2. Bathing and Skin Care: Consider a patient's normal grooming routines, including type of hygiene products used and the time of day when
hygiene is routinely performed. In addition to cleansing baths, the health care provider may prescribe therapeutic baths, including sitz
baths or medicated baths. A sitz bath cleans and reduces pain and inflammation of perineal and anal areas. Medicated baths relieve skin
irritation and create an antibacterial and drying effect. *The extent, type, and timing or frequency of bathing and the methods used
depend on a patient's physical abilities, health problems, and the degree of hygiene required. * Types of bathing: Complete bed bath: Bath
administered to totally dependent patient in bed. * Partial bed bath: Bed bath that consists of bathing only body parts that would cause
discomfort if left unbathed such as the hands, face, axillae, and perineal area. Partial bath may also include washing back and providing
back rub. *Sponge bath at the sink: Involves bathing from a bath basin or sink with patient sitting in a chair. Patient is able to perform part
of the bath independently. Assistance is needed for hard-to-reach areas.
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3. Shower: Patient sits or stands under a continuous stream of water. *Bag bath/travel bath: Contains several soft, nonwoven cotton cloths that are
premoistened in a solution of no-rinse surfactant cleanser and emollient. The bag bath offers an alternative because of the ease of use. reduced time
bathing, and patient comfort. Fundamental of Nursing Regardless of the type of bath the patient receives, use the following guidelines: * Provide privacy.
Close the door and/or pull room curtains around the bathing area. * Maintain safety. Keep side rails up when away from the patient's bedside when
patients are dependent or unconscious. Maintain warmth. Keep the room warm because the patient is partially uncovered and easily chilled. Wet skin
causes an excess loss of heat through evaporation. Control drafts and keep windows closed. Keep patient covered, only exposing the body part being
washed during the bath. * Promote independence. Encourage the patient to participate in as much of the bathing activities as possible. Offer assistance
when needed. * Anticipate needs. Bring a new set of clothing and hygiene products to the bedside or bathroom. Instruct patients avoiding excessive
rubbing. Also encourage them to eat nutritious foods from all food groups, including those rich in vitamins and minerals, and to consume adequate
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4. Back Rub. A back rub or back massage usually follows the patient's batht promotes relaxation, relieves muscular tension, and decreases perception of pain. Consult the
medical record for any contraindications to a massage (e.g., fractured ribs, burns, and heart surgery). Oral Hygiene. *Regular oral hygiene, including brushing, flossing, and
rinsing, preven and controls plaque-associated oral diseases. * Brushing cleans the teeth of food particles, plaque, and bacteria. It also massages the gums and relieves
discomfort resulting from unpleasant odors and tastes. Flossing removes tartar that collects at the gum line. Rinsing removes dislodged food particles and excess
toothpaste. Complete oral hygiene enhances well-being and comfort and stimulates the appetite. *For effective oral hygiene include brushing the teeth at least twice a day
with approved fluoride toothpaste. Fluoride and antimicrobial mouth rinses also help prevent tooth decay. Do not use fluoride rinse in children ages 6 or under because of
the risk of swallowing the rinse. *Instruct patients to obtain a new toothbrush every 3 months or following a cold or upper respiratory infection to minimize growth of
microorganisms on the brush surfaces. Some treatments such as chemotherapy, immunosuppressive agents, head and neck radiation, and nasogastric intubation place
patients at
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5. higher risk of experiencing stomatitis or inflammation of the oral mucosa. *Stomatitis causes burning, pain, and change in food and fluid tolerance. When
caring for patients with stomatitis, brush with a soft toothbrush and floss gently to prevent bleeding of the gums. Hair and Scalp Care *Frequent brushing
helps keep hair clean and distributes oil evenly along hair shafts. * Combing prevents hair from tangling. * Patients who develop head lice require special
considerations in the way combing is performed. The lice are small, about the size of a sesame seed; thus you need bright light or natural sunlight to see
*Care of the Eyes, Ears, and Nose. Basic Eye Care. *Cleaning the eyes involves simply washing with a clean washcloth moistened in water. * When cleaning
a patient's eyes, obtain a clean washcloth and clean from inner to outer canthus. * Use a different section of the washcloth for each eye. When an eye
does not close completely, you may need to place an eye patch over the involved eye to prevent corneal drying and irritation. Apply lubricating eyedrops
according to the health care provider's orders.
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6. Ear Care. Routine ear care involves cleaning the ear
with the end of a moistened washcloth, rotated
gently into the ear canal. Gentle, downward
retraction at the entrance of the ear canal usually
causes visible cerumen to loosen and slip out.
Instruct patients never to use objects such as bobby
pins, toothpicks, paper clips, or cottontipped
applicators to remove earwax. These objects can
injure the ear canal and rupture the tympanic
membrane. They may also cause cerumen to become
impacted within the car canal.
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