Basic Client Needs

 Hygiene

• It is the science of health and its preservation.

• It is a condition of practice such as cleanliness that is
conducive to preservation of health.
 1. Bathing

• This is one of the hygienic measures you need to take

as an individual as well as ensuring that the patients
under your care bath frequently
Importance of Bathing
• It cleans, refreshes the patient and makes him/her feel
comfortable.
• Provides chance for the nurse to make observations on
the patient, if remember under physical examination
we mentioned this. You can be able to observe the
patient when they undress to bath.
 cont
• It stimulates the blood circulation because there is
dilatation of blood vessels leading increased blood
flow.
• Increases patient’s sense of wellbeing and self-
esteem
Types of Baths
• Shower bath
• Tab/plunge bath
• Bed bath.
 During bed bath you must observe for the following:

• Posture and mental status- observe whether

changing or not, is the patient confused.
• Signs of discomfort if you are bathing the patient are
the patient comfortable, observe facial expressions.
• Breathing pattern-is it normal breathing or patient is
having difficulties in breathing.
• Odour from the body or clothes- is there an
offensive smell especially where the patient messes
himself
 Care of the Skin

• When pressure is not relieved on any part of

the body regularly, blood supply to the area
will be interfered. This will result in affecting
the nutritional status and oxygen supply to the
area. The end result will be reddening of the
area with possible tissue break down. Good
skin care is helpful in preventing such
problems.
 Pressure areas
• are areas of the body where tissues may be
compressed between the underlying bone and
bed leading to formation of pressure sores.
These are areas where the bones are
prominent and liable to formation of pressure
sores
 pressure sore (Decubitus)

• A pressure sore or decubitus is an ulcer formed on

an area where the skin tissue has been destroyed
and there is progressive destruction of the
underlying tissues. The terms decubitus ulcer,
pressure sore and bed sore are used
interchangeably.
• A pressure sore is an ulcer or sore which forms
at a point of bone prominence due to pressure,
friction or moisture when the patient is confined
to bed or wheel chair
Predisposing Factors to Pressure Sore Formation

Moisture: It reduces skin’s resistance to other physical

factors such as force
Poor nutrition: clients with poor nutrition experience
serious muscle wasting and decrease in subcutaneous
tissue which serves as a pad between the skin and the
underlying bone.
Anaemia: decreased haemoglobin reduces oxygen carrying
capacity of blood and amount of oxygen available to the
tissues. Anaemia also alters cellular metabolism.
.
• Shearing force: force exerted when client is
being moved or pulled in bed. The skin
adheres to the surface of the bed while the
skin slides in the direction of the body
movement.
•   Infection: It increases metabolic and
nutritional demand thereby depriving the
tissues of oxygen and nutrients
 Signs of Pressure Sore Formation

• Bleaching of the skin

• Redness of the skin
• Heat
• Tenderness
• Skin irritation
• Pain on pressure area
 Prevention of Pressure Sores

• Do routine check-ups of pressure areas during

baths for presence of pressure sore formation
• Keep the pressure area clean and free from
irritation to prevent pressure sore formation.
• Promote measures to improve nutritional
status of the patient because malnutrition
predisposes to pressure sore formation as the
skin can easily break
 cont
• Change patient’s position 2 hourly and keep a
chart for turnings to relieve pressure from
bony prominence areas.
• Ensure the bed is free from wrinkles, bed
crumbs or other irritating materials that can
cause friction of the skin.
• Pressure area care should be done 4 hourly in
helpless patients e.g. unconscious patient
 Care of the Mouth (Oral Toilet)

• This is the care given to the patient’s mouth

with the aim of cleansing the mouth, and
promotes the flow of saliva.
Indications for Oral Care
• unconscious and weak patients because there
are not able to clean their mouths.
• Patients with difficulties in breathing
• Those on milk or fluid diet to cleanse the
debris from milk.
• Patients with diseases of the mouth e.g.
stomatitis inflammation of the mouth,
gingivitis inflammation of the gums etc. to
prevent bad breath.
• Patients on artificial feeding
  
Advantages of Oral Care

• Increase salivary flow.

• Prevent mouth infections.
• Prevent dental carries.
• Prevents drying of the mucous membrane of
the mouth.
• Prevent sordes (dirty particles found in
between the teeth).
 Complications of a Dirty Mouth
• Stomatitis– It is inflammation of the mouth.

• Gingivitis – It is inflammation of the gums.

• Tonsillitis– It is inflammation of the tonsils.

• Parotitis –It is the inflammation of the parotid glands.

• Otitis Media –This is inflammation of the middle ear.

• Glossitis– This is inflammation of the tongue.

• Halitosis–This is bad smell of the mouth.

• Anorexia– This is loss of appetite.

 Care of the Hair and Nails.
Hair Care Purpose
• Remove dirt and old cells and avoid the skin irritation.
• Remove dead cells from the scalp.
• Stimulate scalp circulation just as you can promote blood
circulation when you give a patient a bath in the same way there is
blood vessel dilation hence increased blood circulation.
• Remove the chemicals especially when insecticide has been used
to clean the hair.
• It improves the patient’s body image as the patient will look nice
when the hair is washed especially with unkempt hair as a result of
self-care deficit
 Indications

• Chronically ill patients

• Patient undergoing special operation on the
head.
• Patients with dirty hair.
• Patients infested with lice.
• Patients who have been in bed for too long.
• Mentally ill patients
 Common Problems of the Scalp and Hair

1. Dandruff
2. Pediculosis
• types of pediculosis. These are:
I. Pediculosis capitis its found on the head
II. Pediculosis corporis its found on the body
III. Pediculosis pubis it’s found in the pubic area
3. Hair loss (alopecia) or Boldness