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Hygiene Assisting with Elimination Hygiene & Peri-care Mouth care, Hair care, & Shaving Backrub Assisting with Elimination Bedpans - metal or plastic Regular versus fracture bedpan Urinals - male to void. Urinals for females, but not common

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Hygiene

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Hygiene

Assisting with Elimination

Hygiene & Peri-care

Mouth care, Hair care, & Shaving

Backrub


Assisting with Elimination

  • Bedpans - metal or plastic

  • Regular versus fracture bedpan

  • Urinals - male to void. Urinals for females, but not common


  • Commode - toilet on wheels with a catch basin under seat. Be sure to lock wheels


Putting Someone on a Bedpan

  • Provide privacy - close door, pull curtain

  • Siderail up on opposite side

  • Supine or recumbent position

  • Raise buttocks or roll onto pan

  • Elevate HOB, raise near siderail, call light/toilet tissue, leave alone if able

  • Use gloves, remove pan opposite way, wipe genitals

  • I&O, specimens, discard, wash hands, lower bed


Hygiene

  • Maintaining personal hygiene is necessary for an individual’s health, comfort, safety, & sense of well-being

  • Consider the client’s normal grooming routine

  • Convey sensitivity & respect for the person’s personal beliefs & habits


  • Assess the client’s physical and cognitive status to determine specifically what aspects of hygiene can be performed independently, those that require some assistance, and those that require total assistance.


  • Bathe body parts when soiled - incontinent, wound drainage, diaphoresis

  • Long term care - bath day once/week, complete bath, otherwise a partial bath done daily

  • Also, an excellent opportunity to conduct physical assessment


Bathing

  • Complete bedbath - washing whole body in bed

  • Partial bedbath - face, hands, axillae, perineum (or peri-care) & a backrub

  • Tub bath - immersed in water. Do not leave unattended, disinfect tub following

  • Shower - standing or shower chair

  • Shampooing in bed - use a hair trough


  • Bag bath – contains several soft cotton cloths that are premoistened in a solution of no-rinse cleanser & emollient. Easy to use, reduced time bathing, patient comfort


  • Am care - ready for breakfast: void, wash face & hands, brush teeth/dentures in

  • Pm care - relax for the night: void, wash face & hands, brush teeth/take out dentures, straighten bed linens, backrub


Highlights of the Bedbath

  • Maintain safety, use siderails

  • Undress unaffected 1st; dress affected 1st

  • Bath blanket - for privacy & warmth

  • Include ROM

  • Washmitt - retains heat, broad surface area


  • Eyes 1st - inner to outer canthus

  • No soap on face

  • Wash farthest then nearest OR go around the bed

  • Long firm strokes distal to proximal

  • Wash, rinse, & dry

  • Change water when cold, dirty, soapy, after feet, before perineum

  • Gloves for mouth care & perineum

  • Use deodrant, makeup as per client’s wishes

  • Promote client independence


Peri-Care

  • Washing of the genitals or perineum

  • Incontinent clients need frequent peri-care due to risk of skin breakdown

  • No baby powder or cornstarch - no medicinal properties & can cake. Use vaseline or zincoxide instead


Procedure for peri-care

  • Explain in words they will understand, “wash between your legs”

  • Privacy, gloves, dorsal recumbent position, waterproof pad

  • Wash with warm water & soap, separate the labia of female as you clean, begin at tip of penis & move down the shaft in male; rinse & dry


Catheter Care

  • Clean perineum as per usual & down the first 5-10cm of the catheter away from the urethral meatus to remove encrustations.

  • No lotions or powders

  • Keep collection bag off the floor to avoid m.o., but below the level of the bladder to prevent reflux

  • Empty bag q8hr or when 1/2 full

  • Encourage fluids to flush out bladder


Changing an Attends

  • Do not refer to as a diaper!!

  • Peri-care done when changing the Attends

  • Check lines on outside - will change color when wet

  • Mark date & time on outside of Attends


Mouth Care

  • Structures in oral cavity must receive regular hygiene to remain healthy

  • Healthy teeth & mouth influence client’s ability to eat, swallow, digest, & even speak

  • In older adults, often neglected, however older adults have greatest tooth loss due to dental caries


  • Toothbrushing with a soft-bristle toothbrush daily, after each meal & at bedtime

  • Dental flossing eliminate bacteria, reduce plaque, & reduce bacteria & plaque near gum line

  • Mouth care q1-2hr may be needed in the unconscious, on O2, or mouth breathers. Secretions on tongue dry & leads to odor & stomatitis

  • Use K-basin, towel, & glass of water


Mouth Care on Unconscious Client

  • Depend on nurses for their oral care

  • At risk for an altered oral cavity - may not eat/drink by mouth, mouth breathers, on O2 therapy - all are drying to oral mucosa

  • Risk for aspiration - check gag reflex. May need suction apparatus at the bedside


Procedure for mouth care on an unconscious client

  • Sidelying with head turned towards mattress

  • Towel under head, emesis basin under chin, padded tongue depressor

  • Brush with toothbrush or toothettes moistened with diluted mouthwash

  • Suction if necessary

  • Water soluble jelly to the lips


Care of Dentures

  • Clean as often as regular teeth

  • Place cloth in bottom of sink, brush as you would teeth, rinse & return to client or store in cup of tepid water.

  • If left out of water, will dry & warp

  • Be sure denture cup is labeled

  • Should be removed atnight to give gums a rest & prevent buildup of bacteriaunderneath


Hair care

  • Hair & its cleanliness is important to a person’s body image

  • Use a hair trough in the bed. Place padding/towels under the client’s neck

  • Wash & rinse as per usual


Shaving

  • Men without beards usually shave daily

  • Never shave off a beard or moustache without client consent

  • Often electric razors are used - no chance of cutting the skin

  • In older adults, will need to pull skin taught & move in a downward direction


Backrub

  • Helps to relax muscles, decrease stress & anxiety, & stimulate circulation

  • Done as part of the bath and/or at bedtime

  • Use lotion - moisturizes & decreases friction on the skin. Alcohol used in the past, however is drying to the skin.

  • Warm lotion between your hands or under hot water


Technique for a Backrub

  • Long smooth flowing movements over the back to relax

  • Kneading motions to relax tight muscle groups

  • Circular motions to stimulate circulation to an area (esp. for bedridden clients)

  • Time required - 3-5min

  • Caution - do not massage over reddened areas, massage around to stimulate blood flow


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