chapter 24: hygiene

Copyright © 2014. F.A. Davis Company

F. A. Davis's Basic NursingF. A. Davis's Basic Nursing

Chapter 24: HygieneChapter 24: Hygiene



General Concepts Related to General Concepts Related to Hygiene Hygiene

• Activities involved in personal grooming and cleanliness

• Activities of daily living (ADLs) – Bathing– Showering– Combing hair



General Concepts Related to General Concepts Related to Hygiene (cont’d)Hygiene (cont’d)

• Maintenance of personal hygiene– Promotes comfort– Improves self-image– Decreases infection and disease



Nursing RoleNursing Role• Assess self-care abilities• Provide assistance with ADLs• Promote self-care in ADLs• Delegate appropriate parts of hygiene care



Factors That Influence Hygiene and Factors That Influence Hygiene and Self-Care PracticesSelf-Care Practices

• Psychosocial factors• Personal preferences

– When to bathe, what products to use

• Culture and religion– Beliefs about hygiene and cleanliness



Factors That Influence Hygiene and Factors That Influence Hygiene and Self-Care Practices (cont’d)Self-Care Practices (cont’d)

• Economic status– Availability of facilities– Monetary constraints

• Developmental level– Parents, media, peers, age

• Knowledge level




• Physical factors: health status– Pain: limits mobility and energy– Limited mobility: decreased range of motion,

weakness, bedrest– Sensory deficits: decreased independence and

increased safety concerns




• Physical factors: health status (cont’d)– Cognitive impairments

• Cannot determine need for hygiene• Cannot problem-solve ADL processes• Forgets when last performed hygiene and ADLs

– Emotional disturbances• Profound lack of energy for ADLs• Altered reality does not include hygiene



ClickerCheck

Which factor would be most likely to influence the hygiene practice of the homeless client?A. The client’s degree of mental illnessB. The client’s cultural beliefsC. The client’s living environmentD. The client’s knowledge level



Correct answer: C

The homeless client may have no access to facilities in which to perform routine hygiene measures.



Types of Scheduled Hygiene CareTypes of Scheduled Hygiene CareRoutine hygiene care in the in-client facility• Early morning care: on awakening – wash face

and hands, mouth care• A.M. care: after breakfast – bathing, toileting,

hair, skin, bedmaking



Types of Scheduled Hygiene Care Types of Scheduled Hygiene Care (cont’d)(cont’d)

• P.M. care: afternoon – toileting, hand washing, oral care, readying for visitors

• H.S. care: prior to sleep – relaxation activities, readying environment to facilitate sleep



Delegating Hygiene CareDelegating Hygiene Care• Assess prior to delegating• Instruct NAP regarding

– Client’s limitations– Amount of assistance needed– Use of assistive devices– Presence and care of tubes– Observations to make during hygiene care



Major Areas of Hygiene Care: Major Areas of Hygiene Care: BathingBathing

Bathing a client facilitates• Assessment of the integumentary system

– Color: pallor, erythema, jaundice– Conditions that affect the skin: maceration, pruritus, acne– Alterations in skin integrity: abrasions, pressure ulcers



Major Areas of Hygiene Care: Major Areas of Hygiene Care: Bathing (cont’d)Bathing (cont’d)

Bathing a client facilitates (cont’d) • RN assessment of client’s functional abilities and status



Common Types of BathsCommon Types of Baths• Assist bath

– Bathe areas hard to reach

• Partial bath– Bathe only those areas absolutely necessary, including

perineum• Bed bath

– Complete– Partial– Help bath



Other Types of BathsOther Types of Baths• Towel bath• Bag or packaged bath• Shower• Tub bath• Therapeutic bath



ClickerCheck

The confused client becomes distressed and agitated when the NAP attempts to give the morning bath. The nurse instructs the NAP to complete aA. Partial bathB. Help bathC. Bed bathD. Complete bath



Correct answer: A

The intent of the partial bath is to cleanse only the areas in most need of hygienic care. The nurse would continue to monitor the client’s emotional/cognitive status and alter the type of bath accordingly.



Major Areas of Hygiene Care: Oral Major Areas of Hygiene Care: Oral CareCare

Oral care facilitates

• Removal of food particles and secretions

• Improved appetite• Assessment of client’s oral status• Care of dentures



Major Areas of Hygiene Care: Oral Major Areas of Hygiene Care: Oral Care (cont’d)Care (cont’d)

Oral care facilitates (cont’d) • Assessment of the oral cavity

– Condition of the teeth, cavities, gingivitis– Conditions affecting the mouth: stomatitis, glossitis, oral

lesions/malignancies



ClickerCheck

When providing oral care for the unconscious patient, the nurse shouldA. Place the patient on his side with the head of the bed

in a lowered positionB. Skip brushing the teeth as the patient could aspirateC. Swab the patient's lips and oral cavity with lemon glycerin swabs at least hourlyD. Place the patient in an upright position and brush his

teeth with a sponge brush



Correct answer: A

To facilitate oral hygiene and protect the patient's airway, the nurse should keep the patient on his side with his head lower than his stomach.



Other Hygiene Care AreasOther Hygiene Care Areas• Care of the feet

– Special considerations for care of the diabetic client

• Care of the nails• Hair care

– Special considerations for cultural variations in hair– Care for mustaches and beards



Hair CareHair Care



Other Hygiene Care Other Hygiene Care Areas (cont’d)Areas (cont’d)

• Care of the eyes– Special considerations

for clients with contact lenses

– Care of an artificial eye

• Care of the ears– Care of a hearing aid



Suppose you have been providing towel baths to a patient who has mild dementia. One day a visiting family member says, “My father tells me that he has not had a bath all week. What’s going on here?” What would you do? How could you help to prevent this misunderstanding

in the future?

Think Like a NurseThink Like a Nurse

chapter 24: hygiene

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