Area is reddened and may have localized

NCM 122: Fundamentals of Nursing Practice

bleeding or serous weeping.
CLEINT BED BATH
EXCESSIVE DRYNESS

Skin can appear flaky and rough.

HYGIENE
AMMONIA DERMATITIS (DIAPER RASH)
The science of health and maintenance.
Caused by skin bacteria reacting with urea in
PERSONAL HYGIENE the urine.

Is the self-care by which people attend to such ACNE

as bathing, toileting, general body hygiene,
Inflammatory condition with papules and
and grooming.
pustules.
TYPES OF HYGIENE CARE
ERYTHEMA

EARLY MORNING CARE Redness associated with a variety of

conditions, such as rashes, exposure to sun,
Provided to clients as they awaken in the elevated body temperature.
morning.
HIRSUTISM
MORNING CARE
Excessive hair on a person’s body and face,
Is often provided after clients have breakfast, particularly in women.
although it may be provided before breakfast.
GENERAL GUIDELINES FOR SKIN CARE
AFTERNOON CARE
Nurses need to ensure that all skin care
Is provided to clients before they retire for the measures prevent injury and irritation.
night. The degree to which the skin protects the
underlying tissues from the injury depends on
AS NEEDED / PRN CARE the general health of the cells, the amount of
subcutaneous tissue, and the dryness of the
Provided as required by client. skin.
Moisture in contact with the skin for more than
FACTORS AFFECTING HYGIENE PRACTICES a short time can result in increased bacterial
Culture growth and irritation.
Developmental Level Body odors are caused by resident skin
Religion bacteria acting on body secretions.
Health and Energy Skin sensitivity to irritation and injury varies
Personal Preferences among individuals and in accordance with their
health.
5 MAJOR FUNCTIONS OF THE SKIN Agents used for skin care have selective
actions and purposes.
It protects underlying tissues from injury by
preventing the passage of microorganisms. AGENTS COMMONLY USED ON SKIN
It regulates body temperature.
It secretes sebum SOAP
It transmits sensations through nerve
Lowers surface tension and thus helps in
receptors.
cleaning.
It produces and absorbs vitamin D.
Some soaps contain antibacterial agents,
which can change the natural flora of the skin.
COMMON SKIN PROBLEMS

ABRASION CHLORHEXIDINE GLUCONATE (CHG)

Superficial layers of the skin are scraped or A disposable cloth saturated with 2% CHG and
rubbed away. skin-moisturizing substances.
 An advantage is continues antimicrobial TYPES OF CLEANSING BATHS
activity after application.
These cloths are often used in critical-care COMPLETE BED BATH
settings.
The nurse washes the entire body of a
BATH OIL dependent client in bed.

Used in bathwater, provides an oily firm on the SELF-HELP BED BATH

skin that softens and prevents chapping.
SKIN CREAM AND LOTION
Provides a film on the skin that prevents
evaporation and therefore chapping.
Clients confined to bed are able to bathe
themselves with help from the nurse for
washing the back and perhaps the feet.
PARTIAL BATH (ABBREVIATED BATH)

POWDER Only the parts of the client’s body that might

Can be used to absorb water and prevent
friction.
For example, powder under the breasts can
prevent skin irritation.
Some powders are antibacterial.
DEODORANT
Masks or diminishes body odors.
cause discomfort or odor, if neglected, are
washed.
BAG BATH
This bath is a commercially prepared product
that contains 10 to 12 presoaked disposable
washcloths that contain no-rinse cleanser
solution.
The package is warmed in a microwave.

ANTIPERSPIRANTS TOWEL BATH

Reduce the amount of perspiration. This bath is similar to a bag bath but uses
regular towels.
CATEGORIES OF BATHS GIVEN TO It is useful for clients who are bedridden and
PATIENTS client with dementia.
The client is covered and kept warm
CLEANSING BATHS throughout the bathing process by a bath
Cleansing baths are given chiefly for hygiene blanket.
purposes.
TUB BATH

TYPES Tub baths are often preferred to bed baths

because it is easier to wash and rinse in a tub.
Complete Bed Bath
Tubs are also used for therapeutic baths.
Self-Help Bed Bath
The amount of assistance the nurse offers
Partial Bath
depends on the abilities of the client.
Bag Bath
Tub Bath
SHOWER
Shower
Many ambulatory clients are able to use
THERAPEUTIC BATHS shower facilities and require only minimal
assistance from the nurse.
Therapeutic baths are given for physical
Clients in long-term care settings are often
effects, such as to soothe irritated skin or to
given showers with the aid of a shower chair.
treat an area.
Medications may be placed in the water.
LIFESPAN CONSIDERATIONS IN BATHING
A therapeutic bath is generally taken in a tub
1/3 or 1/2 full. INFANTS
The client remains in the bath for a designated
time, often 20 to 30 minutes. Sponge baths are suggested
After bath – Immediately dry and wrap
 CHILDREN Frequently occur between the toes as a result
of dryness and cracking of the skin.
Encourage participation
Closed supervision ATHLETE’S FOOT OR TINEA PEDIS
Do not leave unattended (RINGWORM OF THE FOOT)

ADOLESCENTS Is caused by fungus

Scaling and cracking of the skin, particularly
Assist in choosing deodorants and between the toes.
antiperspirants. Small blisters from, containing thin fluid.

ELDERS INGROWN TOE NAIL

Avoid excessive use of soap The growing inward of the nail into the soft
Avoid excessive powder, cornstarch tissues around it.
Protect elders and children from Often results from improper nail trimming.

HOME CARE CONSIDERATIONS FOOT CARE

Consider purchasing a bath seat that fits in the Wash feet daily, dry well between toes
tub or shower. Inspect skin for breaks or red or swollen areas
Install a hand shower for use with a bath seat (when washing).
and shampooing. Check water temperature before immersing
Use a nonskid surface on the tub or shower. the feet to prevent burns.
Install hand bars on both sides of the tub or Use creams or lotions to moisten the skin.
shower to facilitate transfers in and out of the Wash feet frequently and change socks and
tub or shower. shoes at least daily.
Carefully monitor the temperature of the File the toenails rather than cutting them to
bathwater. avoid injury.
Apply lotion and oil after bath, not during, Wear clean stocking or socks daily.
because these solutions can make a tub Wear correctly fitting shoes that neither restrict
surface slippery. the foot nor rub on area.
Avoid walking barefoot, because injury and
FOOT HYGIENE infection may result.
Exercise the feet several times a day to
promote circulation.
Avoid wearing constricting garments.
COMMON FOOT PROBLEMS
Avoid sitting with crossed legs.
CALLUS Use extra blankets and wear socks when feet
are cold.
A thickened portion of epidermis, a mass of Wash foot thoroughly when there is cut and
keratotic material. apply mild antiseptic.
Avoid self-treatment for corn or calluses.
CORN
NAIL HYGIENE
Is a keratosis caused by friction and pressure
from a shoe.

UNPLEASANT ODORS NAIL CARE

Occur as a result of perspiration and its
interaction with microorganisms.
PLANTAR WARTS
Appears on the sole of the foot.
Caused by papovirus hominis
FISSURES OF DEEP HOOVES
One hand or foot is soaked, if needed and
dried.
Then the nail is cut or filed across beyond the
end of the finger of toe.
Avoid trimming or digging into nails at lateral
corners.
The nail is filed to round the corners and the
nurse cleans the nail.
The nurse then gently pushes back the cuticle.
 The next finger or toe is cared for the same DENTAL CARIES
manner.
Teeth have darkened areas, may be painful.
PARTS OF THE TOOTH
PYRORRHEA
CROWN
The teeth are loose and pus is evident when
The exposed part of the tooth, which is outside gums are pressed.
the gum.
HALITOSIS
ROOT
Bad breath
Embedded in the haw and covered by a bony
tissue called cementum. GLOSSITIS

Inflammation of the tongue.

PULP CAVITY

Contains the blood vessels and nerves. SORDES

Accumulation of foul matter in the mouth.

DEVELOPMENTAL VARIATIONS

Teeth usually appear 5-8 months after birth. STOMATITIS

Baby-bottle syndrome may result in decay of
Inflammation of the oral mucosa.
all of the upper teeth in the lower posterior
teeth.
PAROTITIS
At 2 years old they usually have all 20
deciduous teeth. Inflammation of the parotid salivary glands.
At about 6-7 years old they start losing
deciduous teeth, and gradually replaced with PROMOTING ORAL HYGIENE THROUGH
31 permanent teeth. LIFESPAN
At age 25, most people have their permanent
teeth. INFANTS AND TODDLERS

Dental hygiene begins when the first tooth

COMMON PROBLEMS OF THE MOUTH
PLAQUE
An invisible soft film that adheres to the
enamel surface of the teeth.
TARTAR (DENTAL CALCULUS)
Is a visible, hard deposit of plaque and dead
bacteria that forms the gum lines.
GINGIVITIS
Red, swollen gingiva
Bleeding, receding gum lines, and the
formation of pockets between the teeth and
gums.
PERIDONTAL DISEASE
Gums appear spongy and bleeding.
CHEILOSIS
Cracking of the lips
erupts.
Washcloth or a cotton ball or small gauze
moistened with water.
PRE-SCHOOLERS AND SCHOOL -AGE
CHILDREN
Need to be taught to brush their teeth after
eating and to limit their intake of refined
sugars.
Parental supervision maybe needed to ensure
the completion of the self-care activities.
Regular dental check-ups are required.
ADOLESCENTS AND ADULTS
Proper diet and tooth mouth care should be
evaluated and reinforced.
DEVELOPMENTAL VARIATIONS
LANUGO
The fine hair on the body of the fetus
Also referred to as down or wooly hair
Found over the shoulders, back, and sacrum
 PUBIC HAIR
Usually appears in early puberty followed in
about 6 months by the growth of the axillar
hair, boys develop facial hair later in puberty.
COMMON HAIR PROBLEMS
DANDRUFF
Appears as a diffuse scaling of the scalp.
HAIR LOSS
TICKS
Small gray-brown parasites that bite into tissue
and such blood
PEDICULOSIS (LICE)
PEDICULUS CAPITIS (HEAD LOUSE)
Found on the scalp and tends to stay hidden in
the hairs.
PEDICULUS PUBIS (CRAB LOUSE)
Stays in the pubic hair
PEDICULUS CORPORIS (BODY LOUSE)
Tends to cling to clothing.
SCABIES
Contagious skin infestation by the itch mite.
EYE CARE
EYE HYGIENE
Soften dried secretions that have accumulated
on the lashes by placing a sterile cotton ball
moistened with sterile water or normal saline
solution over the lid margin.
EYEGLASSES CARE
Cleanse with warm water then dried with soft
tissue that will not scratch the lenses.
When not in use, glasses should be placed in
an appropriately labeled case and stored in the
client’s bedside table.
CONTACT LENSES CARE
Each manufacturer provides detailed cleaning
instructions.
Warm tap water, normal saline, special rinsing
or soaking solutions maybe used.
All users should have a special container for
their lenses.
ARTIFICIAL EYE CARE
To remove artificial eye, the nurse puts on
clean gloves.
Cleanse with warm saline and place inn a
container filled with water or saline solution.
GENERAL EYE CARE
Avoid home remedies for eye problems
If dirt or dust gets into the eyes, clean them
copiously with clean, tepid water as an
emergency treatment.
Take measures to guard against eyestrain and
to protect vision such as maintaining adequate
lighting for reading and obtaining shatterproof
lenses for glasses.
Schedule regular eye examinations,
particularly after age 40, to detect problems
such as cataracts and glaucoma.
EAR CARE
The auricles are cleaned during the bed bath.
Remove excessive cerumen that is visible or
that causes discomfort or hearing difficulty.
Visible cerumen maybe removed by retracting
the auricle up and back.
Clients need to be advised never to use bobby
pins, toothpicks or cotton-tipped applicators to
remove cerumen.
NOSE CARE
When the external nares are encrusted with
dried secretions, they should be cleaned with a
cotton-tipped applicator or moistened with
saline or water.
The applicator should not be inserted beyond
the length of the cotton tip; inserting it further
may cause injury to the mucosa.
SUPPORTING A HYGIENIC ENVIRONMENT
Between 20 and 23 degrees Celsius (68- and
74-degrees Fahrenheit) is comfortable for
most clients.
Important to remove unpleasant odors and
stale air.
Odors caused by urine, draining wounds or
vomitus can be offensive to people.
 Room deodorizers can help eliminate odors.
Nurses should control noise in the health care
settings.

“HYGIENE IS
TWO-THIRDS OF
HEALTH”