Review each of the 5 steps in the Nursing Process: How you would apply the Nursing Process in your
care of the patient when focusing on Hygiene? Give examples of each step in the nursing process.
• Assessment: Assessment of a patient's hygiene status and self-care abilities requires you to
complete a nursing history and perform a physical assessment. You do not assess all body
regions routinely before providing hygiene. However, conduct a brief history to determine
priority areas (e.g., an obese patient's skinfolds, a trauma patient's skin condition) and help
you plan individualized hygiene care. Assessment of a patient's ability to provide hygiene self-
care helps you make decisions about the kind and amount of hygiene care to provide and how
much the patient can be encouraged to participate in care.
• Nursing Diagnosis: Thorough assessment of a patient's hygiene status and self-care abilities
identifies clusters of risk factors or defining characteristics that support actual or at-risk
hygiene- related diagnoses. Identification of the defining characteristics or risk factors leads you
to select the NANDA 832International diagnostic label that best communicates the individual
patient's situation. For example, when caring for an older adult with degenerative arthritis, you
observe swollen joints, weakness, and limited ROM in the dominant hand along with a
generally unkempt appearance. Closer review of data reveals defining characteristics of an
inability to wash body parts and difficulty turning and regulating a water faucet. The nursing
diagnosis
of Bathing Self-Care Deficit becomes part of the plan of care. Accurate selection of nursing
diagnoses requires critical thinking to identify actual or potential problems. Be thorough in
assessment to reveal all appropriate defining characteristics or risk factors so you can make an
accurate diagnosis
o Activity Intolerance
o Bathing Self-Care Deficit
o Dressing Self-Care Deficit
o Impaired Physical Mobility
o Ineffective Health Maintenance
, o Risk for Infection
o Risk for Impaired Skin Integrity
• Planning: During planning synthesize information from multiple resources. Critical
thinking ensures that a patient's plan of care integrates all that is known about the
individual patient and key critical thinking elements. In many situations’ patients
present with multiple nursing diagnoses. Use a concept map to visualize and understand
how nursing diagnoses interrelate. Rely on knowledge, experience, and established
standards of care when developing a care plan. Remember critical thinking attitudes
such as creativity when developing a patient-centered plan for hygiene care. Consciously
include the patient in this important step of the nursing process. Partner with a patient
to identify patient goals and outcomes, set priorities for care, and select evidence-based
interventions. Consider continuity of care and involve other health care team members
(e.g., occupational or physical therapy) when developing the plan.
• Implementing: Hygiene is a part of basic patient care. When you use caring practices
to perform hygiene measures, you reduce the patient's anxiety and promote comfort
and relaxation. For example, use a gentle approach when giving patients their baths
and
changing gowns as you turn and reposition them. Implementation also focuses on
assisting and preparing patients to be able to perform as much of their hygiene care as
they can independently. Teach patients proper hygiene techniques and how their use is
associated with better health. Discuss any signs and symptoms of hygiene problems.
Inform patients about available resources in the community for dealing with these
problems if they arise.
• Evaluating: Was goal met? If not go back to step one and figure out what needs to be changed
in order for patient to meet goal
PG 831-840
-Factors affecting Hygiene-
• Social Practices
• Personal Preferences
• Body Image
• Socioeconomic Status
• Health Beliefs and Motivation
• Cultural Variables
• Developmental Stage
• Physical Condition
-What does personal hygiene affect?
• Comfort, safety, health, and well being
-What does personal hygiene include?
• How you take care of your body: showering, moisturize, brushing teeth, doing laundry,
brushing hair, washing hands, clipping fingernails, etc.
-Describe how cultural variables influence personal hygiene.
• Cultural beliefs and personal values influence hygiene care. People from diverse cultural
backgrounds (e.g., level of education, gender preference, geographic location) frequently
follow
, different self-care practices. For example, maintaining cleanliness does not hold the same
importance for some ethnic or social groups as it does for others. In North America many are
fortunate to be able to bathe or shower daily and use deodorant to prevent body odors.
However, people from some socioeconomic or cultural groups are not sensitive to body odors,
prefer to bathe less frequently, and do not use deodorant.
-Describe nursing care for the following devices, eye glasses, contact lenses, artificial eyes, dentures,
and hearing aids.
• Eye Glasses: Eyeglasses are expensive. Be careful when cleaning glasses and protect them from
breakage or other damage when they are not worn. Put them in a case in a drawer of the
bedside table when not in use. Cool water sufficiently cleans glass lenses. Prevent scratching
by using a soft cloth for drying; do not use paper towels. Plastic lenses in particular scratch
easily; special cleaning solutions and drying tissues are available.
• Contact Lenses: A contact lens is a thin, transparent, circular disk that fits directly over the
cornea of the eye. In outpatient or home settings instruct patients on the routines to follow for
regular cleansing and care. Explain that all contact lenses must be removed periodically to
prevent ocular infection and corneal ulcers or abrasions from infectious agents such
as Pseudomonas aeruginosa and staphylococci. Pain, tearing, discomfort, and redness of the
conjunctivae indicate lens overwear. Encourage patients to report persistence of these
symptoms even after lens removal to their health care provider.
• Artificial Eyes: Patients with artificial eyes have had an enucleation (i.e., removal) of an entire
eyeball as a result of tumor growth, severe infection, or eye trauma. Some artificial eyes are
implanted permanently, whereas others must be removed for cleaning. Patients with artificial
eyes usually prefer to care for their own eyes. Respect the patient's wishes and help by
assembling needed equipment. At times patients require help to remove and clean prosthesis.
An artificial eye is usually made of glass or plastic. Warm normal saline cleans the prosthesis
effectively. Clean the edges of the eye socket and surrounding tissues with soft gauze moistened
in saline or clean tap water. Report signs of infection immediately because bacteria can spread
to the neighboring eye, underlying sinuses, or even brain tissue. To reinsert the eye, retract the
upper and lower lids and gently slip the eye into the socket, fitting it neatly under the upper
eyelid. Store an artificial eye in a labeled container filled with tap water or saline.
• Dentures: Encourage patients to clean their dentures on a regular basis to avoid gingival
infection and irritation. When patients become disabled, someone else assumes responsibility
for denture care. Dentures are a patient's personal property and must be handled with care
because they break easily. They must be removed at night to rest the gums and prevent
bacterial buildup. To prevent warping, keep dentures covered in water when they are not worn
and always store them in an enclosed, labeled cup with the cup placed in the patient's bedside
stand. Discourage patients from removing their dentures and placing them on a napkin or tissue
because they could easily be thrown away.
• Hearing Aids:
o • Whistling sound indicates incorrect earmold insertion, improper fit of aid, or
buildup of earwax or fluid.
o • Do not wear aid under heat lamps or hair dryer or in very wet, cold weather.
o • Remove or disconnect battery when not in use.
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