Called the basal stratum as the cells located at the basal / base, stratum germinativum replace cells on it and a stem cells.

The shape is cylindrical (tube) with oval nuclei. In it there is a grain of subtle color called melanin grains.

The cells are arranged like a fence (palisade) at the bottom of the cell there is a membrane called the basement membrane, basal cells with the basement membrane is the bottom line of the epidermis to the dermis.

This limit turns out not flat but undulating, at times korium prominent bulge in the epidermis is called kori papilla (papilla skin). On the other hand protruding toward korium epidermis, bulge is

called Route Ridges or rete peg = prosessus inter papillary.

Dermis.

Dermis layer structure

The dermis is the second layer of skin, the epidermis boundary lined by basal membrane and on the bottom adjacent to subcutaneous but this limit is not clear just taken as a benchmark is the start there fat cells.

Dermis consists of two layers:

Top, Pars papillary (papillary stratum). Bottom, reticularis (reticular stratum).

Boundary between the papillary pars pars reticularis is the bottom up to the subcutis. Good pars and pars papillary reticular fibers consist of collagen fibers which, elastic fibers, and fibers retikulus.

The fibers of each beranyaman and each has a different task.

Collagen fibers, to give strength to the skin, elastic fibers to provide flexibility in klit, and there retikulus especially around glands and hair follicles and gives power to the appliance.

Cell elements:

The main elements of the dermis is the fibroblast cells, macrophages, and there is a group of fat cells. Besides, there are also branched connective tissue cells and epidermal pigmented in an environment that contains pigments such as mammary areola and around the anus.

Muscle fibers:

Smooth muscle fibers found in the dermis are arranged into a file associated with hair follicles (muscular erector fili) scattered throughout the dermis in considerable amounts on the skin, nipple, penis, scrotum and partly perenium.

3.Subkutis.

Subcutis composed of clusters of fat cells and among these gangs running the connective tissue fibers of the dermis. The fat cells are round with essentially pushed to the edge, so as to form such a ring.

This fatty layer called perikulus adiposus, the thickness is not the same in each place and also the division between men and women are not the same (different).

To perikulus adiposus is as Shock Absorber = spring / mechanical trauma when the pressure is

affecting the skin, heat insulators or to maintain temperature, hoarders calories, and added to the body beauty. Below the subcutaneous muscle membranes are new then there is muscle.

Skin tissue.

Integument or skin called cutis which grew from two kinds of tissue jaringanyaitu epitelyang grow layers of the epidermis and connective tissue (supporting) the growing layer of the dermis (skin).

Skin glands.

Skin glands include the sebaceous glands, sweat glands, and mammary glands.

Sebaceous glands.

These glands are associated with hair follicles which empties into a hair follicle. Gland that is not associated with hair follicles leads directly to the surface of the skin as well as on the glans penis, labium minus, and tarsalia glands in the eyelid.

This gland is located in the dermis of the skin and there are feet and hands. Development and growth of sebaceous glands mainly occurs during puberty under the control of hormones, sebum secretion occurs continuously and beneficial for the maintenance of healthy skin.

Sweat glands.

Sweat glands are coiled tubular glands are unbranched; present in all except the skin at the base of the nail, lip border, the glans penis and the eardrum. These glands are most numerous on the palms of the hands and feet. Sekretorisnya section located in the dermis or hypodermis and combine to form its own mass.

Duktusnya out into the epidermis and winding run and walk together with epidermis spiral to reach the skin surface. Bermuaranya place called sweat pores. There are two kinds of sweat glands namely eccrine and apocrine sweat glands.

1) eccrine sweat glands.

Scattered throughout the skin, but the inner foreskin of the penis and the outer ear, the palm of the hands, soles of feet and forehead. There is a border between the gland body epidermis

(epidermis) and the skin dermis. The line winding out and are on the run hides layers straight into the pores of sweat.

2) apocrine sweat glands.

Sweat glands are large and can only be found in the armpit, nipple skin, the skin around the genitals and rectum.

These glands are located deeper and twist both channels and then straight to the epidermis and lead to hair follicle.

Glandular breast (mammary gland).

Including the mammary gland skin glands because it comes from the ectodermal layer functionally including the reproductive system. This gland is located on top of the pectoral fascia superfisilis are connected by means of loose connective tissue and fat tissue. This gland is firmly attached to the overlying skin. Around the nipple (mammary papilla) there reticulum cutis that grow well and called the suspensory ligament. Into a 15-20 lead duktuli nipple ducts.

Around the mammary papilla are areala mammary montgomeri containing sebaceous glands (glands mammary areola) that serve to protect and lubricate the nipple when the baby sucks. In women who are not pregnant and not breastfeeding, looks small and dense alveoli contain granular cells. At the time of pregnancy, the alveoli will be enlarged and enlarged cells.

Skin pigmentation.

Skin color is determined by the color of his own skin factor. The content of carotenoids (pigment) in the blood of the blood vessels, the dermis gives a reddish color and content of melanin pigment gives brown shadow.

Melanin located in the basal layer and the bottom layer of the epidermis taju made by the specialized melanocytes are scattered among the basal keratinocyte layer and layer taju in hair follicles and connective tissue dermis. Skin color difference caused by the difference in the number and size of melanosomes in keratinocytes.

Skin pigmentation depends on various factors: heredity, hormones, and the environment. Genetic factors influence the size of the epidermal melanin unit. Hormone boosters malanosit MSH (melanocyte stimulating hormone) stimulates the transfer of melanosomes into the cytoplasm branches melanocytes and keratinocytes. Environmental factors such as ultraviolet increase enzyme activity and increased production of melanocytes and melanin in the keratinocytes penimbunannya so the skin becomes brown.

Blood vessels.

Pembuluhdarah consists of two woven leather arteries are:

1) Woven leather arteries above or outside.

These are woven between the papillary stratum and stratum reticularis, of the webbing runs arterioles in each papilla kori.

2) Matting arteries under the skin or inside.

There are inter-woven and subcutaneous korium, this matting provides arterial branches lat-kea additional tools contained in korium.

In this case also formed woven branching arteries contained in the subcutaneous layer. These branches will then be a vein / vein which will also form the webbing, the webbing that vein into.

Blood circulation in the skin is imperative therefore estimated one fifth of the circulating blood malalui skin. Besides the blood vessels in the skin very quickly narrowed / widened by influence

or stimulation of heat, cold, pressure sore, nyaeri and emotions, constriction and dilation to occur by reflex.

Skin nerves.

Other organs such as the skin also contained spinal nerve branches and surface consisting of motor nerves and sensory Saaf.

Motor nerve endings is useful to move the muscle cells are found in the skin, whereas the sensory nerve stimulation is useful to accept that there are external or skin. Endings in the skin, the sensory nerves to form a variety of activities to receive stimuli.

Nerve endings which are free to receive stimuli pain / aches are common in the epidermis, nerve endings here have a distinctive shape that is already an organ.

Skin appendages.

Nails.

Nail plate to form a protective phalanx dorsal surface terkhir wrapping tissue and toes. The structure is related to the dermis and epidermis.

1) Structure of the nail.

Proliferating nail tools nail matrix form, directly beneath the epidermis which became the basis of U-shaped nails when viewed from above and flanked by a flap of skin that the nail wall. Nail plate consists of tightly fused epidermal scales and not peeling. Body colored translucent nail that looks reddish because of blood capillaries in the nail elementary.

Stratum corneum cells extends from the wall surface of the nail plate to the nail or cuticle sebgai epikondrium.

Part of the nail, consisting of:

i. Nail tip on the tip line.

ii. Body nails are a large part.

iii. Nail root (radik).

2) The growth of the nail.

Premises growing new cells in the root, nail produces a slow slide over the nail plate polish elementary. Nail growth rate average of 0.5 mm per week.

Hair.

Keratin hair elastic yarn which is evolved from the epidermis and spread throughout the body except the soles of the feet and palms, the dorsal surface of the distal phalanx, anus and urogenital environment. Each hair has a rod that is free and will be embedded in the skin.

Hair roots are wrapped by hair follicles that form of section bersal of epidermis (epithelium) and the part that comes from the dermis (connective tissue).

1) Structure Hair:

Medulla. Merupakn the center of the loose hair is composed of 2-3 layers of cells that contract cabbage sam one another, and dipisahkn by air-filled space. Cortex. The main part of the hair is formed of several layers of cells in flat, long, and shaped waves that form hard keratin. Cuticle. On the surface, a thin layer of cells, clear and cuticles are not core, except that there is at the root of the hair.

2) The hair follicle.

Sheath of hair follicles is composed of the outer sheath of connective tissue (dermis root nest) derived from the dermis and the inner root sheath epithelium derived from the epidermis. Forming swollen follicle and hair bulb papilla in touch with the roots of unity hair and veil.

3) Gloves root origin of the dermis.

Outermost layer of coarse collagen fiber bundle that runs lengthwise in accordance with the reticular layer of the dermis.

The middle layer is thicker in accordance with papillary layer of the dermis. Layer in the form of small homogeneous SABK called glassy, basal membrane beneath the epidermis. Outer hair root sheath has a layer of polygonal cells that resemble cells of the stratum spinosum epidermis.

While the hair root sheath is heavy horn sheath that wraps the hair follicles that are growing, producing soft keratin, also found in the epidermis.

Rambt arrangement:

a) the hair shaft, the hair is contained in the outer skin. Judging a piece of hair from the outside to

the inside as follows:

(1) Membrane hair (cuticle), is the outermost layer and consists of cells arranged bouffant tandukyang well.

(2) Leather hair.

Hair cortex is the thickest layer of the skin and is composed of the stratum corneum is composed of elongated spindle-shaped and contains items myelin.

(3) Hair marrow (medulla), was the most in a cell formed by the horns and looks like woven with air-filled cavity.

(4) Root hair

An oblique section of hair that is embedded in the skin and bladder veiled by hair (hair follicles). This tertanan hair roots can reach deep to the hypodermis layer.

Hair roots consist of:

Bladder tube that envelops the hair hair follicles from the skin surface at the hair bulb samapai. Papil hair, is the bottom of the hair follicle is an egg-shaped oval like the bottom end is open

and contains connective tissue without elastic fibers. Hair bulb (hair buds) are part of the root hair is widened and lymph cells continuously multiply and thrive in mitosis.

(5) Muscle hair enforcement

Muscular enforcement erector pili muscles of hair is made up of smooth muscle in the bladder contained hair through the elastic fibers. When this muscle contracts, the hair will be straight and will undergo compression gland so that it will be pushed out for a hair grease.

(6) Hair Growth.

Hair growth occurs as a result of mitotic cell-derived matrix cells of the epidermis and undifferentiated located above the surrounding peaks hair papilla. The cells at the base of hair follicles into outer root sheath cells of hair matrix is tratum malpigi epidermal cells eventually become Air horn substance. Hair has a certain growth period ie 0-3 years for scalp hair and eyelashes 3-4 months.

Skin as the sense of touch.

The sense of touch due to stimulation of the nerve endings on the skin vary depending on the nerve endings are stimulated, heat, cold, and pain caused due to the pressure and heavy taste of a body such as the muscles and bones.

There are five senses of touch on the skin in addition to the skin as well as the heat release in the body, the skin covering and is associated with mucous membrane that lines the cavities and holes. Skin has many tactile nerve endings that receive stimuli from outside forwarded kepusat nerves in the brain.

Tactile sensation of the skin.

Consists of skin sensation of taste, touch, pressure, heat, cold, and pain. Receptors are widespread in the epithelial layer and the connective tissue of human body. Each receptor is different, which is the most pain receptors, then the sensation of touch, cold, and heat.

Receptors are located in the epithelial layer, found in the mouth and respiratory tract mukos for the sense of touch and pain, and network layers pitel sprawl on the hair roots. Receptors are located in the connective tissue of the skin is very much below the mucosal lining around the joints, pleura, endocardium, peritoneum, and others.

The sense of touch is caused by the stimulation of nerve endings in the skin vary depending on the nerve endings are stimulated heat, cold, pain, all these different feelings. In the skin there are certain places where palpability that is sensitive to cold and sick. Feeling the pressure caused a very deep and taste that allows a person to determine and assess the weight of an object arises in deeper structures such as the muscles and joints.

Function of the skin

Human skin has a very important function in addition to establishing the general viability, namely:

Protection function.

Skin keeping the body against physical or mechanical disruption, such as the friction, traction, chemical disorders that can cause irritation (lisol, carbolic acid and a strong acid). Heat disorders such as radiation, ultraviolet light, interference from outside infections such as bacteria and fungi. Because of the fat pads, thick layer of skin and supporting tissue fibers act as physical protection against tampering. Turutberperan melanocytes in protecting the skin against the sun with tanning holding (treatment with acetyl acid).

Protection chemical stimuli can occur due to the impermeable nature of the stratum corneum to a variety of chemicals and water. In addition, there is a layer of skin that protects the acidity of chemical contact with the skin. Acidity of the skin layer formed from the excretion of sweat and

sebum that causes skin acidity between pH 5 to 6.5. This is protection against fungal infections and skin cells that have died disengage regularly. Function absorbs.

Healthy skin does not easily absorb water, solution and solid, but volatile liquid more easily absorbed, as well as fat-soluble. Skin permeability to O2, CO2 and water vapor allows skin took part in the function of respiration. Absorption ability of skin affected skin thickness, hydration, moisture, and metabolism. Absorption can take place through the gap between cells, penetrate the epidermal cells, glands or through channels and many more through the epidermal cells.

Skin function as a regulator of heat.

Messkipun body temperature remains stable ambient temperature changes. This is due to the adjustment of the heat generated by the heat regulating center, medulla oblongata. Normal body temperature is the temperature visceral 36-37,5 degrees to lower skin temperature. Innervation and vasomotor control of arterial cutaneous vasodilation there are two ways (dilated capillaries, the skin becomes hot and excess heat emitted into the sweat glands, causing evaporation of the liquid on the surface of the body) and vasoconstriction (the blood vessels constrict, the skin becomes pale and cold, sweat loss is limited , and body temperature heat is not removed).

Leather perform this role in a way to sweat, muscle contraction, and pembuluuh daarh skin. Rich in blood vessels of the skin allowing the skin gets enough nutrients either. Vascular tone is influenced by sympathetic nerves (acetylcholine).

Excretion function.

Skin glands secrete substances that are no longer useful or waste products in the body's metabolism in the form of NaCl, urea, ASAMURAT, and ammonia. Sebum is produced by the skin helps to protect the skin because the layer of sebum (an oily substance that melindungikulit) is hold excess water so that the skin does not become dry. Production of fat and sweat glands causing acidity of the skin.

Perceptual functions.

The skin contains sensory nerve endings in the dermis and subcutaneous. Response to heat stimuli played by the dermis and subcutaneous, the cold played by the dermis, papillary dermis played by touching and Markel renvier, while the pressure is played by the epidermis. Sensory nerve fibers are more numerous in areas of erotic.

White reaction.

When the end of an object slowly pressed on the skin, the line pressure to be pale (white reaction). Mechanical stimuli cause constriction of the sphincter capillaries and blood flow out of the capillaries, this response appears for about 15 seconds.

Triple response.

When the skin is pressed even harder with a pointed tool, most reactions are reddish white. At the venue followed by swelling, redness around the wound spots caused dilation of the capillaries is a direct response to pressure from the capillary. Local swelling due to increased capillary permeability and venolus. Redness due to dilated arterioles and nerve denarvasi obstructions cause pain.

Active hyperemia.

Active hyperemia that abnormalities in blood counts suatudaerah revived after a period of blockage or pressure. The response of blood vessels in the skin occurs in organ blood flow in the blood vessels are dilated skin becomes very red because the local effects of hypoxia and is influenced by chemical substances.

Various kinds of Skin Diseases.

1. Scabies

Scabies is a contagious skin disease, this disease called scabies in scientific language, have symptoms of itching, and the itching will be the at night. Often appear in moist places in the body such as, arm, armpit, buttocks, groin and terkang in celang fingers or toes.

Preventive measures scurvy sperai can be done by washing bedding, towels and clothing worn yan in the past 2 days with warm water and detergent.

traditional medicine:

For external treatment, just take the leaves, bark, stems, or roots regards as necessary. Rinse and finely milled until the faint dough like mush. Apply to places that itch, then wrapped

2. Ringworm

Disease Ringworm is a contagious skin disease caused by the function. Ringworm symptoms began to be recognized when there is a small Baian rough on the skin and surrounded by pink

circles. Ringworm can be prevented by washing hands perfect, body hygiene, and avoid contact with people.

Ringworm can be treated with anti-fungal containing miconazole and kloritomazol properly can eliminate the infection.

3. Panau

Panau or Panu is one skin disease caused by a fungus. Panau disease characterized by patches of skin that are itchy when sweating. These patches can be white, brown or red depending on the color of the skin of the patient. Panau is most often found in young teens. Even so Panau can also be found in patients with old age.

How to prevent skin diseases Panau be done by keeping the skin, and can be treated with antifungal medications that are sold on the market,

traditional medicine:

treated with traditional drugs like betel leaves mixed with whiting and be processed on the affected skin Panau.

4. Ulcers, sores, and warts

traditional treatment

Spread with fruit sap or cashew cashew (Anarcadium occidentale L) for several days until the wound dry

For warts, Pluck the strings skillfully LEAF DEWA 5 pieces, crush the leaves until smooth. Lumurkan leaf that has been refined to a warty, make up glue, and let loose one day to the next morning.

Boils, eczema, and skin diseases

Treatment:

The lotus flower crown strands burned, the resulting ash is also efficacious as a medicine. The ash can be used as an external medicine to cure ulcers, eczema, and skin diseases. While pollen and lotus stamen if mixed with honey and cheese would be a cure hemorrhoids.

Dermatitis

understanding

Eczema or dermatitis is the medical term for skin disorder where the skin looks inflamed and irritated. This inflammation can occur anywhere but are most frequently affected are the hands and feet. Type of eczema is the most common atopic eczema or atopic dermatitis. Eczema symptoms will begin to appear in childhood, especially when their children aged over 2 years. In some cases, the eczema will disappear with age, but not a few who will suffer for the rest of his life. With proper treatment, the disease can be controlled by either reducing the recurrence rate.

Symptoms of Eczema

Wherever the location of the onset of eczema, the main symptom is itching perceived patient. Sometimes the itching has appeared before no sign of redness on the skin. Symptoms normally redness will appear on the face, knees, hands and feet, but did not rule redness appear in other areas.

Affected area will feel very dry, thickened or scab. In white men, this area will initially pink then turn brown. Meanwhile in people with darker skin, eczema affects eczema skin pigment so that the area will appear lighter or darker.

Cause of Eczema

Actually the cause of eczema is not known with certainty, but some experts suspect eczema associated with the activity of the body's defense (immune) excessive. This causes the body to overreact to bacteria or irritants that are not harmful to the skin. Therefore, eczema is commonly found in families with a history of allergic disease or asthma.

Each each person has different triggers eczema different. There are people who once held soap or detergent will feel a tremendous itch, some are caused by material or other household appliance. The symptoms were varied, there was a mild itch but the heat is dominant, some are otherwise. Upper respiratory tract infection or flu can also trigger the onset of eczema. Stress experienced by patients will make the symptoms worse.

Although healing eczema is very difficult to do, but in many cases, patients can reduce recurrence by appropriate treatment and avoiding irritants / allergens that cause eczema. Keep in mind, this disease is not contagious and will not spread from one person to another.

Treatment Method

The main goal of treatment is to relieve the itching to prevent infection. When the skin feels very dry and itchy, lotions and creams are highly recommended to make your skin more moist. This action is usually done when the skin is still slightly damp, like the bathroom so exhausted when a

topical lotion will maintain skin moisture. Cold compresses are also thought to reduce the itching can occur.

Ointments or creams containing corticosteroids such as hydrokortison given to reduce inflammation or inflammatory processes. For severe cases, the doctor will give corticosteroid tablets and if the eczema infected area then can be given antibiotics to kill the bacteria causing the infection. Another drug that is required is an antihistamine to relieve itching that is too heavy, and cyclosporin for patients who do not respond to any type of treatment given.

Prevention Method

The emergence of eczema can be avoided by doing some of the following tips:

Keep the skin moist. Avoid temperature and humidity changes suddenly. Avoid sweating or overheating too much. Reduce Stress. Avoid clothing that uses materials such as wool and scratching others. Avoid soaps with ingredients that are too harsh, detergents and other solvents. Avoid other environmental factors that can trigger allergies such as pollen, dust, animal dander, and others.

Be careful in choosing foods that can cause allergies

HYGIENE

Hygiene or cleanliness there are 2 of personal hygiene and environmental

v Cleanliness individual.

skin care. Hand foot and nail care Dental care and oral Hair care Treatment of eye, ear, and nose.

Care and perineal area genetalia

Skin Care.

Assessment:

Physical assessment of skin, inspection and palpation, determine client needs for cleanliness. Assess the condition of the skin: observations: color, texture, thickness, turgor, note the presence of lesions.

Nursing Diagnosis:

1. Potential changes in skin integrity with respect to: physical immobility, inadequate nutrient intake, the drainage from the wound.

2. Changes in skin integrity related to: decubitus sores, dry skin and chapped, open sores, burns.

Goals:

- Maintain cleanliness of the skin

- Helps make the client to relax

- Stimulates circulation to the skin

- Develop self-image.

Implementation:

- Bathing client in bed: complete bed bath, partial bed bath.

- Assist clients with bath tub and shower.

Evaluation:

Expected results:

1. skin clean, dry, elastic, good hydration and no inflamed area.

2. no new skin lesions, such as abrasion, decubitus sores / excoriation.

3. lesions: clean, no drainage, smaller than the previous

Hand foot and nail care.

1. Concepts and Theories

Condition of nails reflect the general health status, nutritional status, occupation, and level of care a person. Even the psychological status also may be disclosed from the evidence of bite nails.

Foot and nail care routine can prevent infection, foot odor, and injuries to the soft tissues. Integrity feet and toenails is important to maintain the normal function of the foot so that people can stand up and walk comfortably. The most common problem on the fingernails, toenails and feet caused by excessive care or poor care such as:

Nail Biting

Cutting improper

decorate inappropriately

Exposure to chemicals that sharp

Using the shoe is too narrow

In foot care we should involve the examination of

The skin surface

Form

Size

The number of fingers

Form feet

Conditions toes

2. Destination

To maintain the normal function of the feet and hands as well as maintaining one's self-image.

3. Benefit

Able to perform the correct treatment for the finger, nail and foot tsngsn, and raised self-esteem.

4. Indication

The area between the toes and fingers should be examined carefully. Heels, soles and sides of the foot tends to irritation if the shoe does not fit. Fingers normally is straight and flat. Feet should be in a straight line with ankles and tibia. Painful foot disorders that cause lameness or gait unnatural.

Is the angle between the normal nail polish and nail plate is approximately 160 degrees.

Normal healthy nails are:

transparent

Soft and convex

Alas pink finger

opaque white tip

brow n pigmentation in African Americans

The cuticle should be soft without imflamasi

Contraindications

Bearing Nail abnormalities:

Percussion Beaus lines Koilonika (spoon nails) Flakes bleeding Paronychia

Common foot problems and nail:

CALLUS

Callus is usually flat, tasteless pain, and found under the surface of the foot or palm of the hand.

Corn

Corns are usually cone-shaped, round, and rose.

Foot warts (plantar warts)

Moldy injuries seen on the heel and foot are caused by papilloma virus

INFECTION FUNGAL FOOT (tinea pedis)

Ie fungal infection on the foot, hand inequality and skin cracks between the fingers and the heel of the foot.

NAIL INTO GROWING NAIL RAM HORN

Usually a swerving long nails

PARONISIA

Inflammatory tissue around the fingers occurs after a hangnail or other injury.

SMELLY FEET

due to excessive sweating that enhance the development of microorganisms.

6. Preparation Equipment

Equipment used for the treatment of foot and nail

wash basin

Pengikir nails

bath towels, face towels

Lotion

washcloth

disposable bath mat

Nail clippers

Disposable Gloves

Rubber pad wear bathing sekai

Board smoothing

7. Procedure

Steps foot and nail care:

Wash hands and wear gloves

Set the equipment to be used on the bed table. Pull the curtains around the bed or close your door

Perform assessment and do treatment

Nurses assess gait clients. painful foot disorders that cause lameness or gait unnatural.

Inspection and palpation:

Nurses inspect bearings nail color, cleanliness, length, thickness and shape of the nail plate, nail texture, angle between the nail and nail bed, and the condition of the lateral and proximal nail fold around the nail. For mempalpasi, nurse holding a finger client with care and menobsevasi color nail beds. Then give a gentle pressure, strong, fast with your thumb nail and remove the pads. At the time pressed, bearing nails look white and pale; But, pink should be back on when the pressure is released.

8. Evaluation

Client's response to foot and nail care evaluated properly for a few days or weeks. If the client is having an issue whatsoever, it takes time for change to improve. Evaluation based on the expected outcome requires nurses to determine the success of the intervention. For example, if the client has a continuous discomfort during running then require different types of footwear. The nurse also instructs clients by evaluating the practice of foot and nail care personal.

Health Improvement:

Clients, especially those affected by diabetes, require proper foot care instructions. Many

complications can be avoided. If the client is motivated to carry out foot and nail care proper hygiene as part of their every day. Proper maintenance can also help the elderly to be active, thus enabling them to participate in improving the health of the other activities.

9. Documentation.

Note any procedures performed, and perbahan and abnormalities that occur.

Dental care.

Consists of:

Brushing teeth Clean the mouth (oral hygiene) Maintain the client's mouth jaw fracture Maintain dentures

Dental Care and Oral destination

In order to keep your teeth and mouth clean / no smell Preventing infection in the mouth, tooth decay, lips, and tongue cracked / stomatitis Gives a sense of excitement and fresh on the client Helps stimulate appetite Educating clients in personal hygiene.

Hair care.

A. Hair Classification

There are 4 types of hair, namely:

a. Long hair and hair that is somewhat coarse head.

b. The hair is a little rough but the short form of eyebrows.

c. The hair is a bit rough but not all head hair, armpit hair for example.

d. Smooth hair found on the cheeks, forehead, arms, stomach, back and legs.

B. PURPOSE

The goal is to clean the germs that exist on the scalp, adds a sense of comfort, eradicate lice or dandruff attached to the skin, as well as expedite the circulatory system under the skin.

C. BENEFITS

Benefits of hair care is to maximize the function of the hair itself, namely:

Protector

Real hair in the skin in direct contact with the end - the end buds, quickly able to deliver signal pulses to the brain, so that people are able to react immediately to the situation that is the cause. If we suddenly became very tense or very frightened, muscle hair stuck enforcement contained in the hair and make skin will shrivel hair, hair-raising, or our goose standing.

Heating

The most dominant scalp hair growth and thickness, forming a natural insulator keeping the temperature stability of the scalp from the influence of the surrounding air temperature. Around the cold can not be directly on the scalp since the air insulator obtained from the fixed heating temperature of our body. Instead, the heat will increase the temperature of the surrounding air quickly stimulate insulator perkeringatan. Sweat will evaporate and heat to evaporate need to be taken from the scalp temperature. Thus there will be no increase in temperature of the scalp.

Beauty Enhancer

When viewed from the side of aesthetics, hair also has the following functions:

a. Sign of social status

b. Professional identity

c. Support the appearance

D. INDICATIONS

As for some disorder that attacks the hair, although abnormalities are clustered not contagious, the abnormalities are as follows:

a. Pearl disease, is a kind of small items attached to the hair, round shape gray rather whitish. This place brittle hair and split in the end. Usually caused by less clean when washing hair or the remnants of chemicals such as shampoo, hair spray (cosmetic ingredients for hair styling). In addition, the most fundamental is the widespread damage to the lining of the hair shaft.

b. Cinities is the term for gray hair (white hair). Gray hair occurs when the hair dye / pigment hair began to disappear pressured by weaker sex. Gray hair condition may occur due to aging, congenital defects, heredity, and so on. In addition, this also causes cinities because of a disease such as leprosy or mental collapse suddenly, many thoughts and so on.

Cinities there are 2 kinds:

1) Congenital Cinities, this occurs from birth. So there is no substance in hair color (pigment) and sometimes there disekelompok her head hair.

2) Acquire Cinities, appeared after the start age or the age of adulthood. This is usually caused by mental depression, anxiety, nervousness, pain or sick time derivative.

c. Trichoclasia hair disease that is characterized by the onset of the vertices of the hair shaft, which is white-white as pearl disease. This is because the hair matrix disturbed. When alternating

white and white is already beginning to emerge, it will be easy hair dotted (brittle), because it does not get the oxygen evenly on each hair shaft.

d. Trichoptilosis, is a state of the ends of your hair cracked like fibers. This arises because of lack of care, in addition, it also caused an unbalanced nutrition, how to use cosmetics that are less suitable / not exact, are often exposed to the sun and too often use power tools for hair care.

e. Hypertrichosis / hirsutism is a term for the hair that grows wider and thicker in excess.

f. Trichorhexis nodosa hair is at a certain distance enlarged, bulging / thickened and lump near the broken hair like fibers on the edges and sometimes occurs simpulsimpul. This is due to lack of oil and hair protein substances, resulting in deterioration in the quality keratin hair shaft.

g. Monilethri / monilethria is at a certain distance dibatang hair grows kind of abnormalities in the hair shaft in the hair grows thicker and then thins then dashed, after the ends of the hair as well as hair serabut.Biasanya when experienced something like that, then the scalp be dry. The main cause is due to heredity.

h. Alopecia, or baldness is called hair loss disorder continuously until the bald head. Alopecia is generally caused by several factors:

1) Eating less regularly, of course health is impaired, causing body suffering / lack of calcium, vitamins, less blood, the glands in the body is not working properly or because of infectious

diseases such as typhoid or syphilis.

2) Because the disease often have hair like pearls and other diseases.

3) Suffering diseases such as dandruff scalp or tinea.

4) The physical state of the nervous tension that lasts a long time, a lot of thoughts, or mental stress.

5) Due to mechanical state, constantly wearing a hat / headgear or not to give air tight at all for hair.

6) Hereditary factors, including factors that it is rather difficult in treatment.

E. Contradictions

As already explained above that a disease to be moved (transmitted) and then evolve very easy while for treatment would be troublesome therefore the main points that must be considered as a preventive action is as follows:

a. Hair and scalp should always be clean.

b. All equipment used must be clean and sterile (observe sanitary appliances). At least once

every two days should be washed thoroughly and if necessary use hot water for a few specific tools such as combs, wire tongs, and so on.

c. Keep tools for hair care (certain tools, such as a comb, clip, comb or blow headgear is not worn by others / just anyone, because it would be very easy for the infectious hair diseases.

d. When visible signs such as scalp fungus, immediately treated with antifungal drugs. Or when it looks like the hair kelainankelainan on white or white-and resemble broken fibers, do regular maintenance on a regular basis and choose materials for appropriate care cosmetics such as creams or oils.

e. For people who love pets bianatang ought to maintain them properly, for example, set a good diet where he ate and he ate, where feces (not disembarang place), setting his bath, and shelter / cage. It's all aimed at preventing diseases transmitted by ticks / feces. Usually the animal fleas will move the human head rub and he lodged and inflammation and eventually breed head. This is of course interfere with hair growth.

f. For those who like to swim, public pool when swimming pond, ought to be careful and always wear headgear. It aims to avoid diseases that interfere with fertility piodra hair.

g. For patients with scalp belonging either caused by the fungus Trichophyton or by eczema as has been explained before, we know it is most important to prevent it is to avoid / prevent visible signs when bercakbercak. Especially when accompanied by a yellow color and moist,

secepatnyalah treatment and avoid fatty foods, avoid stressful thoughts and avoid much you sweat out.

h. Attention to balanced nutrition in everyday life for healthy hair growth.

F. PREPARATION TOOL

1. Towel to taste.

2. Perlak or pengalas.

3. Basin of warm water.

4. Shampoo or soap in place.

5. Gauze and cotton.

6. Comb.

7. Crooked.

8. Bailer.

9. Empty bucket.

G. PROCEDURE

1.Jelaskan procedures on patients.

2. Wash your hands.

3. Jendcla cap or plug sampiran.

4. Position the patient to sleep.

5. Place the basin under the bed just below the patient's head.

6. Pairs of waterproof or pcngalas under the direction of the head and connect the parts baskomdengan rolled edge.

7. Close the ears with cotton.

8. Close the chest up to the neck with a towel.

9. Then comb your hair and do the washing with warm water, then use a shampoo and rinse with water warm while a massage.

10. After a dry finish.

11. Wash hands

H. EVALUATION Look back hair treatment results following completion of the above procedure. Notice how the changes in the hair after hair melakukanperawatan Ask the client to explain back procedures and tools used in hair care Ask the client to explain lanhkah done to reduce the transmission and prevention of disorders of the hair. I. DOCUMENTATION

Document every procedure and stage - the stage is done, the condition and hair condition, as well as findings or changes such as abnormalities in the hair. Record the results of hair treatments performed in order to know whether or not achieve the expected goals.

Eyecare

The eye is one of Allah-given human senses. The human eye can see beauty, to distinguish light and dark, and finally to appreciate the greatness of God in the universe.

Damaging things eye

Modern lifestyle as it can cause stress on the body and especially on eye fatigue. sometimes your eyes feel tired because it is used to examine data or computer work day or sting the eyes also exposed to road dust that fly when home from work, and so forth. Keeping Eyes

Keeping an eye would be a task that needs to be carried and lived in earnest. For eye care and eye health, some things that could be used to help:

See the eye doctor 12 months Wear protective goggles or a light in the summer when the blazing sun Makanlan good nutrition, including nutrition for eyes If reading or working in front of a computer, make sure the light is right Rest your eyes Find contact lenses with good quality Take care of your contact lenses properly

Nasal treatment.

Clients usually gently lift nasal secretions by cleaning into the soft tissue. It is a necessary daily hygiene. Nurses do not remove dirt to prevent client harshly because the resulting pressure can injure the nasal mucosa, and even the structure of the eye is sensitive. Nose bleeding is a key

sign of the expenditure rough, mucosal irritation, or dryness.

If the client can not get rid of nasal secretions, nurses help by using a wet washcloth or stemmed cotton applicator, moistened in water. Applicators should not exceed the length of the tip is inserted cotton. Excessive nasal secretions can also be removed by suction.

If clients use a hose or suksion dimsukkan eating into the nose through the nurse should replace the plaster that binds hose at least once a day. If the plaster moist as nasal secretions, skin and mucosa can easily maceration. Upward and downward movements of the hose causing tissue injury. Nurses need to know how to attach the hose to the right to minimize stress or friction in the nostrils. If the tissue injury occurs, it is necessary to remove the hose and put the hose on the other nostril. Nurses should always clean the nostrils carefully placed around the hose because there is a secretion of the clot.

If epistaxis or bleeding nose-bleeding is a very common condition occurs .. Epistaxis is usually the result of trauma, localized intranasally. However, it may be an early sign of a more serious systemic disease.

INDICATIONS Patients with epistaxis should be evaluated judiciously. All epistaxis patients require a thorough examination as well as control the bleeding.

CONTRAINDICATIONS

There are no contraindications to treatment of epistaxis. Need management of unstable vital signs, respiratory unstable, lower-extremity injuries requiring treatment, or other complications associated with blood loss

EQUIPMENT

Nose clip Headlight or overhead light source Yankauer suction caheter Frazier suction caheter, # 5 and # 7 Nasal speculum, short and medium lenghts Bayonet forceps Kidney basin Weeder metal or wooden tongue blade tongue depressors Gowns, gloves and face shield Cotton balls Topical anesthetics and vasoconstrictors Silver nitrate applicator stick Petroleum (Vaseline)-impregnated gauze ribbon 0.5 inchies wide Synthetic nasal sponges / tampons, various lenghts Nasal ballons (anterior, posterior, anterior and posterior) 14 French Foley catheter with a 30 mL balloon Gelfoam

4 4 gauze squares Surgicel ENTaxis nasal packing 3 inch long rolls or tonsil dental packs, or 3 36 inch Vaseline gauze Umbilical tape or 0 silk suture Red rubber catheters Lubricant

PATIENT PREPARATION

Explain the procedure to be performed, the risks and benefits to patients and or their opinions about the procedure. Make informed consent to perform the procedure. And make sure the patient has understood all instructions and post procedure follow-up is required.

ANESTHESIA AND vasoconstriction

Anesthesia Lidocaine (4%) Cocaine (4%) Pontocaine (2%)

Vasoconstriction Phenulephrine (0.5 to 1.9%) Cocaine (4%) oxymetazoline (0.05%) Epinephrine (1:1000) Xylometazoline Ephedrine (3%) Combination anesthesia and vasoconstriction

CocaineLidocaine and phenylephrine (50:50). Lidocaine and oxymetazoline (50:50). Epinephrine (0.25 mL of 1:1000) and lidocaine (20 mL)

Techniques for handling epistaxis. Consists of

use pack absorbabel an electric cautery catheter folley Rull gauze intranasal balloon catheter petrolatum (petroleum jelly) filled with ribbon gauze tampon / sponge nasal and silver nitrate.

Techniques and materials are chosen depending on the location of bleeding (anterior and posterior) as well as the physician desires.

ENGINEERING penaganan anterior epistaxis

PACK ABSORBABELGelfoam absorbabel gelatin sponge that is easily obtainable inexpensive, available in the form of nets for the formation of blood clots.

Surgicel selluloid containing oxidized and regenerated. Surgicel further enhance the coagulation of the Gelfoam. However, surgical causes pemyembuhan be hampered; thus used for persistent bleeding or if Gelfoam is not available.

Thrombin topical bovine thrombin is made of. Place a piece of Gelfoam saturated with thrombin in areas of bleeding. Will Thrombin converts fibrinogen into fibrin and aid rapid coagulation process to form a blood clot. Collagen is suitable for various forms of multiple sources of bleeding varies. This material increases platelet aggregation and the formation of the nets for the formation of blood clots.

Ear care.

A. Destination

Prevent further complications from infection or ear abnormalities

B. Benefit

Do not joke about ear care. Any-one even cause problems. Therefore care must be done by ear means tertentu.telinga have the parts to be treated very carefully.

C. Indication

a. Internal Factor

Ear Inflammation

Ear inflammation can occur on the outside and middle. Inflammation of the outer ear occurs due to bacteria. mushrooms. or virus that enters through various ways. for example entry with water while swimming. Inflammation of the middle ear (otitis media) can occur due to bacteria or viruses. eg influenze virus. coming from the oral cavity melirlui Eustachian canal.

Otosclerosis

This disease is a chronic conductive hearing loss due to stapes stiff and can not move freely.

Nerve deafness

Caused by damage to the auditory nerve or auditory center in the brain damage. On the other hand, we also know as congek ear disease. Symptoms, of the ear, exactly from a perforated tympanic membrane, fluid out. "The hole could be due to anything. Usually due to complications

from the nose and throat. "Between the ears, nose, and throat, Noerbaiti explained, there is a line that connects all three. Channel that connects the nose to the ear serves to maintain the air pressure in the middle ear to match the outer ear. When the child got the flu or a cold, the channel that connects the ear and nose could be clogged mucus fluid, causing pain. In addition, the blockage causing the air pressure difference in the middle ear and the outside. Like the a well, the pressure difference will form a vacuum that can "pump up" the snot out of fluid through the ear. "This is called congek. At first only the clear liquid that comes out alone, but soon thickens, fester, and smell. "Furthermore, due to the pressure difference, can cause breakdown congek tympanic membrane and lead to 2 risk of infection, ie from outside and inside.

That from within, for example, occurs when a child is suffering from flu / colds. Liquid snot from the nose into the channel associated with the ear, thus causing middle ear infections. "If left unchecked, will spread to the lining of the brain and can cause death." Therefore, be aware of when flu / colds come because they can cause further complications to the ear even to the brain. Flu / cold should only be treated myself for 3 days. More than that if not improve, immediately take the child to the doctor because they feared a barrage of effects caused by this disease can be very long.

b. External Factors

Any one habit that we often do is scrape the inside of the ear with cotton buds or "metal" which ends hollowed like a spoon. According Noerbaiti, "Liang inner ear should only be cleaned with a special tool that can rotate and be done by experts. Encouraged the use of cotton buds ear wax

further into the entrance again. "

Dirt, he continued, it is trapped in the ear basin shape UUUU burrow in the ear canal will harden and petrified.

FOREIGN OBJECTS

If the ear possessed foreign objects, no first aid can be done at home. "Handling is wrong it will bring consequences even worse. Do not try to remove objects earlier by scraping-match. Immediately brought to the ENT doctor. "These foreign objects into the ear usual:

* Water

When bathing or swimming, water often go into the child's ear. During his ears clean, the water will automatically exit itself. But if there is dirt inside the ear, the water will make it expand so it can not get out. Immediately to the ENT doctor to clean ear wax there.

* Ants

When the ear to concede ants, something is wrong with the inside of the ear. In principle, the ear has its own mechanism to inhibit animals like ants to not get into.

* Cotton Buds

Cotton buds are not medically advisable for prying ears, although there is still some use. In addition to cotton could be left in the ear, the other danger is that it can pierce the membrane drum if not used carefully. There is a case, a mother cleaning the ears old baby 7 days with cotton buds. Instead of being clean, even the baby's ears bleed.

In adults, 3 cm length of this canal, the baby being only 1.5 cm. Therefore, be careful. If the cotton remains in the ear, immediately take your child to the ENT doctor and do their own digging to remove the cotton.

* Small objects

Small children often do not accidentally put something in his ear. For example, beads toys. If this happens, immediately take it to the ENT doctor. Do not try to remove it yourself, as it could cause new problems. In the practice room, the doctor has a special tool to remove the object.

Contraindications

1) These are important points to consider in maintaining ear health. Do not prying ears. Either with cotton buds or other objects.

2) Familiarize children chew food properly because chewing is a natural mechanism of the body to remove impurities from the ear.

3) In infants, this mechanism has also been carried out, that is when the baby sucks the nipple or pacifier.

4) When the ear was reduced hearing, immediately to the ENT doctor to be cleaned.

5) Ear has its own mechanism to inhibit and remove foreign objects that enter. If this does not happen, then there is something wrong with the ear. Immediately consult an ENT doctor to look for the cause.

6) Keep the cotton buds out of the reach of children. They do not know the danger. In addition to cotton could be left in the ear, if not heart-hatimenggunakannya, could pierce and tear the eardrum membrane.

E. Preparation

Prepare tools and materials. Explain the procedure to the client Education, nurses have to master first will be an explanation and action against the client.

F. Procedure

To reduce litigation in ear syringing and provide patients with effective treatment safer ear wax

or cerumen is a normal secretion of the glands ceruminous in meatus outside, which is slightly acidic, giving quality bactericidal good, sticky wet form (as secreted by Caucasians and s) AfroCaribbean or dry, flaky form (as secreted by Oriental). In addition to epithelial migration, jaw movement helps move the candle to the entrance of the ear canal where it exits into the skin. A small amount of wax is usually found in the ear canal and the absence may be a sign that the dry skin conditions, infections or excessive cleaning has disrupted the normal production of wax. Only when there is accumulation of wax removal may be required. Spending more candles may occur in people who apply to enter the ear, have narrow ear canals, hearing aid users, older adults and patients with learning difficulties. expenditures can also occur with anxiety, stress and diet or heredity. Excessive wax must be removed before the impact of tinnitus, hearing loss, vertigo, pain and discharge. If the wax is removed for presenting complaints audiologist loss of hearing, either ascertain whether hearing recovered after treatment or if the patient would benefit from a formal assessment by an expert surgeon ENT or audiologist. Experienced practitioners can use clinical judgment or the best method for inspection and removal of ear wax.

Guidelines for the examination of the ear

Before careful physical examination of the ear, listening to the patient, the symptoms clay and took a careful examination of history. Explain each step of every procedure or and ensure that the patient understands and gives consent. Make sure that you and the patient sitting comfortably, at the same level, and that you have privacy. Check the pinna, outer meatus and adjacent scalp. Check the previous incision scar surgery, infection, discharge, swelling and other signs of skin lesions or defects.

G. Evaluation

Determine the most appropriate size speculum that will fit comfortably into the ear and place it on auriscope it. Gently pull upward to straighten out the pinna and ear canal. If there is inflammation and the examination causes pain, do not continue. Hold auriscope like pens and a small number remaining in the patients' heads as a trigger for any unexpected head movement. Use light to observe the direction of the ear canal and tympanic membrane. There is an increased visualization of the eardrum by using the left hand to the left ear and right hand to right ear but clinical judgment should be used to assess your own abilities. Insert the speculum gently into the meatus to pass hair at the entrance to the canal. see through the ear canal and check auriscope tympanic membrane. Set your head and auriscope to see all timpani.Telinga membranes can not be assessed until all areas of the membrane normally seen; reflex light, grip malleus, pars flaccida, pars anterior and the breaks Tensa. If the ability to see all of the tympanic membrane is hampered by the presence of wax, then the wax removal should be done. If the patient has a bottom channel wall mastoid surgery, methodically examine all parts of the cavity, tympanic membrane or drum with your head and adjust the rest of the auriscope. Mastoid cavity can not be assessed completely free of the disease until the entire cavity of the ear and tympanic membrane or drum remnant was visible. Normal appearance or mastoid cavity membrane varies and can only be learned with practice. Carefully check the condition of the skin in your ear canal is interesting auriscope. If there is any doubt about the patient's hearing

audiology assessment should be made.

Ask the client to explain the proper techniques for cleaning ears At follow-up examination ask the client about inspection frequency hearing Observation means clients with hearing loss how to berkomunikasinya with family.

H. Documentation

Document what is seen in both ears, procedures performed, the conditions tympanic membrane and external auditory meatus and treatment given. The findings should be documented with KMP Nurses follow guidelines on record keeping and accountability. If any abnormalities are found referrals to be done with the ENT Outpatient Department following local policy.

Perineal care.

Cleaning the pubic area and surrounding areas in which the client can not do it alone.

Type:

1. Vulvar hygiene

2. Pnil hygiene

v. Environmental hygiene.

Cleaning Bed Melawa-lawa Sweep Swab

Clean bed.

Goals:

Eliminate dust and dirt stains from t.t Preventing the spread of Can be used at any time

Tool

Tray: soft brush, brush work, dark lap, lap work and Vim Place dirty clothes

Small bucket of lysol solution of 1-2% / soapy solution Bucket of clean water

Working principle:

Wash hands Rolled looms Pillows and mattresses brushed and dried (@ level 2 hours) Brushing t.t. with a damp brush, if using board: wipe with a damp cloth + lysol Clean the iron with lysol, clean cloth with water If there are stains clean up with vim

Bed treatment principle:

Avoid contamination of clean linen Prepare linen as needed Do mengkibaskan linen Do not place soiled linen on the equipment covered t4 klien From side to side KU observations client

Melawa-cross beam.

Definition:

Cleaning the cobwebs, dust, dirt on the walls and ceiling

Destination

In order to be maintained and clean room Preventing the spread of Comfortably viewed either by the patient, [and others etugas

Working principles:

Equipment moved beyond Disposable: Aprons, mitella, mask Lawa2 broom wrapped with a damp cloth Perinsip: from the corner to the outside, continue dr middle of the room or less gross to gross Clean the wall: from top to bottom Bottom: clean with a broom

Sweep

Tools:

Sweep the floor Kom small water-filled Scoop stemmed Trash can

Working principles:

Floor sprinkled with water first Sweep; perinsip: start angle, toward the middle, toward the door Scoop dirt If there are impurities such as orange peel, banana immediately mskkn scoop

Swab

Tools:

Mop Tangaki mop Bucket : disinfected solution: Creolin, lisol

Bucket : water clean

Working principles:

Dampen mop disinfected with a solution of Mopping; perinsip: from the corner toward the center of the room then menujunke door How to swing a mop stalk: to the left and right to move backward Mop rinsed clean in water, disinfectant to decommission inbox