COLLEGE OF NURSING

In Partial Fulfillment of the Requirements for

NCM 103: Fundamentals of Nursing Practice

CASE STUDY ABOUT

PROMOTION OF HYGIENE

Submitted by:

Group 3, BSN 1C
Leader: ESTEBAN, REYMART
Members:
FABIAN, CHRISTHAL ANNE
MANUEL, ANDREA KHAYE
MACACADAYA, NORHAYNIE W.
SEFUENTES, ROSA CAMILA
MAMAYOG, BAI HAIDEE R.
DEGUZMAN, KEN
GATCHALIAN, AINE JERMAINE
JUNDARINO, DIANNE

Group 4, BSN 1C
Leader: MATIAS, JOHN KHYLE T.
Members:
MARTINEZ, CHRISTHEL C.
MORGIA, MONIQUE T.
MEDINA, AXIEL LAV N.
NERA, JOANA MAE C.
NOVICIO, ASHLEY M.
OCUAMAN, ROSA ANNE C.
OH, SANDER JEAN II C.
OLFINDO, CARMELA AMOR

Submitted to:

Dean Emily Aquino, MAN, RN

I. Learning Objectives
At the end of the case presentation the students will be able to:
1. To apply an accurate nursing process in a given hypothetical situation through the
presentation of the 11 Gordon's Functional Health Pattern and a Nursing Care Plan for
the priority nursing problem.
2. Learn proper way of using 11 Gordon’s Functional Health Pattern and Nursing Care Plan
and use it to promote a good intervention to clients
3. Realize factors to be used in creating or planning individualized care plan to have an
accurate diagnosis and plan to promote fast, safe, high quality patient care.

II. Objectives of the Study

A. General Objectives

Upon completion of the study, the students will demonstrate the health promotion
of hygiene and how it will affect the patient's recovery. Increase knowledge of
positive health behaviors and enhance wellness. By reducing high-risk hygiene
practices, promoting appropriate use and maintenance of sanitation.

B. Specific Objectives

● Assess the client using Gordon’s 11 Functional Health Pattern.

● Formulate a Nursing Care Plan related to Hygiene Promotion. Specifically in Self-care

Deficit.
 III. Case Situation

● You are caring for an 82 year old female. During your early morning assessment, you
note that the client's hair is oily and matted and she has an unpleasant body odor. Her
dentures in a container at the bedside are in need of cleaning. The client said that she
feels that she needs a bath and personal care.

Vital Signs:

1. Blood Pressure - 140/70 mmHg

2. Pulse Rate - 71 bpm

3. Temperature - 36.9°C

4. Oxygen Saturation - 97%

5. Respiratory Rate - 18 bpm

6. Severity - 5/10

GORDON’S TYPOLOGY OF 11 FUNCTIONAL HEALTH PATTERNS

FUNCTIONAL BEFORE DURING INTERPRETATION

HEALTH HOSPITALIZATION HOSPITALIZATIO
PATTERNS N
Health – - Have unprescribed - Have taken drug - Given the patient's age
perception and medications to use as maintenance and current health
health pain killers and for prescribed for her condition, she must
management other purposes. condition and was have full support and
pattern taken during guidance from her
Compliance - Does not perform any hospitalization and at guardian/s in
with medication exercises because of her home. performing simple
regimen, use of condition. And lack of activities such as light
health support from the family - Does perform exercises. The patient
promotion as well as knowledge minimal exercises but shows minimal
activities such about proper exercises not regularly. improvements during
as regular to perform. her hospitalization,
exercise and - Have been checked considering that lack of
annual check - - No annual check-ups by the physician only support from her family
ups and consultation to any during her time in the is the primary factor that
healthcare professional Hospital. affects her medication
was made because of intake.
financial problems.
-Treating yourself can
actually make your
status worse. Without
the words of someone
who has knowledge in
medicine, self-treatment
and perception about a
condition can be a
problem with a person's
recovery.

A proper assessment,
medication, exercises,
and recommendation
accurate for your
condition is advisable to
 improve health status.

Reference:
https://bmcgeriatr.biom
edcentral.com/articles/1
0.1186/s12877-023-
03917-y

Ruiz, M. E. (2010).
Risks of self-
medication. Rockville
Pike Pethesda MD:
National Library of
Medicine
https://pubmed.ncbi.nl
m.nih.gov/20615179/

(n.d.). Dangers of Self-

Medication. Chicago:
Gateway Foundation.
https://www.gatewayfo
undation.org/addiction-
blog/dangers-of-self-
medication/

Nutritional –
metabolic - Only eat 2 times a day - Has a regular meal -Healthy diet is
pattern with less fluid intake. schedule of 3 times a important after
Condition of Her meals consist day and is advised to experiencing stroke, to
skin, teeth, hair, mostly of meat (pork) drink 5 or more glasses prevent future strokes
nails, mucous products and lessof water a day and eat and to help for the
membranes; vegetables. more vegetables and recovery of the body.
height and fruits. Foods that are Foods that a person
weight - Dentures are cleaned rich in protein and takes is one of the
1-2 times every 2 days, nutrients. factors of their health
if the daughter has time status. Changes occur
to clean it and do mouth - Mouth care and for it can be either
care. cleaning of dentures helpful or harmful.
are performed with use
- Skin didn’t go back to of soft-bristled brush
Good hygiene prevents
its normal position due and nonabrasive
further development of
to loss of elasticity. denture cleanser. complications on health
status. A good
- When skin turgor is mouthcare and dentures
performed, skin didn’t help clients on their
Weight: 55kg go back to normal physiological and
position, mental health. It also
Height: 170cm gives comfort and
confidence.
BMI: 20.522 (Normal) Weight: 53kg
Performing skin turgor
Height: 170cm test is often use to know
the skin condition of a
BMI: 18.339 person as it can also
(Normal) indicate further
complications. But,
having a poor skin
turgor for older adults
are normal due to aging.
The elasticity decrease
 thus skin doesn’t go
spring back to its normal
position.

REFERENCES:
Leszczak, J., Czenczek-
Lewandowska, E.,
Przysada, G.,
Wyszynska, J., Weres,
A., Barani, J., ....
Mazur, A. (2019). Diet
after Stroke and Its
impact on the
Components of Body
Mass and Functional
Fitness- A 4- Month
Observation. Rockville
Pike Bethesda MD:
National Library of
Medicine
https://www.ncbi.nlm.n
ih.gov/pmc/articles/PM
C6627133/#

(n.d.). IMPORTANCE
OF GOOD ORAL
HEALTH. Bull Creek,
Australia.: Access
Dental Care
https://accessdentalcare
.com.au/media/importa
nce-good-oral-health/

Cafasso, J. (2016).
Understanding Skin
Turgor. New York City:
Healthline
https://www.healthline.
com/health/infected-
scab#prevention

Elimination -Defecates 1-2 times -Defecates once a day, Bedridden patient is at

pattern per week, soft stool and stool soft formed and risk of constipation, but
Frequency of light yellow in color light yellow color with can be treated with
bowel moderate amount lifestyle modification.
movements, -Urinates 2-3 times a
voiding pattern, day, yellowish urine. - Voids 4-5 times a day
pain on to a light yellow/amber Decreased urine output
urination, -A bit of pain during urine. No pain during common causes are
appearance of urination urination. dehydration or
urine and stool inadequate fluid intake,
-Diaper change only medicines such as
happens when a family antibiotics or other
member is present, even - Diapers change daily medical conditions.
if there is a presence of or when they are soiled.
stool and filled with With the use of wipes Proper hygiene is also
urine. and warm water to crucial and the patient's
clean the area. skin should be cleaned
 - They use cloth or well each time the
wipes to eliminate diaper is switched. This
visible output on the can help prevent or
patient's bed. minimize skin issues.

References:
Anne mounsey, MD
(2015) Management of
Constipation in Older
Adults
https://www.aafp.org/p
ubs/afp/issues/2015/091
5/p500.html#:~:text=M
ost%20patients%20are
%20initially%20treated
,or%20psyllium%20ma
y%20improve%20symp
toms.
Molitoris BA. Acute
kidney injury. In:
Goldman L, Schafer AI,
eds. Goldman-Cecil
Medicine. 26th ed.
Philadelphia, PA:
Elsevier; 2020:chap
112.
https://www.mountsinai
.org/health-
library/symptoms/urine-
output-
decreased?fbclid=IwA
R2pKzZ5b253PgwnsK
wYj5Qkcqlqk_VXKuM
ipLGoDZtT5v0JXk0wF
8bLAbA#:~:text=Com
mon%20causes%20incl
ude%3A,as%20antichol
inergics%20and%20so
me%20antibiotics

Michael Silva (2022)

How Often Should a
Nursing Home Change
a Patient’s Diaper?
Silva Injury Law.
https://silvainjurylaw.co
m/how-often-should-a-
nursing-home-change-
a-patients-
diaper/?fbclid=IwAR1
GPEgyEqlk1YChr4V_
mIKGLuSWN6RxVqm
LIQXPdYgPxVKYK8i
m1hJ7iCk

Activity – - There are no activities -She had simple During hospitalization,

exercise pattern or exercises performed. exercises such as Toe Her simple ac by
- bends, ankle bends, and activity and exercise
Exercise, - There is no sign of hand Rolling helped her to better her
hobbies, may difficulty in breathing.
movements during her situation and to
include therapy but the maintain her physical
cardiovascular activities were limited health. Additionally, it
and respiratory - Had no sign or due to the short prevents contractures
status, mobility evidence of a cough. hospitalization. and other bone and
and activities of muscular problems.
daily living - There is no exercise
performed, thus not
affecting the heart rate. Reference:
Denslow.E.(2021)
-Her hobbies before are Bedridden After Stroke
playing cards and maximize recovery
watching TV https://www.flintrehab.
com/bedridden-after-
stroke/#:~:text=All%20
movement%20is%20be
neficial.,never%20give
%20up%20on%20
recovery.

Sleep - rest -Sleeps around 10 -Different turning Proper positioning and

pattern o'clock PM. Butpositions by family supporting body will
Client’s whenever she can't members and nurses add more comfort and
perception of sleep, she watches TV creates discomfort and improve sleep
quality and til she gets sleepy. comfort at the same
quantity of sleep time due to often
and energy, -Normal waking time changes of position.
sleep aids, and up around 7 or 8 AM.
routines client -She sleeps soundly Sleeping is essential to
uses -Doesn't use any and peacefully due to restore energy levels
sleeping pills when she limited noises and good and improve health.
can't sleep. environment And a good comforting
temperature. environment improves
the sleep cycle.
-Going to bed at any
time, waking up at Reference:
various hours. DailyCaring Editorial
Team 11 tips to improve
senior sleep by reducing
pain and discomfort
Medical Conditions /
Practical Tips
https://dailycaring.com/
11-tips-to-improve-
senior-sleep-by-
reducing-pain-and-
discomfort/#:~:text=It's
%20best%20to%20avoi
d%20stomach,on%20ne
rves%20in%20the%20n
eck.&text=For%20hip
%20pain%2C%20sleep
%20on,%2C%20pelvis
%2C%20and%20spine
%20aligned.

The importance of sleep

for older people (The
good care group)
 https://www.thegoodcar
egroup.com/news/impo
rtance-sleep-older-
people/

Dubose, J. R., & Hadi,

K. (2016). Improving
inpatient environments
to support patient sleep,
Volume 28, Issue 5, pp.
540-553. Oxford:
International Journal
for Quality in Health
Care.
https://doi.org/10.109
3/intqhc/mzw079
Cognitive – -There are no changes -No changes in -Due to the presence of
perceptual in cognitive function. cognitive function cataracts, the vision gets
pattern either. But whenever more declined but for
Vision, -All senses function, she speaks, it causes older adults, it is normal
hearing,taste, except for vision due to her discomfort to have cataracts. But
touch, smell, presence of cataract you can get cataracts for
pain perception and hearing as she ages -it became so hard for other reasons like
and her to see clearly. Her having an eye problem
management; hearing capability gets after surgery but no
cognitive more declined as it matter what type of
functions such needs to get near her cataract you'll need
as language, ears in order to be surgery to treat it.
memory, and heard.
decision The lens opacity
making. Her cognitive function reduced visual acuity.
has not changed, but As the eye ages, the lens
she experiences loses water and
discomfort and increases in size and
difficulty speaking density, causing
clearly ever since she compression of lens
had a stroke, especially fibers. A cataract then
with regard to his forms as oxygen uptake
vision since as she is reduced, water
ages, her cataract content decreases,
worsens and spreads, calcium content
making more of the increases, and soluble
lens clouded.. protein becomes
insoluble.

Reference:
Tsaii .J.(2023)
Cataract RNpedia
https://www.nei.nih.gov
/learn-about-eye-
health/eye-conditions-
and-
diseases/cataracts#:~:te
xt=Most%20cataracts%
20are%20related%20to,
need%20surgery%20to
%20treat%20it.
Self – -not sensitive in her -Too sensitive about Her self-perception is
Perception – everything that makes complicated, impacted
Self Concept body comfort
Pattern
Body comfort,
-Capable of expressing
body image,
feelings and opinions.
feeling state,
attitudes about
self, perception -The tone of voice
of abilities, doesn't sound harsh
objective data while answering the
such as body questions.
posture, eye
contact and
-her voice tone was
voice tone.
clear and don't have
difficulty in speaking
-The posture cannot be
verified as she is
bedridden.
-There are signs of
insecurities due to what
her body experienced,
as she cries and is
unable to continue
telling her stories.
-States that "because of
being bedridden, there
are a lot of things I can't
do".
-I notice that I bathe
every 3 days which
sometimes leads to
redness and rashes in
the diaper area.
- She states that her hair
tends to get oily and
matted and also she
detects that there is
presence of foul body
odor.
her uncomfortable like by both physical and
the bed sheets, pillow. emotional aspects. Her
feeling of being delicate
or vulnerable may be
-Therapy stopped after influenced by her
months. increased sensitivity and
discomfort in different
areas of her
-Have taken drug
environment, such as
maintenance but not
bed linens and pillows.
regularly.
The discontinuation of
therapy and the absence
of maintenance
-Voice of tone had medication could imply
difficulty speaking and a sense of autonomy or
was weak self-reliance in
managing her health.
Her hygiene was
-not possible to essential, but during
confirm or ascertain hospitalization, there
her body posture was a noticeable effort
because she is confined to address and improve
to her bed during upon personal care with
hospitalization. the support of her
daughter. The transition
to bathing every other
-She seems uncertain day and using
or anxious while alternative methods to
answering the cleanse herself exhibits
questions, and her her resilience and
emotions is crying and adaptiveness in
inability to continue challenging
speaking that she may circumstances. Good
feel vulnerable hygiene prevents further
development of
complications on health
-due to her condition of status. Help for good
being bedridden, there hygiene to immobile or
are many activities or incapable ones is a need
tasks she is unable to to promote cleanliness
perform. and prevent aggravation
or spread of
microorganisms.
-she managed to bathe
every other day with
the assistance of her
daughter while she was
Reference:
in the hospital.
-she used warm hot Daryl, J. (1972b). Self-
water to ease the Perception Theory. In
itchiness caused by the Advances in
diaper. Experimental Social
Psychology (pp. 1–62).
 Elsevier BV. c
-she couldn't stand or
take a proper shower,
Goldenhart, A. L., &
she resorted to using a
Nagy., H. (2022).
soaked towel to wash
Assisting Patients With
her head.
Personal Hygiene.
Rockville Pike Pethesda
MD: National Library
of Medicine
https://www.ncbi.nlm.n
ih.gov/books/NBK5631
55/

Role – -Deceased husband -Wanting to live more The patient sought to

Relationship since 1988. Only lives to be with her children concentrate on her
Pattern with her sons and and to see her children and grandkids
daughters. grandkids grow and after losing her husband.
Perception of
have their own family. The patient offers her all
current major
by carrying out her
roles and
- Feel a bit sad as she primary parental duties
responsibilities
was not well taken care -Has a good i for them. Despite the
(e.g. father,
of by her family.. relationship with her fact that they lost the
husband, son,
family and people foundation of their
etc) ;
around her. family, she gave them
satisfaction with
-Her perception about the joy of being a
family, work or
being a mother to her wonderful mother.
social
children is not as big a Since the patient is
relationships
factor as before to her unemployed, she
as her children already concentrates on
have a family of their teaching the children the
own and she is very old. duties and obligations of
a good mother. She also
pays attention to her
grandchildren. Besides,
Parents' love and
support can never be
replaced by anything we
have. But due to her
condition right now that
she is bedridden now, it
lessens the work and
task physically but
emotionally and
mentally, she still
supports and provides
what is the role of being
a mother to them.

Reference
Delvecchio E, Di Riso D
and Salcuni S (2016)
 Self-Perception of
Parental Role, Family
Functioning, and
Familistic Beliefs in
Italian Parents: Early
Evidence.
https://www.frontiersin.
org/articles/10.3389/fps
yg.2015.01983/full

Sexuality -4 history of pregnancy -Has no more number Women who are

& childbirth of pregnancies and menopausal or
Reproductive
childbirth due to age postmenopausal may
pattern -
and Reproductive have reductions in
Number and
- Has inactive sexual pattern (menopause) libido, orgasm, and
histories of
life as her husband died frequency of coitus;
pregnancy and
year 1988 these reductions are
childbirth,
-No sexual relationship most frequently brought
difficulties with
and activities on by physiologic
sexual
- Already menopause changes brought on by
functioning and
since around the age of menopause, however
satisfaction with
55 above. -Sexual functioning depression or marital
sexual
decreased. strife are other possible
relationship
causes. And, desires for
-Sexual functioning sexual activities
decreased. decrease due to changes
physically and mentally
and all are normal due to
aging.

Reference:
Jeanne L. Leventhal,
MD. Perm J. 2000
Summer; Management
of Libido Problems in
Menopause.
https://www.ncbi.nlm.n
ih.gov/pmc/articles/PM
C6220606/#:~:text=Sex
uality%20and%20Agin
g,marital%20discord%2
0(Figure%201).

Coping – Stress -Felt stressed about -Cope with family and The patient's coping
Tolerance her current situation friends with their mechanism of stress is
Pattern and cries whenever she support whenever she to interact with her
thinks of it. Often cries is feeling down or not family , nurses before
Client’s usual
to express her emotion. good. and during
manner of
hospitalization
handling stress,
whenever she
available
-Family members, experiences stress and
support
the ability of the patient
systems, especially -In times of stress or to adapt to her condition
perceived ability granddaughters, problems, she talked to lessen stress.
to control or comfort her whenever about her life and
manage she feels stressed. experiences to her
situations grandchildren and With the
nurses instead of being presence/interaction of
-she also listens to the quiet when they visited her family and nurses.
radio to relieve stress her. That helped her
mentally and physically
in recovering
-She expresses her
desire to recover and
her ability to accept the
situation by Reference:
collaborating with Eaton, P. M., Davis, B.
medical L., Hammond, P. V.,
recommendations. Condon, E. H., &
McGee, Z. T. (2011).
Coping strategies of
family members of
hospitalized Nursing
research and practice,
2011.
https://www.hindawi.c
om/journals/nrp/2011/
392705/

Value – Belief -She was not associated -Improved relationship Hospitalization led to
Pattern with any religious with God. Praying to significant
entity. get better at all times. improvement in the
Religious
client's faith, as she
affiliation, what -When she is admitted experienced significant
client perceives
-Being with her to the hospital, she just changes in her religious
as important in prays and believes that beliefs.
children, she believes,
life, value-belief everything will soon be
is what's most
conflicts related okay.
important in life.
to health,
special religious -Her relationship and Reference:
practices faith in God became
Robinson, L. M. (2017,
-Did not have much of a stronger.
November 4). Suffering
strong relationship with
God. -Prays to God to help can 'strengthen faith,
her during hard times increases resilience’.
Rome Sentinel.
https://romesentinel.co
m/stories/suffering-can-
strengthen-faith-
increases-
resilience,12416