Chapter 26: Hygiene

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 Scientific Knowledge Base
• Good physical hygiene is necessary for
comfort, safety, and well being.
• Ill clients require assistance with personal
hygiene.
• Several factors influence a client’s hygiene
practices.

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 The Skin
• Functions of the skin: protection, secretion,
excretion, temperature regulation, and
sensation
• Three layers
– Epidermis: shields underlying tissue
– Dermis: contains nerves, vessels, and glands
– Subcutaneous tissue: insulates and cushions
skin
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 Feet and Nails
• The feet and nails require special attention.
• Discomfort causes stress and pain.
• The normal nail is transparent, smooth, and
convex with a pink nail bed and white tip.
• Changes in shape, thickness, and curvature
can occur.

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 Oral Cavity and Teeth
• Mucous membranes
• Oral mucosa is light pink and moist

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 Nursing Knowledge Base
• Personal preferences for hygiene
• Hygiene care is never routine
• During hygiene
– Assess physical status and limitations
– Assess client’s readiness to learn
– Provide privacy
– Foster physical well being

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 Factors Influencing Hygiene
• Body image • Personal preferences
– A person’s subjective – Frequency
concept of their – Preferred products
appearance • Physical condition
• Social practices – Lack of physical energy
– Social groups and – Loss of dexterity
family practices • Knowledge about
• Socioeconomics importance of hygiene
• Cultural variables
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• How about scabies?

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• Is a contagious skin infestation by the itch mite
• Burrow by female mite- penetrates into the upper layer of
skin
• Burrow are shory wavy brown or black, threadlike lesions
• Find between fingers, in the creases of the wrists and
elbow, beneath the breast tissue and in the groin area
• Intense itching, worse at night- secondary lesions
• Scabicide lotion, linens and clothing should be washed in
very hot or boiling water

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 Hygiene
• Bathing
• Oral hygiene
• Dressing/ grooming
• Toileting

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 Bathing and Skin Care
• Tub or shower
– More thorough than bed bath
• Complete bed bath
– For clients who are dependent and require total
hygienic care
• Partial bed bath
– Involves bathing only those parts that would
cause discomfort or odor if left unbathed
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 Bathing
• Therapeutic bath
– Physical effect
– E.g. skin or perineum

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 Perineal Care
• Part of the bed bath
• Clients most in need are those with
secretions or Foley catheters and following
rectal surgery or childbirth
• Be alert to discharge, skin irritation, and
odors
• Good perineal care prevents skin irritation
and breakdown
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 Feet
• Corn- avoid pressure
• Planter warts
– Virus papovavirus hominis
– Currettage, freeze with solid carbon dioxide, apply salicylic acid
• Fissures
– Good foot hygiene
– Application of an antiseptic to prevent infection
• Tinea pedis
– Antifungal ointment
• Ingrown toe nail
– Proper nail trimming

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 Foot and Nail Care
• Soak and soften cuticles.
• Cleanse and dry the feet thoroughly.
• Trim nails straight across (check agency policy
regarding trimming of nails).
• Inspect for lesions, dryness, and signs of infection.
• Clients with DM (Diabetes Mellitus)or PVD
(Peripheral Vascular Disease) are at risk for impaired
circulation.

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 Nails
• Avoid trimming or digging into nails at
lateral corners

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 Oral Hygiene
• Involves cleanliness, comfort, and
moisturizing the mouth
• Unconscious client
• Flossing and brushing
• Denture care

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 Hair
• Dandruff
• Hair loss
• Ticks, lice, scabies
• Hirsutism

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 Hair Care
• Brushing and combing
• Brushing/combing hair from scalp to end
• Shampooing

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 Shaving
• Facial hair
• Electric razor
• Refer to the client’s normal routine
• Never shave off a mustache or beard
without the client’s consent

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 Eyes
• Contact lens
– Refer to book for removing of the contact lens
– Soft lens- use the pads of the thumb and index finger
• General eye care
• Eyes care for the comatose client
– cleaning
– Moist compress
– Protective shield
– Continuous monitoring

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 Ears
• Avoid bobby pins and cotton- tip applicator
• Retracting the auricle up and back
• Irrigating
• Proper usage and care of hearing aids
– Behind- the- ear (BTE)
– In- the- ear (ITE)
– In- the- canal (ITC)
– Eyeglasses Aid
– Body hearing aid

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