HYGIENE

Hygiene
The science of health and its maintenance
Personal Hygiene
- self care by which people attend top
functions such as bathing, toileting,
general body hygiene and grooming
(ADL)
- care of skin, hair, nails, teeth, oral and
nasal cavities, eye and perineal areas
Skin
Largest organ of the body
Functions:
- first line of defense against injury and
microorganism
- maintains body temperature
- secretes sebum
- sensory organ
- produces and absorbs Vit D
Bathing
Removes accumulated oil, perspiration,
dead skin cells, and some bacteria
Categories:
- Cleaning baths – given chiefly for hygiene
purposes
- Therapeutic bath – given to produce specific
effects
Cleaning baths
Complete Bed Bath
- The nurse washes the entire body of a
dependent client
Self-help Bed Bath
- Clients confined to bed are able to bathe
themselves with the help of the nurse for
washing the back and feet
Cleaning baths
Partial Bath (Abbreviated Bath)
- Only parts of the client’s body that might
cause discomfort or odor is washed
- Face, hands, axillae, perineal area, back
Cleaning baths
Bag Bath
- a commercially prepared product that
contains 10-12 presoaked disposable
washcloths that contain no-rinse cleanser
solution
- the package is warmed in a microwave
- each area is cleaned with a different
cloth then air dried
Cleaning baths
Tub Bath
Sponge Bath
Shower
Therapeutic Bath
 Tepid Sponge Bath
- done by sponging the body with htin washcloth from cold or tepid
water to reduce body temp & refresh patient
 Alcohol Sponge Bath
- sponging the body with a washcloth from a mixture of alcohol and
tap water (1:3), to reduce temp
 Hot Sitz Bath
- consists of immersion of the pelvic region and the upper thighs in
a tub of hot water, to relieve congestion and pain in the pelvic
region
- to relieve pain and hasten healing after hemorrhoidectomy
- to induce urination in some case of urinary retention
- to produce muscular relaxation
Bathing
Purpose:
- remove transient microorganisms, body
secretions and excretions, dead skin cells
- stimulate circulation to the skin
- promote sense of well being
- produce relaxation and comfort
- prevent and eliminate unpleasant body
odors
Bathing
Assessment:
- condition of the skin
- physical or emotional factors
- presence of pain and need for adjunctive
measures
- ROM
Equipments
 basin with warm water (43-46 degrees
Celsius)
Soap and soap dish
Bath blanket, bath towels, washcloth
Gloves if necessary
Personal hygiene articles (deodorant,
lotion, powder)
Shaving equipment (if necessary)
Procedures and guidelines
Introduce self
Verify patient’s identity
Explain the procedure
Hand hygiene
Provide privacy
Prepare the environment
- close windows
- encourage to void
- encourage client to perform self-care as
much as possible
Procedures and guidelines
Prepare the bed and position the client
appropriately
- adjust bed to a comfortable working
height, side rails
- assist client to move near you
- place the bath blanket over the top sheet,
then remove the top sheet then the gown
keeping the client covered
Make a bath mitt
Procedures and guidelines
Begin from the cleanest area, downward to the
feet
Wash the face
- wash the client’s eyes with water only
- ask if client wants soap used on the face
Wash the arms and hands
- Place towel on the arm away from you
- Wash, rinse and dry the arm by elevating it supporting
the wrist and elbow
- Use firm stokes from wrist to shoulder to axilla
- Repeat on the arm near you
- Wash the hands by placing them in a basin of water
Procedures and guidelines
Wash the chest and abdomen
- place the towel over the chest, fold the
bath blanket down to the pubic area
- bathe the chest and abdomen with firm
strokes
- replace the bath blanket when the areas
are dried
Procedures and guidelines
Wash the legs and feet
- expose the leg farthest to you, put a
towel under the leg
- with long, firm strokes wash from the
ankle, to the knee, to the thigh
- repeat for the other leg
- wash the feet by placing them in the
basin of water
- dry
Procedures and guidelines
Wash the back then the perineum
- prone or side lying position
- place towel alongside the back and the
buttocks
- wash from the client’s back to the
buttocks and upper thighs, paying
attention to the gluteal folds
- perform back massage
Procedures and guidelines
Back Rub
- massage of the back with 2 chief
objectives: (1) relax and relieve muscle
tension (2) stimulate blood circulation to
the tissues and muscles
- effleurage
- tapotement
- petrissage
Procedures and guidelines
Effleurage – smooth, long stoke, moving
the hands up and down the back
Tapotement – the little finger side of the
hand is used in a sharp, hacking
movement on the back (tapping)
Petrissage – a large pinch on the skin,
subcutaneous tissue and muscle is quickly
done (kneading)
Procedures and guidelines
Assist the client on supine position
Perform perineal care if the patient is not
able to do so
Assist client on grooming aids
Put on clean gown, pajamas
Assist in care of the hair, mouth and nails
Document
Perineal – Genital Care
Perineal care or pericare
Purpose:
- remove normal perineal secretions and
odor
- prevent infection
- promote comfort
Assessment:
◦ Irritation, swelling, excessive discharge, odor,
pain, perineal hygiene practices, self-care
abilities
Perineal – Genital Care
Introduce self
Verify patient’s identity
Explain the procedure
Hand hygiene
Provide privacy
Prepare client
- position and drape the client
- female: back lying with knees flexed and
spread well apart
- male: supine with knees flexed slightly and
hips externally rotated
Perineal – Genital Care
Dry upper thighs
Inspect the perineal area
Wash and dry the perineal area
Female:
- Clean the labia majora, spread the labia to
wash the folds between the majora and minora
- Use separate quarters of the washcloth for
each stroke, wipe from pubis to rectum
- Rinse the area well
Perineal – Genital Care
Male:
- Wash and dry the penis with firm strokes
- If uncircumcised, retract the perpuce to expose
the glans penis for cleaning, replace the
foreskin after cleaning
- Wash and dry the scrotum
Perineal – Genital Care
Clean between the buttocks
- assist client to turn to side facing away
from you
- clean the anal area, gluteal folds and
posterior folds of the scrotum
- dry the area
Document
Foot Care
Wash feet daily, dry thoroughly esp the
interdigital spaces
Use warm water for foot soak to soften
nails and loosen debris under them
Use cream or lotion to moisten skin and
soften calluses
Use deodorant sprays or foot powder to
prevent or control unpleasant odor
Foot Care
Cuttoenails straight across, file toenails
Change socks or stockings daily
Wear comfortable, well-fitted shoes
Don’t go barefooted
Exercise the feet to promote circulation
Nail Care
Trim nails straight across, or follow the
contour of the fingers
File nails to have smooth edges
Do not trim at the lateral corners to prevent
ingrowns (inguis incarnatu)
Diabetic clients: do not cut hangnails or
cuticles
Onycholysis – separation of the nail from the
nail bed
Paronychia – inflammation of the skin fold st
the nail margin
Mouth Care/Oral Hygiene
Purpose:
- Remove food particles from around and
between the teeth
- Remove dental plaque
- Promote sense of well-being
- Prevent sores and infection of oral tissues
Assessment:
- lips, gums, oral mucosa, tongue, tooth caries,
halitosis, gingivitis, loose or broken teeth,
dentures
Mouth Care/Oral Hygiene
Equipment:
- Towel
- Disposable gloves
- Emesis basin
- Soft bristled toothbrush
- Water
- Toothpaste
- Mouthwash
- Dental floss
Mouth Care/Oral Hygiene
Introduce self
Verify patient’s identity
Explain the procedure
Hand hygiene
Provide privacy
Prepare the client
- Sitting position
- Side lying
Mouth Care/Oral Hygiene
Place towel under the client’s chin
Put on disposable gloves
Moisten the toothbrush, apply toothpaste
Brush the teeth, then the tongue
Rinse the mouth
Floss the teeth
Mouth Care/Oral Hygiene
Artificial dentures:
- Wear cloves when handling and cleansing
dentures
- Place a washcloth in a basin or bowl of the
sink when brushing dentures to prevent
damage if the dentures are dropped
Mouth Care/Oral Hygiene
Unconscious client:
- Place in side lying position to prevent
aspiration
- Have suction apparatus readily available
- Use padded tongue blade to open mouth
- Brush teeth and gums, using toothbrush or soft
sponge – ended swab
- Apply thin layer of petroleum jelly to lips to
prevent drying or cracking
Hair Shampoo
Purpose:
- Stimulate circulation of the blood in the scalp
- Clean the hair and improve the client’s well being
Assessment:
- Hair care practices, condition of the hair and
scalp, self-care abilities
Equipment:
- comb/brush, plastic sheet or pad, bath towels,
basin, washcloth/pad, receptacle for shampoo
water, shampoo, hair dryer
Hair Shampoo
Determine if the institution requires
doctor’s order for hair shampoo
Place client diagonally in bed near you
Remove pins from hair, comb and brush
hair thoroughly to remove tangles
Place the plastic sheet under the head
Remove pillow and place it under the
shoulder
Hair Shampoo
Tuck bath towel on the client’s shoulders
Place the Kelly pad under the head, place a
folded washcloth where the neck rests
Place the spout of the Kelly pad on the
receptacle
Place a damp washcloth over the patient’s
eyes
Shampoo the hair
Rinse and dry
Document
Eye Care
Cleanse the eyes from inner to outer
canthus, use a new cotton balls for each
wipe
Avoid rubbing eyes
Maintain adequate lighting when reading
Avoid regular use of eye drops
If dirt/FB gets into the eyes, clean them
with copious, clean, tepid water as
emergency treatment
Ear Care
Cleanse the pinna with moist wash cloth
Do not use bobby pins, toothpicks or
cotton-tipped applicators to remove
cerumen
Nose Care
Clean nasal secretions by blowing the
nose gently into a soft tissue
Both nares should be open when blowing
the nose to prevent forcing debris into the
middle ear
May use cotton-tipped applicator
moistened with saline or water to remove
encrusted, dried secretions