Personal

Hygiene
 What is it???

• Hygiene : Health

• Personal hygiene :
the self care
measures people use
to maintain their
health

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 Is it important for nurse???
• Why???
• Lets discuss!!!

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 PURPOSE OF NURSE
PROVIDED HYGIENE
• Remove
microorganisms
• Do physical
assessment
• Increase
circulation
– Distal to proximal
– Return to heart
• Improve self image
• Provide comfort
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Factor Affecting
Personal Hygiene

???
 SOCIOCULTURAL
FACTORS
• Bathe daily; not all cultures do
• Economics
• Some cultures wear items not to be
removed in bath
– examples: wigs, head dressings, medals or
shawls
• Male nurse only or female nurse only
may be necessary in some cultures

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 SOCIOCULTURAL
FACTORS
• Male relative may not allow male
nurse alone with woman patient
• Autonomy of patient is paramount;
in others, family makes decisions for
care
• Level of education
• Nurse accepts all who lovingly
participate

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 KNOWLEDGE

• May need teaching regarding:

– Front to back perineal care
– Special foot care for circulatory
problems
– Skin inspections by dermatologist

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DEVELOPMENTAL LEVEL:
NEWBORNS
• Do not place under
running faucet
• Do not submerge
until umbilical cord
drops off
• Dry carefully,
especially the head
• Place cap after bath

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 YOUNG CHILDREN
• Children can drown in 2 inches
of water; never leave alone
during bathing
• No milk or juice bottles in bed
• Wipe off teeth after eating with
soft cloth
• Demonstrate on teddy bear

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 CHILDREN
• Children may have
natural parents,
stepparents, four
sets of grandparents

• For decision making,

some cultures must
ask father, some
must ask
grandmother
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ADOLESCENTS
• Modesty essential
• Normal clothes, not
gowns
• Bed pans not
acceptable
• Allow decision
making

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 OLDER ADULTS

• Heat insensitivity;
can burn easily

• Foot care

• Skin very fragile

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 Personal Preferences
• In providing hygiene, may find
very personal details
• Report on “need to know” basis
• Decide together on what to take
further
• Must break personal preferences if
signs of abuse

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 Physical Condition
• Patient receiving chemotherapy

• Patient receiving radiation therapy

• Unconscious patient

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 Hygiene Care Schedule
• Early morning care: Urinal/bedpan, wash
hands and face, brush teeth
• Morning care: After breakfast, complete bath
or shower, hair care, nail care, oral care, back
rub, linen change
• Afternoon care: straighten linen, offer
urinal/bedpan/commode, wash hands/face
• Evening care: Elimination, wash hands and
face, oral care, linen straightening, back rub

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HYGIENE includes:
• Care of the skin
• Care of the feet and
nails
• Oral hygiene
• Hair care
• Care of the eyes,
ears, and nose
• Client’s room
environment

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 Diskusi kasus
1. Ny. A usia 50 tahun di rawat di RS terkena
hipertensi dan stroke. Ny. A tampak kotor dan
pergerakan terbatas. Kulit tampak kemerahan
terutama bagian yang terdapat penekanan..
Berdasarkan kasus diatas:
2. Pengkajian fokus apa yang saudara lakukan
terkait personal hygiene klien
3. Diagnosa keperawatan apa yang muncul
4. Intervensi apa yang saudara lakukan untuk
pemenuhan personal hygiene klien
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 tugas
Carilah 1 jurnal setiap kelompok yang terkait
dengan personal hygiene:
- Lakukan jurnal sharing:
- Topik/judul jurnal
- Tujuan
- Hasil jurnal

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Care of Skin

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 SKIN
• Regulates body temperature
• First line of defense against harm
• Antibacterial and antifungal
• Transmits sensations
• Signs of problems
• Redness (erythema)
• Wet
• Not intact

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PATIENTS AT RISK FOR SKIN
PROBLEMS
• Altered level of consciousness
• Altered nutrition
• Immobility
• Dehydration
• Altered sensation
• Secretions on skin
• Mechanical devices, restraints
• Altered venous circulation
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 Nursing Diagnosis
• Impaired skin integrity related to
immobilization, exposure to chemical
irritants

• Hygiene self care deficit : bathing

related to pain in hands, forced
immobilization, musculoskeletal
weakness
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NURSING INTERVENTIONS
• Goals :
- Client will have intact skin
- Client will be free of odors

• Expected outcomes :
- Skin will be without redness
- Skin will be warm, soft, smooth, and
well hydrated
- Odors will be reduced or eliminated

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 Continue…
Intervention :
 Bathe client daily

 Dry skin thoroughly

after each cleansing

 Apply lotion to skin

after bathing

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NURSING ASSESSMENT
WHILE BATHING

• Color and condition of

skin
• Pain on movement
• Level of consciousness
• Injuries
• Scars
• Skin turgor
• Nevi
• Weight loss or gain

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 PERINEAL CARE
• Professionalism always
• Female
– Always sterile to contaminated (urethra to
rectum)
• Male
– Assess for circumcision
• If not, cleanse under foreskin and replace

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Care of the feet and nails

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 Common Foot & Nail
Problems
 Callus
 Corns
 Plantar warts
 Ingrown nails
 Ram’s horn nails
 Paronychia
 Foot odors

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 Nursing Diagnosis
• Pain related to callus formation, ingrown
toenails

• Impaired physical mobility related to painful

foot lesion

• Impaired skin integrity related to improper

nail-cutting practices, friction of shoes, injury
to nail

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 FOOT CARE
• Soak feet as part of bath
• Clean toes and toenails
• Teach as you go
• Range of motion of legs
• Feet of diabetic patients and patients
with vascular disease are inspected
carefully; Never cut toenails of these
patients
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 NAIL CARE
• Observe circulation; color, capillary
refill time
• Observe color, sensation, and
movement (CSM)
• Cut nails straight across and file
smooth; Do not go down into corners
• Assess for rings too tight or too loose

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Oral hygiene

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 Oral Hygiene
 Common oral problems :
– Dental caries
– Periodontal diseases

 Nursing Diagnosis :
 Altered oral mucous membrane related to
radiation of oral cavity

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 MOUTH CARE
• Examine with gloves and light,
especially smokers
• Use only water soluble lubricants
• Unconscious patient has no gag
reflex, position on side for care
• Teach about brushing and flossing

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Hair care

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 Hair and Scalp Problems
• Dandruff
• Pediculosis (Lice)
– Pediculosis Capitis (Head Lice)
– Pediculosis Corporis (Body Lice)
– Pediculosis Pubis (Crab Lice)
• Hair Loss (Alopecia)

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 Nursing Diagnosis
• Impaired skin integrity related to scalp
laceration
• Pain related to scalp lesion, accumulated
secretions in hair
• Body image disturbance related to
unkempt physical appearance
• Risk for infection related to scalp
laceration

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Nursing Interventions

• Brushing
• Combing
• Shampooing
• Mustache and beard
care

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Care of the eyes, ears, and
nose

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 Nursing Diagnosis
• Sensory perceptual alterations (visual,
auditory, or olfactory) related to
obstruction in ear canal, nasal
obstruction, inflammation of eyes or
local eye infection

• Risk injury related to decrease of visual,

auditory, or olfactory function

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 EYE CARE
• Contact lenses usually removed
• Stored in saline liquid; case labeled
• Also label and safeguard glasses in drawer
• Clean inner to outer canthus
• Patient must be able to blink to protect cornea
• Never use cotton near eyes
• Treat each eye separately
• Eyes considered sterile
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 EARS
• Allow nothing sharp in ears
• Hearing aids now miniscule in size –
don’t lose! Label case
• Cerumen in ears may need softening
and removing
• Speak directly to patient’s face

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Continue…

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Client’s room environment

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BEDMAKING

• Make bed for patient

comfort
• If incontinent, wash,
rinse, dry, change
linen
• Position as ordered

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Procedure bed making

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 NURSE SAFETY IN
BEDMAKING
• Raise bed to
working height
• Face patient
• Conserve steps
• Don’t lift alone
• Side rails as ordered
• Lower bed and place
call bell when
leaving

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Any Questions ???

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