Published on

  • Be the first to comment

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide


  1. 1. Nursing SkillsHygienePrepared by: Mark Fredderick R. Abejo R.N, M.A.N 1 Equipments:  Tray with: soap, comb, toothpaste and toothbrush  Basin  Pitcher of warm water  Clean gown  Bath towel  Kidney basin  Bed screen PRN NURSING SKILLS Procedure: Hygiene 1. Prepare equipment and arrange them within reach of patient. Lecturer: Mark Fredderick R. Abejo R.N, M.A.N 2. Loosen top sheet at the foot remove patient’s gown. 3. Screen the bed, provide privacy. 4. Bathe the face, hands and axilla as in giving a cleansing bath. HYGIENE 5. Place on client gown, change PRN 6. Clean teeth, brush or comb hair. 7. Serve bedpan and follow with external douche. The science of health. 8. Loosen bottom sheet, brush away crumbs and Promotes cleanliness, provides for comfort and relaxation, straighten it. improves self-image, promotes healthy skin. 9. Remove pillow and change pillow case; change other Is a basic need for a client’s well-being and self esteem and linens PRN. also necessary for infection control. 10. Replace pillow and place client in a comfortable Hygiene practices are highly individualized and can be position ready for breakfast. influenced by client’s culture, socio-economic status, 11. Gather and bring all used articles to utility room of religion, developmental level, health status and personal CSR. preference. 12. Wash and clean equipment and return client’s The nurse must be knowledgeable about these factors to belonging to bedside stand. provide individualized client care, meeting hygiene needs 13. Record time and type of care given and condition of by providing care that the client alone cannot or should not the client. provide. The nurse should also encourage the client to meet personal hygiene when possible. Afternoon CareCultural Considerations and Hygiene  Some cultures do not permit women to immerse their bodies in water during menstruation for fear they will Ensure patient’s comfort after lunch: drown. • Offer assistance with toileting, handwashing, oral care  In North America, people typically bathe daily and use • Straighten bed linens deodorants. • Help patients with mobility to reposition themselves  In Europe, many people do not bathe daily or use deodorants.Factors Influencing Personal Hygiene • Culture Evening Care • Socioeconomic class • Spiritual practices • Developmental and knowledge level • Health state The care given to client after evening meal and • Personal preference bedtime medication. Purposes:  To refresh the client  Give comfort to the client in preparation for sleepMorning Care General Considerations:  Assist the client according to his condition  Observe the skin and report any reddening or developing decubitus ulcer. The care given to a client in the early morning prior toserving breakfast. Equipments:  Tray with: soap, comb, toothpaste and toothbrushPurposes:  Basin  To refresh the client  Pitcher of warm water  To prepare client for breakfast  Clean gown  Bath towelGeneral Consideration:  Kidney basin  Client should be encouraged to help themselves if  Bed screen PRN condition permits.  Client who is critically ill and debilitated must be given assistance. No over exertion should be allowed. Procedure: 1. Arrange equipment on bedside within reach of the  When a large number of client’s are to be morning client. cared, a systematic procedure for distributing and 2. Screen the bed collecting water used for washing should be devised 3. If the client is strong, washing of hands. Brushing of according to facilities available. teeth may be done by himself.Foundations of Nursing AbejoHygiene
  2. 2. Nursing SkillsHygienePrepared by: Mark Fredderick R. Abejo R.N, M.A.N 2 4. Loosen the top sheet at foot part of bed and remove Equipments: gown.  Inflated Kelly pad 5. Turn the client to side. Expose back and place towel  Face towel beneath it on the bed.  Newspaper 6. Rub and massage the back, hips and other pressure  Cotton balls areas with alcohol using gentle soothing strokes.  Soap or hair shampoo 7. Dry and apply talcum powder.  Pitcher of hot water 8. Offer bedpan and follow it with external douche.  Bath towel 9. Loosen bottom sheets. Remove crumbs and straighten  Rubber protector it.  Bed screen 10. Turn pillow 11. Adjust height of backrest to client’s comfort. Preparation: 12. Turn off light except for the night light. Gather all needed articles. 13. Place call light or bell within reach of client. Identify the client 14. Remove all used articles. Wash, clean and return to Introduced yourself proper places. Inform the patient about the procedure 15. Record time care was given, procedure done and Provide privacy significant observation. Close the window and door, turn off air conditioning unit or electric fan if any. Arrange all needed materials within reach, line a chair or table with newspaper or a piece of rubber where the basin will be placed. BATHING Lower the back and the knee rests depending on the condition of the patient. Prepare the water at the desired temperature.General Information: Procedures: 1. Loosen and fold the top sheet down to the waistline or a. The nurse provides cleansing or therapeutic baths. replace with a bath blanket. b. Cleansing bath include a complete bed bath, a partial 2. Remove the pillow and bring the patient’s head close bed bath and a tub bath or shower. to the edge of the bed by placing her diagonally across c. A complete bed bath consists of washing a dependent the bed. client’s entire body in bed; a complete bed bath with 3. Line a pillow with a rubber protector and bath towel assistance involves helping the client to wash. and place it under the patient’s neck and shoulder so d. A partial bed bath consists of or buttocks that may that the head is slightly incline. cause discomfort or odor if le washing only parts of 4. Remove pins, ribbons from the hair and comb the hair the client’s body such as feet ft unwashed. 5. Cover the eyes with a folded towel. e. A tub bath or shower provides a more thorough 6. Plug the ear with cotton balls. cleansing than a bed bath; the amount of nursing 7. Moisten the hair thoroughly then pour the soap assistance is determined by the client’s age and health solution or liquid shampoo slowly on the scalp and and safety consideration. hair while the other hand tries to spread it. f. A therapeutic bath is ordered by a physician for a 8. Massage the scalp with the ball of your finger not the specific purpose. nails. g. Therapeutic baths include: 9. Rinse, repeat process until the hair is thoroughly  Sitz bath – to reduce inflammation and clean cleansed, taking care to avoid undue jagging or the perineal area. frequent turning of the head.  Tepid sponge bath – to reduce fever. 10. Use cold water, whenever required for final rinse.  Medicated tub bath – to relieve skin 11. Squeeze off the excess water from the hair. irritation. 12. Remove the eye cover or ear plug. 13. With one hand raise the head with the other, remove the Kelly pad and drop it to the pail. Then wrap the hair with the bath towel under the head and readjust the pillow. 14. Dry the hair well then comb it. BED SHAMPOOING 15. Move back the patient to the center of the bed. Leave the rubber protector until the hair is completely dry. 16. Arrange the bed linen and make the patient comfortable. It is the washing of the hair with the patient in bed 17. Leave the unit in order. 18. Discard soiled linen in the hamper. Clean usedPurposes: equipment and keep in their proper places.  To maintain cleanliness and provide comfort 19. Document the time of procedure, reaction of the  To refresh the patient patient and abnormality noted  To wash the hair after application of a pediculocide.General Considerations:  Be sure the procedure is ordered by the physician. BED BATH  Be certain that the patient is not febrile or within normal body temperature.  See to it that the patient is comfortably placed in position. A bath given to a patient on bed  Arrange the Kelly pad so as to llow the free flow of water from the head. Purposes:  Protect the patient from chilling and falling.  To cleanse, refresh and give comfort the patient who  Observe principles of body mechanics must remain in bed.  To stimulate circulation and aid in elimination.  To provide for an opportunity to inspect the patient’s body for any signs of abnormality.Foundations of Nursing AbejoHygiene
  3. 3. Nursing SkillsHygienePrepared by: Mark Fredderick R. Abejo R.N, M.A.N 3  To help the patient have some form of movement and exercise.  To provide for an opportunity for nurse-patient interaction.General Consideration:  Avoid unnecessary exposure and chilling. Expose, wash, rinse and dry only a part of the body at one time. Avoid draft Use correct temperature of water.  Observe the patient’s body closely for physical signs such as rashes, swelling, discoloration, sore, burns etc.  Give special attention to the following body areas; behind the ears, axilla, under the breast, umbilicus, 6. Apply soap pubic region, groin and spaces between the fingers and 7. Start cleaning the eyes, wipe from inner to outer toes. canthus. Using circular strokes, bathe the face, neck  Do the bath quickly but unhurriedly, use even, smooth and ears. but firm strokes.  Use adequate amount of water and change as frequently as necessary.  If possible, do such procedure as vaginal douche, enema, shampoo, oral care etc. before bath.Equipments:  Pitcher of water  Bath basin  Bath towel  Face towel  Soap in soap dish  Talcum powder  Deodorant  Rubbing alcohol  Gown  Bed screen Eye Care  Linen for changing Cleanse the eyes from inner canthus to the outer  Rubber sheet or news paper canthus. Use a new cotton ball for each wipe. If the client is comatose, cover the eyes withPreparation: sterile moist compresses. To prevent dryness and Gather all needed articles. irritation of cornea. Identify the client Introduced yourself Health Teachings Inform the patient about the procedure  Eyeglass should be cleansed with warm water Provide privacy and soap, dried with soft tissue. Adjust the temperature and ventilation of the room  Clean contact lens as directed by the Remove unnecessary articles on the bed and clear up manufacturer. the work area.  Hold the artificial eye with thumb and index Arrange all needed materials within reach, line a chair finger. Clean the artificial eye with warm normal or table with newspaper or a piece of rubber where the saline, the place in a container with water or basin will be placed. saline solution. Lower the back and the knee rests depending on the  Avoid rubbing the eyes. condition of the patient.  Maintain adequate lighting when reading Offer the bedpan or urinal as desired.  Avoid regular use of eyedrops  If dirt or foreign bodies get into the eyes, cleanProcedure: them with copious, clean, tepid water as 1. Loosen the sheet, this may be replaced by a bath emergency treatment blanket. 2. Assist the patient to the side of the bed for Ear Care convenience and ease in working. Cleanse the pinna with moist wash cloth 3. Remove patient’s clothing under cover of the sheet or Remove visible cerumen by retracting the ears blanket. downward. If this is ineffective, irrigate the ear 4. Fill the basin with one half t two-thirds full of as ordered. comfortably warm water. 5. Wrap the washcloth around the palm and fingers to Do not use bobby pins or toothpicks to remove form a mitten cerumen these can rupture the tympanic membrane or traumatize the ear canal.Making a bath mitt: Rectangular method: • Lay your hand on the washcloth and fold one side over Nose Care your hand; Clean nasal secretion by blowing the nose gently • Fold the second side over your hand; into soft tissue. • Fold the top of the cloth down; and Both nares should be open when blowing the • Tuck it under the folded side against your palm to nose to prevent forcing debris into the middle ear secure the mitt. via the Eustachian tube. May use cotton-tipped applicator moistened with saline or water to remove encrusted, dried secretions. Insert only up to cotton tip.Foundations of Nursing AbejoHygiene
  4. 4. Nursing SkillsHygienePrepared by: Mark Fredderick R. Abejo R.N, M.A.N 4 8. Rinse the area two or three times; then put it dry with the towel. 9. Spread the towel lengthwise under the father arm. 10. Soap, rinse and dry, paying particular attention to the axilla and using long firm strokes. 11. Place the basin on the towel near the edge of the bed and wash the hands in water paying special attention to the nails. 12. Do the same with the nearer arm. 13. Spread the towel over the chest and abdomen. Wash, rinse and dry, giving special attention to the area beneath the breast and the umbilicus. Change water  Tapotement, in here the little finger side of each 14. Assists the patient to turn to his/her side with the back hands is used in a sharp hacking movement on the towards the nurse and spread the bath towel on the bed back. Care must be taken with this type of rub to not close to the body. hurt the patient. Also called tapping. 15. Expose the entire back. Then soap, rinse and dry from the nape. 16. Rub the back with alcohol, lotion or powder (depending on the condition of the skin ) followed by talcum powder. 17. Expose the thigh, leg and foot on the far side, draping of the top sheet or blanket around the groin.  Petrissage, is a large pinch of the skin, subcutaneous tissue and muscle quickly done. The pinches are taken 18. Flex the knees and spread the bath towel under the first up the vertebral column and then over the entire entire leg. Soap, rinse and dry up to the ankle giving back. particular attention to the inguinal and popliteal areas. 19. Place the basin on the towel between the legs. Lift father foot with the heel in the palm of your hand and lower it slowly into the water, with the leg resting on the bend of your elbow. Soap, rinse and dry well between the toes. 20. Repeat the procedure on the other leg. 21. Clean the pubic and perineal areas. If the patient is a female, finish with external douche or perineal flushing. If the basin is big enough both feet may be washed at the same time. 22. Put on the new gown 23. Assist with hair care 24. Discard dirty linens into hamper, clean and return used equipment and leave the unit in order 25. Document relevant information Procedure: 1. Help client to side-lying or prone position. 2. Expose back, shoulder, upper arms and sacral area. Cover remainder of the body with bath blanket. This prevent unnecessary exposure and chilling whileBack Rub maintaining dignity. 3. Wash hands in warm water. Warm lotion by holding container under running water. Warm hands and lotion prevent startle response and muscle tension from cold The backrub is a massage of the back with two chief hands and lotion.objectives: 4. Pour small amount of lotion into palms. Lubricating a. To relax and relieve muscle tension. palms reduces friction on skin during massage. b. To stimulate blood circulation to the tissues and 5. Massage sacral area with circular motion. Move hands muscles. upwards to shoulder, massaging over scalpulae in smooth, firm strokes. Without removing hands fromTypes of Techniques that can be used in Back Rub skin, continue in smooth strokes to upper arms and down sides of back to iliac crest. Continue for 3 to 5  Effleurage, is a smooth, long stroke, moving the minutes. hands up and down the back. The hands are moved 6. Continuous, firm strokes promote relaxation and lightly down the sides of the back, maintaining contact stimulate circulation. with the skin but moved firmly up the back 7. Use petrissage over shoulders and gluteal area and tapotement up and down the spine.Foundations of Nursing AbejoHygiene