St.

Paul College of Ilocos Sur

(A Member, St. Paul University System)
St. Paul Avenue, Bantay, 2727 Ilocos Sur
College of Nursing

SCHOOL YEAR 2020-2021

NCM 103: Fundamentals of Nursing Practice
Learning Objectives:
After completing this lessons, you will be able to:
1. Describe hygienic care that nurses provide to clients.
2. Identify factors influencing personal hygiene.
3. Identify normal and abnormal assessment findings while providing hygiene care.
4. Apply the nursing process to common problems related to hygienic care of the:
● Skin
● Feet
● Nails
● Mouth
● Hair
● Eyes
● Ears.
5. Identify purposes of bathing
6. Describe various types of baths.
7. Compare and contrast the task- centered approach and the person- centered approach
to bathing.
8. Explain specific ways in which nurses help hospitalized clients with hygiene.
Hygiene
⮚ Is the science of health and its maintenance.
⮚ Personal hygiene is the self- care by which people attend to such functions as bathing,
toileting, general body hygiene, and grooming. Hygiene is highly personal matter
determined by individual values and practices.
⮚ It envolves care of the skin, hair, nails, teeth, oral and nasal cavities, eyes, ears, and
perineal- genital areas.

✔ It is important for nurses to know exactly how much assistance a client needs for
hygienic care. Clients may require help after urinating or defecating, after vomiting, and
whenever they become soiled, for example, from wound drainage or from profuse
perspiration.

Hygienic Care
Nurses commonly use the following terms to describe types of hygienic care.
▪ Early morning care is provided to clients as they awaken in the morning.
 ⮚ This care consist of providing a urinal or bedpan to the client confined to bed,
washing the face, hands, and giving oral care.
⮚ Morning care is provided after clients have early breakfast, although it may be
provided before breakfast. It is usually includes providing for elimination needs, a
bath or shower, perineal care, back massages. And oral, nail, and hair care.
⮚ Making the client’s bed is part of morning care.

▪ Afternoon care often includes providing a bed pan or urinal, washing the hands and face,
and assisting with oral care to refresh clients.

▪ Hours of sleep (HS) care is provided to clients before they retire for the night.

⮚ It usually involves providing for elimination needs, washing face and hands, oral
care, and providing a back massage.
⮚ As- needed (prn) care is provided as required by the client. For example, a client
who is diaphoretic (sweating profusely) may need more frequent bathing and a
change of clothes and linen.

Skin
The skin is the largest organ of the
body. It serves 5 major functions:
1. It protects underlying tissues
from injury by preventing the
passage of microorganisms.
The skin and mucous
membranes are considered
the body’s first line of
defense.
2. It regulates the body
temperature. Cooling of the
body occurs through the heat
loss processes of evaporation
of perspiration, and by radiation and conduction of heat from the body when the blood
vessels of the skin are vasodilated. Body heat is conserved through lack of perspiration
and vasoconstriction of the blood vessels.
3. It secretes sebum, an oily substance that (a) softens and lubricates the hair and skin, (b)
prevents the hair from becoming brittle, and (c) decrease water loss from the skin when
the external humidity is low. Because fat is a poor conductor of heat, sebum (d) lessens
the amount of heat lost from the skin. Sebum also has a bactericidal (bacteria- killing)
action.
4. It transmits sensation through nerve receptors, which are sensitive to pain, temperature,
touch, and pressure.
5. It produces and absorbs vit D in conjunction with ultraviolet rays from the sun, which
activate a vit D precursor present in the skin.
 Sudoriferous (sweat)
glands are on all body
surfaces except the lips and
parts of the genitals. The
body has from 2 to 5
million, which are all
present at birth. They are
most numerous on the
palms of the hands and the
soles of the feet.
Apocrine glands, located
largely in the axillae and
anogenital areas, begin to
function at puberty under
the influence of androgens.
Although they produce
sweat almost constantly,
apocrine glands are of little use in thermoregulation. The secretion of these glands is odorless,
but when decomposed or acted on any bacteria on the skin, it takes on a musky, unpleasant
odor.
Eccrine glands are important physiologically. They are more numerous than the apocrine
glands and are found chiefly on the palms of the hands, the soles of the feet, and forehead. The
sweat they produce cools the body through evaporation. Sweat is made up of water, sodium,
potassium, chloride, glucose, urea, and lactate.

Assessing
Assessment of the client’s skin and hygienic practices
includes:
a. A nursing health history to determine the
client’s skin care practices, self- care abilities,
and past or current skin problems;
b. physical assessment of the skin; and
c. identification of clients at risk for developing
skin impairments.
Nursing History
● Data about the client’s skin care practices
enable the nurse to incorporate the client’s
needs and preferences as much as possible
in the plan of care.
● Assessment of the client’s self- care abilities determines the amount of nursing
assistance and the type of bath (e.g., bed, tub, or shower) best suited for the client.
 ● Important considerations include the client’s balance (for tub and shower), ability to sit
unsupported (in the tub or bed), activity tolerance, coordination, adequate muscle
strength, appropriate joint range of motion, vision, and the client’s preferences. Cognition
and motivation are also essential.
● Clients whose cognitive function is impaired or whose illness alters energy levels and
motivation will usually need more assistance. It is important for the nurse to determine
the client’s functional level and to maintain and promote as much client independence as
possible. This also enables the nurse to identify the client’s potential for growth and
rehabilitation.
● The presence of past or current skin problems alerts the nurse to specific nursing
interventions or referrals the client may require. Many skin care conditions have
implications for hygienic care. The client may provide descriptions of these problems
during the nursing health history, or the nurse may observe some during the physical
examination that follows.
Factors Influencing Individual Hygienic Practices

Factor Variables
Culture North American culture places a high value on cleanliness. Many north
Americans bathe or shower once or twice a day, whereas people from
some other cultures bathe once a week. Some cultures consider
privacy essential for bathing, whereas others practice communal
bathing. Body odor is offensive in some cultures and accepted as
normal in others.
Religion Ceremonial washings are practiced by some religions.
Environment Finances may affect the availability of facilities for bathing. For
example, homeless people may not have warm water available; soap,
shampoo, shaving lotion, and deodorants may too expensive for people
who have limited resources.
Developmental Children learn hygiene in the home. Practices vary according to the
level individual’s age; for example, preschoolers can carry out most task
independently with encouragement.
Health and energy Ill people may not have the motivation or energy to attend to hygiene.
Some clients who have neuromuscular impairments may be unable to
perform hygienic care.
Personal Some people prefer a shower to a tub bath.
preferences

Physical Assessment
Physical assessment of the skin, which involves inspection and palpation. When assisting with
bathing and other hygienic care, the nurse often has the opportunity to collect data about skin
color, uniformity of color, texture, turgor, temperature, intactness, and lesions.
 Definitions and Descriptions for Functional Level

(0) (+ 1) Semidependent (+ Moderately Totally

2) dependent (+ 3) Dependent (+ 4)
Completely Requires Requires help Requires help Dependent does
use of from another from another not participate
Independen
equipment person for person and in activity
t
or device assistance, equipment or
supervision, or device
teaching
Bathing Nurse provides all Nurse supplies all Client needs
equipment; equipment; complete bath;
positions client in positions client; cannot assist at
bed/ bathroom. washes back, legs, all.
Client completes perineum, and all
bath, except for other parts, as
back and feet. needed. Client can
assist.
Oral Nurse provides Nurse prepares Nurse completes
hygiene equipment; client brush, rinses entire procedure.
does task. mouth, positions
client.
Dressing/ Nurse gathers item Nurse combs Client needs to
grooming for client; may client’s hair, assist be dressed and
button, zip, or tie with dressing, cannot assist the
clothing. Client buttons and zips nurse; nurse
dresses self. clothing, ties combs client’s
shoes. hair.
Toileting Client can walk to Nurse provides Client is
bathroom/ bedpan, positions incontinent,
commode with client on or off nurse places
assistance; nurse bedpan, places client on bedpan
helps with clothing. client on or commode.
commode.
Note: from Nursing Diagnosis Handbook with NIC Interventions and NOC Outcomes, 7 th ed. (pp.382,385,393), by J.M. Wilkinson, 2000. Upper
Saddle River, NJ: Prentice Hall Health.

Common Skin Problems

Problem and Appearance Nursing Implications

Abrasion
Superficial layers of the 1. Prone to infection; therefore, wound should be kept
skin are scraped or rubbed clean and dry.
away. Area is reddened 2. Do not wear rings or jewelry when providing care to
and may have localized avoid causing abrasions to clients.
bleeding or serous 3. Lift, do not pull, a client across a bed.
weeping.

Excessive Dryness
1. Prone to infection if the skin cracks; therefore, provide
Skin can appear flaky and
alcohol- free lotions to moisturize the skin and prevent
rough.
cracking.
2. Bathe client less frequently; use no soap, or use
nonirritating soap and limit its use. Rinse skin thoroughly
because soap can be irritating and drying.
3. Encourage increased fluid intake if health permits to
prevent dehydration.
Ammonia Dermatitis
(Diaper Rash)
1. Keep skin dry and clean by applying protective
Caused by skin bacteria ointments containing zinc oxide to areas at risk (e.g.,
reacting with urea in the buttocks and perineum).
urine. The skin becomes 2. Boil an infant’s diapers or wash them with an
reddened and is sore. antibacterial detergent to prevent infection. Rinse
diapers well because detergent is irritating to an infant’s
skin.
Acne
Inflammatory conditions 1. Keep skin clean to prevent secondary infection.
with papules and pustules. 2. Treatment varies widely.
Erythema
Redness associated with a 1. Wash area carefully to remove excess microorganisms.
variety of conditions, such 2. Apply antiseptic spray or lotion to prevent itching,
as rashes, exposure to promote healing, and prevent skin breakdown.
sun, elevated body
 temperature.
Hirsutism
Excessive hair on a
person’s body and face,
particularly in women.
1. Remove unwanted hair by using depilators, shaving,
electrolysis, or tweezing.
2. Enhance client’s self- concept.

Diagnosing
⮚ Difficulties encountered by the client in performing bathing activities include the
inability to wash the body or body parts, to obtain or get to a water source, and to
regulate water temperature or flow.
⮚ Difficulties in dressing and grooming include inability to obtain, put on, take off,
fasten, or replace articles of clothing and to maintain appearance at a satisfactory
level. Toileting problems may involve difficulties getting to the toilet or commode
or sitting on and rising from it. In addition, the client may experience problems
manipulating clothing for toileting, carrying out proper toilet hygiene, or flushing
the toilet or emptying the commode.
Examples of associated diagnosis include:
● Deficient Knowledge related to:
a. Lack of experience with skin condition (acne) and need to prevent secondary
infection
b. New therapeutic regimen to manage skin problems
c. Lack of experience in providing hygiene care to dependent person
d. Unfamiliarity with devices available to facilitate sitting on or rising from toilet.
● Situational Low Self- Esteem related to:
a. Visible skin problem (e.g., acne or alopecia)
b. Body odor
● Risk for Impaired Skin Integrity
Vulnerable to alteration in epidermis and/or dermis which may compromise health
● Impaired Skin Integrity
Altered epidermis and/or dermis
Commonly applies to pressure ulcers and to wounds extending through the epidermis
but not through the dermis.
Planning
In planning care, the nurse and, if appropriate, the client and/or family set outcomes for each
nursing diagnosis. The nurse then performs nursing interventions and activities to achieve the
client outcomes.
▪ The specific, detailed nursing activities provided by the nurse may include assisting
dependent clients with bathing, skin care, and perineal care; providing back massages to
promote circulation; instructing clients/ families about appropriate hygienic practices and
alternative methods for dressing; and demonstrating use of assistive equipment and
adaptive activities.
 ▪ Planning to assist a client with personal hygiene includes consideration of the client’s
personal preferences, health, and limitations; the best time to give the care; and the
equipment, facilities, and personnel available.
▪ A client’s personal preferences—about when and how to bathe, for example—should be
followed as long as they are compatible with the client’s health and the equipment
available. Another consideration for the nurse is to assess the client’s comfort level with
the gender of the caregiver.
▪ Hygienic care, particularly bathing, can be embarrassing and stressful to modest
individuals. Women in some cultures (e.g., Hindu, Iranian, Arab, and Navajo Indian) are
generally modest. Nurses must respect a person’s modesty, whether male or female,
and provide adequate privacy and sensitivity. If possible, try to provide a caregiver of the
same gender. Nurses need to provide whatever assistance the client requires, either
directly or by delegating this task to other nursing personnel.
Planning for Home Care
To provide for continuity of care, the nurse should assess the client’s and family’s abilities to
provide self- care/ care and the need for referrals and home health services. In addition, the
nurse needs to determine the client’s learning needs.
Implementing
The nurse applies the general guidelines for skin care while providing one of the various types
of baths available to clients.
General Guidelines for Skin Care
1. Intact, healthy skin is the body’s first line of defense. Nurses need to ensure that all
skin care measures prevent injury and irritation. Scratching the skin with jewelry or long,
sharp fingernails must be avoided. Harsh rubbing or use of rough towels and washcloths
can cause tissue damage, particularly when the skin is irritated or when circulation or
sensation is diminished. Bottom bedsheets are kept taut and free from wrinkles to
reduce friction and abrasion to the skin. Top bed linens are arranged to prevent undue
pressure on the toes. When necessary, footboards are used to keep bedclothes off the
feet.
2. The degree to which the skin protects the underlying tissues from injury depends
on the general health of the cells, the amount of the subcutaneous tissue, and the
dryness of the skin. Skin that is poorly nourished and dry is less easily protected and
more vulnerable to injury. When the skin is dry, lotions or creams with lanolin can be
applied, and bathing is limited to once or twice a week because frequent bathing
removes natural oils of the skin and cause dryness.
3. Moisture in contact with the skin for more than a short time can result in
increased bacterial growth and irritation. After a bath, the client’s skin is dried
carefully. Particular attention is paid to areas such as the axillae, the groin, beneath the
breasts, and between the toes, where the potential for irritation and fungal infection is
greatest. A nonirritating dusting powder tends to reduce moisture and can be applied to
these areas after they are dried. Clients who are incontinent of urine or feces or who
perspire excessively are provided with immediate skin care to prevent skin irritation.
4. Body odors are caused by resident skin bacteria acting on body secretions.
Cleanliness is the best deodorant and antiperspirants can be applied only after the skin
 is cleaned. Deodorants diminish odors, whereas antiperspirant reduce the amount of
perspiration. Neither is applied immediately after shaving because of the possibility of
skin irritation, nor are they used on skin that is already irritated.
5. Skin sensitivity to irritation and injury varies among individuals and in accordance
with their health. Generally speaking, skin sensitivity is greater in infants, very young
children, and older people. A person’s nutritional status also affects sensitivity.
Emanciated and obese people tend to experience more skin irritation and injury. The
same tendency is seen in individuals with poor dietary habits and insufficient fluid intake.
Even in healthy people, skin sensitivity is highly variable. Some people’s skin is sensitive
to the chemicals used in skin care agents and cosmetics. Hypoallergenic cosmetics and
soaps or soap substitutes are now available for these people. The nurse needs to
ascertain whether the client has any sensitivities and what agents are appropriate to
use.
6. Agents used for skin care have selective actions and purposes.

Bathing
⮚ Bathing removes accumulated oil, dead skin cells, and some bacteria. The nurse can
appreciate the quantity of oil and dead skin cells produced when observing a person
after the removal of a cast that has been for 6 weeks. The skin is crusty, flaky, and dry
underneath the cast. Application of oil over several days are usually necessary to
remove debris.
● Excessive bathing however, can interfere with intended lubricating effect of sebum,
causing dryness of the skin. This is an important consideration, especially for older
adults, who produce less sebum.
● In addition, cleaning the skin, bathing also stimulates circulation and produces a sense
of well being. Bathing offers an excellent opportunity for the nurse to assess the clients
and open the door for establishing trust. The nurse can observe the client’s skin for
conditions such as a sacral edema or rashes.
● While assisting a client with a bath, the nurse can also assess the client’s psychosocial
needs, such as orientation to time and ability to cope with illness. Learning needs, such
as the need for a client who has diabetes to learn foot care, can also be assessed.

Categories
❖ Cleansing baths are given chiefly for hygiene purposes and include these types:

● Complete bed bath. The nurse washes the entire body of a dependent client in bed.
● Self- help bed bath. Clients confined to bed are able to bathe themselves with help
from the nurse for washing the back and perhaps the feet.
● Partial bath (abbreviated bath). Only the parts of the client’s body that might cause
discomfort or odor, if neglected, are washed: the face, hands, axillae, perineal area, and
back. Omitted ar the arms, chest, abdomen, legs and feet. The nurse provides this care
for dependent clients and assist self- sufficient clients confined to bed by washing their
backs. Some ambulatory clients prefer to take a partial bath at the sink. The nurse can
assist them by washing their backs.
● Bag bath. This bath is a commercially prepared product that contains 10 to 12
presoaked disposable washcloths that contain no rinse cleanser solution. The package
is warmed in a microwave. The warming time is about 1 minute, but the nurse needs to
determine how long it takes to attain a desirable temperature. Each area of the body is
not rubbed dry, the emollient in the solution remains on the skin.
● Towel bath. This bath is similar to a bag bath but uses a regular towels. It is useful for
clients who are bedridden and clients with dementia. The client is covered up and kept
warm through out the bathing process by a bath blanket. The nurse gradually replaces
the bath blanket with a large towel that has been soaked with warm water and no- rinse
soap. The client is then gently massage with the warm, wet, soapy towel. The wet towel
is replaced with a large dry towel for drying the client’s skin.
● Tub bath. Tub baths are often preferred to bed baths because it is easier to wash and
rinse in a tub. Tubs are also used for therapeutic baths. The amount of assistance the
nurse offers depends on the abilities of the client. There are specially designed tubs for
dependent clients. These tubs greatly reduce the work of the nurse in lifting clients in
and out of the tub and offer greater benefits than a sponge bath in bed.
Sponge bath are suggested for the newborn because daily tub baths are not considered
necessary.

⮚ After the bath, the infant should be immediately dried and wrapped to prevent
heat loss. Parents need to be advised that the infants ability to regulate body
temperature has not yet fully developed.
● Shower. Many ambulatory clients are able to use shower facilities and require only
minimal assistance from the nurse. Clients in long- term care settings are often given
showers with the aid of a shower chair. The wheels on the shower chair allow clients to
be transported from their room to the shower. The shower chair also has a commode
seat to facilitate cleansing of the client’s perineal area during the shower process.

❖ Therapeutic baths are given for physical effects, such as to soothe irritated skin or to
treat an area (e.g., the perineum).
▪ Medications may be placed in the water. A therapeutic bath is generally taken in
a tub one third or one half full. The client remains in the bath for a designated
time, often 20 to 30 minutes. If the client’s back, chest, and arms are to be
treated, these areas need to be immersed in the solution.

I. Bed Bath

Purpose:
▪ To remove transient moist, body secretions and excretions, and dead skin cell
▪ To stimulate circulation
▪ To produce a sense of well being
▪ To promote relaxation, comfort and cleanliness
▪ To prevent or eliminate unpleasant body odors
▪ To give an opportunity for the nurse to assess ill clients
▪ To prevent pressure sores

Bed Bath Equipment

 • Trolley • Bed protecting materials such as rubber sheet and
towels
• Bath blanket (or use top linen) • Two bath towels
• Wash cloth • Clean pajamas or gown
• Additional bed linens • Hamper for soiled cloths
• Basin with warm water (43-460 c for adult and 38-400 c for children)
• Soap on a soap disc • Hygienic supplies, such as, lotion, powder or deodorants (if
required) • Screen • Disposable gloves • Lotion thermometer (if available)

Procedures in Bed Bath

How to make a bath mitt:
 Points to remember:
▪ Face, neck, and ears…. Soap? Rinse and dry well
▪ Bath farthest hand and arms first.
▪ Use long, firm strokes
-Distal to proximal including axilla
-Rinse and dry
-Deodorant?
-other arm

▪ Always keep water at a warm temperature

Procedures in Bed Bath

Steps Rationalization

1. Silently recite the prayer for the success of the procedure.

2. Assess client’s tolerance for activity, discomfort level, cognitive
ability and musculo- skeletal function.

3. Review orders for specific precautions concerning client’s

movement or positioning.

4. Explain procedure to client and ask client about bathing

preferences.
5. Prepare room for comfort and privacy.
6. Prepare equipment and supplies.
7. Bathe client:
 7.1.1 Complete or partial bed bath:
7.1.2 Offer client bedpan or urinal. Provide towel and washcloth.
7.1.3 Wash hands.
7.1.4 Apply disposable gloves as needed.
7.1.5 Lower side rail closest to you, and assist client in assuming
a comfortable position that maintains body alignment. Bring client toward
side of bed closest to you. Place bed in high position.
7.1.6 Loosen top covers at foot of bed. Place bath blanket over
top sheet. Fold and remove top sheet from under blanket.

7.1.7 If top sheet is to be reused, fold it for later replacement. If

not, place it in laundry bag.

7.1.8 Remove client’s gown or pajamas.

7.1.9 Pull side rail up. Fill wash basin two thirds full with warm
water. Have client test temperature. Place plastic container of lotion in
bath water to water, if desired.

7.1.10 Remove pillow if allowed and raise head of bed 30 to 45

degrees. Place bath towel under client’s head. Place second bath towel
over client’s chest.
7.1.11 Fold wash cloth around fingers of your hand to form mitt.
Immerse mitt in water and wring thoroughly.
7.1.12 Wash client’s eyes with plain warm water. Inquire if client is
wearing contact lenses. Use different section of mitt for each eye. Move
mitt from inner to outer canthus. Soak any crusts on eye-lid for 2 to 3
minutes with damp cloth before
attempting removal. Dry thoroughly but gently.
7.1.13 As if client prefers to have soap used on face.
Wash, rinse, and dry well client’s forehead, cheeks, nose,
neck, and ears.
7.1.14 Remove bath blanket from client’s arm that is closest to you.
Place bath towel lengthwise under arm. Rinse side rail and
remove to other side to wash arm, if desired.

7.1.15 Bath client’s arm with soap and water using long, firm strokes
from distal to proximal areas. Raise and support client’s arm
above head (if possible) while washing axilla.
7.1.16 Rinse and dry arm and axilla thoroughly. Apply deodorant or
talcum powder, if used.

7.1.17 Fold bath towel in half and lay it on bed beside client. Place
basin on towel. Immerse client’s hand in water. Allow hand to
soak for 3 to 5 minutes before washing hand and fingernails.
Remove hand from basin and dry well.
7.1.18 Raise side rail and move to other side of bed. Lower side rails
and repeat steps 13 through 16 for other arm.

7.1.19 Check temperature of bath water, and change water if

necessary.
7.1.20 Cover client’s chest with bath towel, and fold bath blanket
down to umbilicus. Lift edge of towel away from client’s chest.
Bathe client’s chest using long, firm strokes with mitted hand.
Wash skinfolds under female clent’s breasts. Keep client’s
chest covered between washing and rinsing. Dry well.

7.1.21 Place bath towel(s) lengthwise over client’s chest and

abdomen. Fold blanket down to just above client’s pubic
region.
7.1.22 Lift bath towel. Bathe client’s abdomen with mitted hand. Stroke
from side to side. Keep client’s abdomen covered between
washing and rinsing. Dry well.
7.1.23 Help client put on clean gown or pajama top.
7.1.24 Cover client’s chest and abdomen with top of bath blanket.
Expose client’s nearer leg by folding blanket toward midline.
Drape client’s perineum.
7.1.25 Bend client’s leg at knee by positioning your arm under client’s
leg. Elevate leg from mattress slightly while grasping client’s
heel, and slide bath towel lengthwise under leg. Ask client to
hold foot still. Place bath basin on towel on bed, and secure its
position next to the foot to be washed.
7.1.26 Allow client’s feet to soak after the bath, unless contraindicated.
7.1.27 Use long, firm strokes in washing from client’s ankle to knee and
from the knee to thigh, unless contraindicated. Dry well.

7.1.28 Cleanse client’s foot, making sure to bathe between toes. Clean
and clip nails as needed. Dry well. Apply lotion to dry skin. Do
 not massage any reddened area on client’s skin.
7.1.29 Raise side rail and move to other side of bed. Lower side rail
and repeat steps 23 through 27 for client’s other leg and foot.
7.1.30 Cover client with bath blanket, raise side rail for client’s safety,
and change bath water.
7.1.31 Lower side rail. Assist client in assuming a prone or side lying
position (as applicable). Place towel lengthwise along client’s
side.
7.1.32 Keep client draped by sliding bath blanket over his or her
shoulders and thighs. Wash, rinse, and dry back from neck to
buttocks using long, firm strokes. Give client a back rub.
7.1.33 Apply disposable gloves if not done previously.
7.1.34 Assist client in assuming a side- lying or supine position. Cover
client’s chest and upper extremities with towel and lower
extremities with bath blanket. Expose client’s genitalia only.
Wash, rinse, and dry perineum. Apply water- repellent ointment
to area exposed to moisture.
7.1.35 Dispose of gloves in receptacle.
7.1.36 Apply additional body lotion or oil to client as desired.
7.1.37 Assist client in dressing. Comb client’s hair.
7.1.38 Make client’s bed.
7.1.39 Remove soiled linen and place it in laundry bag. Clean and
replace bathing equipment. Replace call light and client’s
personal possessions. Leave room as clean and comfortable as
possible.
7.1.40 Wash hands.
8. Observe client’s skin, paying particular attention to areas that were
previously soiled, reddened, or that showed early signs of
breakdown.
9. Observe client’s range of motion during bath.
10. Ask client to rate level of comfort.
11. Record bath on flow sheet. Note level of assistance required.
12. Record condition of client’s skin and any significant findings.
13. Report evidence of alterations in client’s skin integrity.

❖ Bed bath procedure video is posted in your gclassroom for your reference.
References:
Books:

♦ Kozier & Erb (2020), Fundamentals of Nursing (10th Edition), Pearson Publishing
House, Ca.
Url:
http://www.heris.nhs.uk/RMCNP/contant/mars32.htm The Royal Marsden Hospital Manual of
Clinical Nursing Procedures 6th edition.)