Bathing

Bathing removes accumulated oil, perspiration, dead skin cells, and some bacteria. Excessive bathing, can interfere with the intended lubricating effect of sebum, causing dryness of the skin. Bathing stimulates circulation Bathing offers an excellent opportunity for the nurse to assess all clients.

Cleaning baths Given chiefly for hygiene purposes and include these types:

Complete bed bath. The nurse washes the entire body of a dependent client in bed. Self- help bed bath. 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). Only the parts of the clients body that might cause discomfort or odor, if neglected, are washed: the face, hands, axillae, perineal area and back. Bag bath. This bath is a commercially prepared product that contains 10 to 12 presoaked disposable washcloths that contain no- rinse cleanser solution. Tub bath. Tub baths are often preferred to bed baths because it is easier to wash and rinse in a tub. Shower. Many ambulatory clients are able to use shower facilities and require only minimal assistance from the nurse.

Ear Care
Nursing Interventions

Cleanse the pinna with moist wash cloth Remove visible cerumen by retracting the ears downward. If this is ineffective, irrigate the ear as ordered. Do not use bobby pins, toothpicks or cotton-tipped applicators to remove cerumen. These can rupture the tympanic membrane or traumatize the ear canal. Cottontipped applicators can push wax into the ear canal, which can cause blockage.

Eye Care
Nursing Interventions

Cleanse the eyes from the inner cantus to the outer cantus. Use a new cotton ball for each wipe. To prevent contamination of the nasolacrimal ducts. If the client is comatose, cover the ayes with sterile moist compresses. To prevent dryness and irritation of the cornea. Eyeglass should be cleaned with warm water and soap; dried with soft tissue. Clean contact lens as directed by the manufacturer To remove artificial eyes, wear clean gloves, depress the clients lower eyelid. Hold the artificial eye with thumb and index finger Clean the artificial eye with warm normal saline, then place in a container with water or saline solution. Avoid rubbing the eyes. This may cause infection. Maintain adequate lighting when reading. Avoid regular use of eye drops If dirt/ foreign bodies get into eyes, clean them with copious, clean, tepid water as an emergency treatment.

Nose Care
Nursing Interventions

Clean nasal secretions by blowing the nose gently into the soft tissue. Both nares should be open when blowing the nose to prevent forcing debris into the middle ear, via Eustachian tube. May use cotton tipped applicator moistened with saline or water to remove encrusted, dried secretions. Insert only up to cotton tip.

Oral Cavity Care

Brush the teeth thoroughly after meals and at bedtime. Floss the teeth daily. Ensure adequate intake of food rich in calcium, phosphorous, Vit. A, C and D and fluoride. Avoid sweet foods and drinks between meals Eat coarse, fibrous foods (cleansing foods) such as fresh fruits ant raw vegetables. Have dental check up every 6 months. Have topical fluoride applications as prescribed by the dentists.

Brushing and Flossing the Teeth Purposes

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remove food particles from around and between the teeth. remove dental plaque. enhance the clients feelings of well- being prevent sordes and infection of the oral tissues.

Nursing Interventions When Providing Oral Care for Conscious Patient

Inform the client and explain purpose of the procedure. Provide privacy. Assist in sitting or side-lying position. Place towel under the clients chin. Moisten bristles of toothbrush and apply dentifrice. Hold kidney basin under the chin. Allow the client to brush his teeth, if possible. Use downward strokes fro upper front teeth; upward strokes for lower front teeth; back and forth strokes for the biting surfaces of the teeth; and hold the brush against the teeth with bristles at 45 degrees angle to penetrate and clean under the gingival margins. Rinse the mouth with adequate amount of water. Floss the teeth. Keep the client comfortable. Do after-care of the equipment and articles. Document relevant data.

For Unconscious Client

Place in side-lying position to prevent aspiration. Have suction apparatus readily available. Use padded tongue blade to open the mouth. Brush teeth and gums, using toothbrush or soft sponge-ended swab. Apply thin layer of petroleum jelly to lips to prevent drying or cracking.

Note: Lemon glycerin swabs can be drying to the oral mucosa if used for extended periods. Care of Artificial Dentures

Wear gloves when handling and cleansing dentures. Place a washcloth in a basin or bowl of sink when brushing dentures to prevent damage if the dentures are dropped. Store the dentures in a container with water.

Common Problems of the Mouth

1. Plaque. An invisible soft film of bacteria, saliva, epithelial cells and leukocytes that adhere to the enamel surface of the teeth.

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Tatar. A visible, hard deposit of plaque and bacteria that forms at the gum lines. Halitosis. Bad breath. Glossitis. Inflammation of the tongue. Gingivitis. Inflammation of the gums. Stomatitis. Inflammation and dryness of oral mucosa. Parotitis. Inflammation of the parotid salivary glands (mumps). Sordes. Accumulation of foul matter (food, microorganisms, and epithelial elements) on the gums and teeth. 9. Periodontal disease. Gums appear spongy and bleeding (pyorrhea). 10. Cheilosis. Cracking of the lips. 11. Dental Caries. Teeth have darkened area, may be painful (cavities).

Hair Care
The appearance of the hair may reflect a persons sense of well being and health status. Brushing and combing the hair stimulate circulation of blood in the scalp; distribute the oil along the hair shaft; help to arrange the hair.

Hair shampoo Purposes

1. To stimulate the circulation of the blood in the scalp through massage. 2. To clean the hair and improve the clients sense of well-being. Nursing Interventions during Hair Shampoo

Determine if the institution requires doctors order for hair shampoo. Place client diagonally in bed. Remove pins from hair. Comb and brush hair thoroughly. This is to remove tangles. Place Kelly pad under the head, with neck hyper extended. The trough of the Kelly pad should be directed to a pail. To prevent spillage of the water onto the floor. Cover the eyes with wash cloth. To protect them from irritation. Plug the ears with cotton balls. To prevent entry of the water into the external auditory canal. Apply small amount of shampoo. Massage the scalp with the fat pads of the fingers and make a rich lather. Massage promotes circulation on the scalp. Rich lather ensures through cleansing of the hair. Rinse the hair thoroughly. Soap residue in hair may cause irritation of the scalp and may dry hair. Dry the hair thoroughly.

Keep he client comfortable. Do after-care of equipment and articles. Make relevant documentation.

Common Hair and Scalp Problems 1. Dandruff. Is a chronic diffuse scaling of the scalp, with pruritus (seborrheic dermatitis). 2. Alopecia. Lair loss or baldness. 3. Pediculosis. Infestation with lice.

Padiculosis capitis is head louse Pediculosis corporis is body louse Pediculosis pubis is crab louse