SKILLS LABORATORY

LECTURE NOTES
BEDBATH 31. Wipe one side from back of shoulder, to buttock, to upper thigh
1. Introduce self 32. Repeat step 31 for other side
2. Verify patient with identifiers o For the midline of the back, wipe from the nape to above the
o Name sacral region
o DOB 33. Tap the patient’s back or perform massage (effleurage and
3. Perform hand hygiene petrissage)
4. Attend to client’s privacy (e.g. close curtains) o In performing tapping, tap from the base of the lungs to the
o Place incontinent pad under the patient top
5. Let the patient hold a bath towel, then cover the whole body
6. Remove top sheet and blanket underneath the towel Perineum
o Place on bedside chair or hamper 34. Ask if the patient is able or unable to clean his/her perineum area
7. Miter hand towel 35. If unable, use the towel to wipe genitals with the same principle of
o Three ways to miter the hand towel the perineal care
1. Triangular fold o For females, wipe from top to bottom and start at mons
2. Rectangular fold pubis, labia majora, labia minora, clitoris
3. Four-folds o For males, wipe from cleanest to dirtiest and start from the
8. Ask patient if he/she wants the nurse to use soap thighs, penis, scrotum, perineum
o Usually, soap is not used 36. If the patient defecated, use wet wipes to clean
37. If the patient has a catheter, use betadine paint in cleaning
Head
9. Place bath towel under the head Last step is to document the whole bed bath for skin integrity (for wounds,
10. Clean the eye from inner canthus to outer canthus with the sides of edema, lesions), patient’s temperament, etc.
the mitered towel (side of the fingers)
11. Clean the ears with each side (palm side v.v.) Post-Bath
12. Rinse, Dry - Use powder or lotion
13. Wipe the rest of the face from top to bottom - Change the top sheet by slowly removing the towel under the top
o Forehead to cheeks/nose to chin sheet
o One side per stroke
Additional Notes
Neck - In performing the bed bath, always make sure that the patient is
14. Wipe the neck from the nape to thyroid area clean
15. Rinse, Dry - Always remove secretions
o Remove towel under the patient’s head - If the patient is intubated, always look after the tube

Arms and Hands SHAMPOOING

16. Place towel on arm away (far) from the nurse 1. Remove pillow to place the Kelly pad under the patient’s head and
17. Wipe from wrist to elbow with long, firm strokes place a pail on the side of the Kelly pad
o Wipe each side of the arm with each side of the wash cloth
18. Wipe the upper arm, shoulder and axilla
19. Place towel under a basin to place patient’s hand in the basin, and
wash the hand
20. Rinse, Dry
o Wipe hand dry with the towel under the basin
21. Move to the other side of the patient to clean the other arm and
other hand. Repeat steps 15-19
o Move to the other side to clean arm away from the nurse 2. Wrap the patient’s neck with the towel
3. Place a damp towel on patient’s eyes
Chest and Abdomen 4. Place cotton balls in ears
o If the patient is female. 5. Comb the patient’s ears and check for accessories
- Ask if the patient allows to let her chest be 6. Rinse hair with a water dipper
cleaned by the nurse. If not, let the patient clean 7. Lather shampoo and massage patient’s head
herself 8. Rinse hair with a water dipper
- If the patient has big breasts, clean under folds 9. Comb patient’s hair and use hair blower to dry hair
o If the patient is obese, clean skin folds 10. Remove towels placed on the patient and the Kelly pad
22. Move towel down to pubic area 11. Return pillow under patient’s head
23. Place another towel on patient’s chest
24. Wipe chest to abdomen (then dry)
o Raise the patient’s shirt to wipe chest and abdomen
25. Ask if patient feels cold

Legs
26. Expose the leg to be cleaned
27. Wipe from ankle to thigh (then dry)
28. Clean foot, the same procedure with hands
29. Repeat steps 26-28 for other leg

Back
30. Let patient hold towel and move the patient to lie prone or side-lying
SKILLS LABORATORY
LECTURE NOTES
Possible Questions: Bed Bath
- Why do we perform bed bath?
o Cleans the skin, stimulates circulation, provides mild
exercise, and promotes comfort. Bathing also allows
assessment of skin condition, joint mobility, and muscle
strength. According to this link:
https://nursekey.com/bed-bath/
- Why do we only expose the area to be cleaned?
o To preserve patient’s privacy and to prevent chills
- Why do we place towel under the area cleaned?
o To prevent the linens from getting soiled while the nurse
performs the bed bathing procedures
- Why do we clean the patient from head to toe?
o Prioritize cleaning from the cleanest body part to dirtiest
according to this yt vid:
https://www.youtube.com/watch?v=P0N5KXDT_iE
- Why do we clean the arm away from the patient?
o To avoid contaminating the patient from bending over
- Why should we ask if the patient feels cold during the procedure?
o To prevent patient discomfort
o With low body temperature, this compromises the
patient’s immunity making them susceptible to diseases
like colds
- Why do we wipe the patient with long, firm strokes?
o To avoid tickling the patient (according to this link:
https://nursekey.com/bed-bath/), tickling the patient will
render them intolerant in bathing because there are
studies that show that there are people who hate being
tickled due to the loss of control over their bodies.
o Tickling also stimulates the hypothalamus which is in
charge of the person’s emotional response, fight or flight
response, and pain responses. This will make the
patient to act unruly and/or will give an unpleasant
reaction
- What if the patient has wounds or fissures in his/her foot?
o Whether if it is wet or dry, place a towel (instead of the
basin?) and carefully wash his/her feet and sanitize
o After performing the procedures, document findings
- Why do we massage the patient after performing bed bath?
o This relaxes the patient and promotes blood circulation
- Why do we perform chest tapping after performing bed bath?
o To move secretions in the chest, done before or after
nebulization, and to ease the difficulty breathing

Possible Questions: Shampooing

- What to do if the patient has head lice?
o Inform the physician right away