Fundamentals of Nursing, 3e

Barbara L Yoost
Lynne R Crawford

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 Chapter 27

Hygiene and Personal Care

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LO 27.1 Structure and Function of Skin,
Hair, and Nails
 Skin, hair, and nails
 Integumentary system
• Skin, nails, hair, sweat glands, and sebaceous (oil) glands
 Nose, mouth, and oral cavity
 Mucous membranes
• Mucus
• Cilia
 Salivary glands
 Teeth
• Mastication
 Gingivae (gums)
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 LO 27.2 Alterations in Structure and
Function Affecting Hygienic Care
 Ulcers, incisions, and
wounds
 Decreased sensation
 Alopecia
 Pediculosis
 Nails
 Oral cavity
 Self-care alterations

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 LO 27.3 Assessment (1 of 2)

 Assess skin, hair, nails, and oral cavity

 Before care, ask the patient about skin changes
 Observe the condition of exposed skin and note odors
 Observe the hair for cleanliness and grooming
 Observe fingernails and toenails when assessing
peripheral vascular status
 Assess oral hygiene as part of a head-to-toe
assessment

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 LO 27.3 Assessment (2 of 2)

 Assess self-care abilities

 Ask questions about home care
 Observe the patient’s ability to complete ADLs
 Refer to community resources for assistance after
discharge if needed
 Hygiene and infection
 Observe skin for signs of infection due to poor
hygiene
 Provide patient education as needed

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 LO 27.4 Nursing Diagnosis

 Examples
 Self-Care Deficit (i.e., bathing)
• Supporting Data: Respirations 28 and labored, strong body
odor, uncombed hair, skin on feet dry and flaky
 Able to Perform Self-Care
• Supporting Data: Patient able to get out of bed and stand at
sink, patient expressing a desire to be independent in ADLs
 Impaired Health Maintenance
• Supporting Data: Lack of understanding of diabetes care,
inability to recall most recent meal, poor hygiene, unkempt
appearance, halitosis

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 LO 27.5 Planning

 Prioritize identified hygiene-related nursing

diagnoses according to patient needs and
recognized risks
 Develop a nursing care plan for each nursing
diagnosis, considering the patient’s self-care
abilities, available resources, and family
involvement.
 Collaborate with other health care professionals,
patients, and families when setting long- and
short-term goals.
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LO 27.6 Implementation and Evaluation
(1 of 7)
 Interventions
 Bathing and skin care
• Complete bed bath
• Partial bed bath
• Sink bath
• Shower
• Chair shower

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LO 27.6 Implementation and Evaluation
(2 of 7)
 Interventions
 Perineal care
• Male
• Female
 Foot and hand care
 Massage
• Effleurage
• Pétrissage
• Tapotement

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LO 27.6 Implementation and Evaluation
(3 of 7)
 Hair care
 Shampooing
• Shower
• Shampoo basin
• No-rinse shampoo
• Shampoo cap
• Pediculicidal shampoo

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LO 27.6 Implementation and Evaluation
(4 of 7)
 Oral care
 Brushing teeth and tongue,
flossing, rinsing mouth, and
cleaning dentures
 Patients with special needs
include patients
• Who are to receive nothing by
mouth
• Are receiving oxygen
• Are unconscious or intubated
• Have undergone
chemotherapy

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LO 27.6 Implementation and Evaluation
(5 of 7)
 Eye care
 Visual aids
• Glasses
• Contact lenses
 Prosthetic eye
• Most patients care for their own prothesis
 Nose care
 Secretions

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LO 27.6 Implementation and Evaluation
(6 of 7)
 Ear care
 Cerumen
 Hearing aids
 Shaving a patient
 Should not be performed without consent
 Bed making
 Reduces the risk of skin breakdown
 Beds may be made while unoccupied or occupied

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 LO 27.6 Implementation and Evaluation
(7 of 7)
 Evaluation
 Observes the patient during care to assess the
attainment of self-care goals.
 When goals are reached, establish new goals that
may be longer-term goals.
 Patients who are able to do more of their own care on
a daily basis are showing increased self-care abilities.

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