Chapter 017+Personal+Hygiene

Chapter 17
Personal Hygiene
Copyright © 2022 Elsevier, Inc. All Rights Reserved. 1

Personal Hygiene (1 of 5)
 Promotes comfort, safety, and health
 Includes activities to clean the skin, mouth,
genital area, and anus
 Intact skin and mucous membranes:
 Are the body’s first line of defence against disease
 Prevent microbes from entering the body and
causing an infection

 Good hygiene:
 Cleanses the body
 Prevents body and breath odours
 Is relaxing
 Increases circulation

 Support workers help clients with personal
hygiene
 Some clients require minimal help
 Others may need all hygiene are done for them
 Illness, disability, and changes associated
with aging may affect the client’s ability to
practise hygiene independently.
 Culture and personal choice also affect
hygiene.

 Factors affecting hygiene and skin care:
 Perspiration, elimination, vomiting,
drainage from wounds or body openings,
bed rest, and activity
 Client’s care plan identifies the personal
hygiene measures for your client
 Follow the nurse’s directions and the care
plan
 See textbook box: Respecting Diversity: Personal

Hygiene Practices of Different Cultures

 Daily care:
 Most people have hygiene routines and habits
 Routine care is given during the day and evening
• AM care: early morning care (before breakfast); morning care
(after breakfast)
• Afternoon care: after lunch, before evening meal
• HS care (PM care or evening care) before sleep
 You assist with hygiene whenever it is needed.
 Your client may feel frustrated, angry, or
embarrassed because of needing help with
personal care—always promote DIPPS.

Oral Hygiene (1 of 2)
 Oral hygiene (mouth care) does the following:
 Keeps the mouth and teeth clean
 Prevents mouth odours, infections, cavities (dental
caries)
 Increases comfort
 Makes food taste better
 Prevents periodontal disease (gum disease,
pyorrhea)—inflammation of tissues around the
teeth
 Oral care is given on awakening, after each
meal, and at bedtime.
Oral Hygiene (2 of 2)
 Dry mouth is common as a result of:
 Oxygen administration
 Smoking
 Decreased fluid intake
 Mouth breathing
 Anxiety
 Medications
 The mouth contains many microbes—always
wear gloves and follow Standard Practices
when providing mouth care to clients.
Equipment
 Oral hygiene:
 Toothbrush
 Toothpaste
 Dental floss
 Mouthwash
• For clients with dentures:
 Denture cleaner
 Denture cup
 Denture brush/toothbrush

Observations for Oral Hygiene
 After giving oral hygiene, report and record:
 Dry, cracked, swollen, or blistered lips
 Bleeding, redness or swelling of the gums,
irritation, sores, or white patches in the mouth or
on the tongue
 Missing or loose teeth
 Rough, sharp, or chipped areas on dentures
 Complaints of pain or discomfort
 Difficulty swallowing or speaking
 Foul breath
 Presence of food or foreign objects
Brushing Teeth (1 of 2)
 Many clients perform oral hygiene themselves.
 Some clients need help gathering and setting
up equipment.
 Encourage the client to be as independent as
possible.
 You may have to brush the teeth of clients who:
 Are very weak
 Cannot use or move their arms
 Are too confused to brush their teeth

Brushing Teeth (2 of 2)
 Brushing a child’s teeth
 Children should start brushing teeth at the age of
3 years.
 Children 3-6 years should be given toothpaste
containing fluoride (size no bigger than a pea)
with each brushing.
 Older children can do a thorough job, but may
need to be reminded to brush.

Flossing
 Flossing:
 Removes plaque and tartar from the teeth
 Removes food from between the teeth
 Is preventative—do at least once per day
 See textbook boxes:

 Focus on Children: Flossing
 Focus on Older Persons Flossing
 See textbook procedure: Flossing a Client’s Teeth

Mouth Care for an
Unconscious Client (1 of 4)
 Unconscious clients may have mouth dryness
and crusting on the tongue and mucous
membranes
 The care plan tells you what cleaning agent to use
• Use sponge swabs to apply the cleaning agent.
 Applying a lubricant to the lips after cleaning
prevents cracking of the lips.
• Check the care plan.
 Follow agency policy and your scope of practice
to be sure you are can provide this type of care.

Mouth Care for an
 Protect unconscious clients from choking and
aspiration (breathing fluid, food, vomitus, or an
object into the lungs):
 Position the client on one side with the head turned
well to the side.
 Use only a small amount of fluid to clean the mouth.
 Do not insert dentures.
 Keep the client’s mouth open with a padded tongue
blade.
 Always assume that unconscious clients can hear.
 Mouth care is given at least every 2 hours
 Follow the nurse’s directions and the care plan.
Mouth Care for an

Mouth Care for an

Denture Care (1 of 2)
 Dentures are a set of artificial teeth
 Complete and partial dentures are common.
 Mouth care is given and dentures are cleaned as
often as natural teeth.
 Dentures are slippery when wet.
 To use a cleaning agent, follow the manufacturer’s
instructions.

Denture Care (2 of 2)
 Hot water causes dentures to lose their shape
(warp).
 Remind clients and residents not to wrap dentures
in tissues or napkins.
 You clean dentures for those who cannot do so
themselves.
 Follow agency policies regarding cleaning
dentures.
 See textbook procedure: Providing Denture Care

Bathing (1 of 2)
 Bathing has the following benefits:
 Cleans the skin—removes microbes, dead skin,
perspiration, excess oils
 Cleans the mucous membranes of the genital and
anal areas
 A bath is refreshing and relaxing
 Circulation is stimulated and body parts are
exercised
 Observations are made
 You have time to talk to the person

Bathing (2 of 2)
 Complete or partial baths, tub baths, or
showers may be given.
 The bathing method depends on:
 The client’s condition

 Self-care abilities
 Personal choice
 The client’s choice of bath time is respected
whenever possible.
 Bathing frequency is a personal choice or
employer policy.
 Weather, physical activity, and illness may also
affect bathing frequency.
Observations for Bathing a Client
 Report and record the following:
 Colour of skin, lips, nail beds and sclera (whites of the eyes)
 Location and description of rashes
 Dry skin
 Bruises or open skin areas
 Pale or reddened areas
 Drainage or bleeding from wounds or body openings
 Swelling of the feet and legs
 Corns or calluses on the feet
 Skin temperature
 Complaints of pain or discomfort

The Complete Bed Bath
 Involves washing the client’s entire body in
bed.
 Bed baths are usually needed by clients who are:
• Unconscious
• Paralyzed
• In casts or traction
• Weak from illness or surgery
 This may be a new experience for many clients—it
may cause embarrassment, feelings of loss of
privacy.
 See textbook procedure: Giving a Complete Bed
Bath
Towel Baths and Bag Baths
 For a towel bath, an oversized towel is used
 Covers client’s body from neck to feet
 Bath towel is saturated with a cleaning solution – quick and
soothing
 Bag baths are commercially prepared or
prepared at the agency
 8-10 washcloths are moistened with a cleaning
agent that does not require rinsing
 Before use, they are warmed in microwave

The Partial Bath
 Involves bathing the face, hands, axillae
(underarms), back, buttocks, and perineal
area
 Some clients bathe themselves in bed or at the
sink.
 You assist as needed.

Tub Baths and Showers (1 of 3)
 Tub baths and showers
 Falls,burns, and chilling from water are risks.
 Safety is important.
 Protect the client’s privacy.
 Tub bath should be no longer than 20 minutes.
 Follow the nurse’s directions and the care plan.

 Safety with a tub bath or shower:
 Be alert—the client may become faint, weak, or
very tired during the bath.
 The tub is cleaned before and after use—to
prevent the spread of microbes and infection
 See textbook box: Think About Safety: Safety

Guidelines for Assisting Clients During Tub Baths
and Showers box

 Safety with a tub bath or shower:
 When using hydraulic lifts, apply all safety devices
• Follow employer policy—using lifts requires two staff
members.
• Lock wheels of shower chair.
• Test water temperature.
 In client’s home
 Safety devices such as grab bars, transfer boards or
shower chairs may be helpful for some clients.

Dealing with Bathing Challenges
(1 of 3)
 Client has the right to refuse a bath—you
need the client’s informed consent.
 Reasons for refusal:
• Client feels too ill or weak
• Client is afraid of falling or getting chilled
• Client is embarrassed
• Client cannot tolerate the bathing position.
 Inform your supervisor of a client’s refusal—
do not bathe the client against their wishes.

(2 of 3)
 Clients with dementia may be frightened by bathing
procedures
 Use a calm, pleasant voice
 Do not rush
 Divert the client’s attention
 Try the bath again later

(3 of 3)
 Client urinates or defecates
 Drain tub
 Remove stool
 Control your verbal and nonverbal reactions
 Hardened secretions of stool on the client’s body
 Erection
 Privacy is important
 Provide for safety; give the client some time alone, if
possible

The Back Massage (1 of 2)
 Back massages (back rubs):
 Relax muscles and stimulate circulation
 Are given after the bath and with evening care
 Can be given after repositioning or to help the
client relax
 Last 3 to 5 minutes

The Back Massage (2 of 2)
 Observe the skin before the massage.
 Lotion reduces friction during the massage
 Warm the lotion by placing it in warm water

 During the massage, use firm strokes
 After the massage, apply some lotion to the
elbows, knees, and heels

Perineal Care (1 of 4)
 Perineal care (pericare) involves cleaning the
genital and anal areas.
 Cleaning prevents infection and odours, and
promotes comfort
 Removes smegma
 Perineal care is done:
 Daily during the bath
 Whenever the area is soiled with urine or feces
 Clients do their own perineal care if they can.

 This procedure embarrasses many clients and
nursing staff.
 Follow Standard Practices and medical
asepsis—always wear gloves.

 When giving perineal care:
 Use warm water, not hot
 Work from cleanest (urethra) to the dirtiest (anal)
area
 Use washcloths, towelettes, cotton balls, or swabs,
according to agency policy
 Clean down each side and then the centre
 Rinse thoroughly; pat dry after rinsing

 Reporting and Recording
 When providing perineal care, report the following
observations at once:
• Redness, swelling, discharge, or irritation
• Presence of hemorrhoids
• Odours
• Complaints of pain, burning, or other discomfort
• Signs of urinary or fecal incontinence
• A male client’s foreskin not retracting
 Report and record the care given
• If care is not recorded, it is assumed that care was not
given.

Menstrual Care (1 of 2)
 Menstruation is the monthly bleeding of a
client with female genitalia, when blood flows
from the uterus through the vaginal opening.
 Sanitary pads should be changed often
(every 3–5 hours) to promote good hygiene
and comfort and prevent odours and
infection.
 Wear gloves when providing menstrual care.
 Dispose of sanitary pads according to
employer policy.
Menstrual Care (2 of 2)
 Reporting and Recording:
 When providing menstrual care, report and record the
following:
• Odours
• Fever
• Redness, swelling, or irritation in the perineum
• Complaints of pain, burning, difficulty urinating, or other
discomforts
• Heavy bleeding—for example, the sanitary pad becomes
soaked within 1 hour of application (report this at once)
• Large number of blood clots on the pad (report this at once)

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Chapter 17

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 See textbook box: Respecting Diversity: Personal

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 See textbook boxes:

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 The client’s condition

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 See textbook box: Think About Safety: Safety

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 Warm the lotion by placing it in warm water

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