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07/04/2010 Tina Handayani Nasution/FN II 1

CURRICULUM VITAE Name : Tina Handayani Nasution Place of Birth : Tanjungpandan Belitung Marital Status : Married Address : Jl. MT Haryono, Gg. 6,

No.868, Dinoyo, Malang Mobile Phone : 081334395093

E-mail :[email protected] Lulusan : FIK UI Tahun 2004
mailto:[email protected]:[email protected]


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Personal ygieneBy :

Ns. Tina HandayaniNasution, S.Kep

Jurusan KeperawatanFakultas Kedokteran Universitas Brawijaya

April 2010


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What is it???

Hygiene : Health

Personal hygiene :the self caremeasures people useto maintain theirhealth


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PURPOSE OF NURSEPROVIDED HYGIENE

Removemicroorganisms

Do physicalassessment

Increase circulation Distal to proximal Return to heart

Improve self image Provide comfort


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Factor AffectingPersonal Hygiene

???


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Continue Male relative may not allow male

nurse alone with woman patient

Autonomy of patient is paramount;in others, family makes decisions forcare

Level of education Nurse accepts all who lovingly

participate


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2. KNOWLEDGE

May need teaching regarding: Front to back perineal care Special foot care for circulatory

problems Skin inspections by dermatologist


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3. DEVELOPMENTAL LEVELNEWBORNS

Do not place underrunning faucet

Do not submergeuntil umbilical corddrops off

Dry carefully,especially the head

Place cap after bath


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YOUNG CHILDREN Children can drown in 2 inches

of water; never leave alone

during bathing No milk or juice bottles in bed Wipe off teeth after eating and

before sleep Demonstrate on teddy bear


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CHILDREN Children may have

natural parents,stepparents, four sets

of grandparents For decision making,

some cultures mustask father, somemust askgrandmother


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ADOLESCENTS Modesty essential Normal clothes, not

gowns Bed pans notacceptable

Allow decisionmaking


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OLDER ADULTS

Heat insensitivity;can burn easily

Foot care

Skin very fragile


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5. Physical Condition Patient receiving chemotherapy

Patient receiving radiation therapy

Unconscious patient


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Hygiene Care Schedule Early morning care: Urinal/bedpan, wash

hands and face, brush teeth Morning care: After breakfast, complete bath or

shower, hair care, nail care, oral care, back rub,linen change Afternoon care: straighten linen, offer

urinal/bedpan/commode, wash hands/face Evening care: Elimination, wash hands and

face, oral care, linen straightening, back rub


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HYGIENE includes: Care of the skin Care of the feet and

nails

Oral hygiene Hair care Care of the eyes, ears,

and nose Clients room

environment


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1. Care of Skin


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SKIN Regulates body temperature First line of defense against harm

Antibacterial and antifungal Transmits sensations Signs of problems

Redness Wet or damp Not intact


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PATIENTS AT RISK FOR SKINPROBLEMS

Altered level of consciousness Altered nutrition

Immobility Dehydration Altered sensation Secretions on skin Mechanical devices, restraints Altered venous circulation


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Nursing Diagnosis Impaired skin integrity related to

immobilization, exposure to chemical

irritants Hygiene self care deficit : bathing related

to pain in hands, forced immobilization,musculoskeletal weakness


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NURSING INTERVENTIONS Goals :

- Client will have intact skin- Client will be free of odors

Expected outcomes :- Skin will be without redness- Skin will be warm, soft, smooth, and

well hydrated- Odors will be reduced or eliminated


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Continue Intervention :

Bathe client daily

Dry skin thoroughlyafter each cleansing

Apply lotion to skinafter bathing


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NURSING ASSESSMENTWHILE BATHING

Color and condition ofskin

Pain on movement Level of consciousness Injuries Scars Skin turgor Weight loss or gain


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2. PERINEAL CARE Professionalism always Female

Always sterile to contaminated (urethra torectum) Male

Assess for circumcision If not, cleanse under foreskin and replace


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3. Care of the feet and nails


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Common Foot Nail ProblemsCallus (kulit tebal)Warts (kutil)Ingrown nails (tdktumbuh nyeri)Rams horn nails(tumbuh lambat,dasar kuku rusak)Paronychia (radangjaringan)Foot odors


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Nursing Diagnosis Pain related to callus formation, ingrown

toenails

Impaired physical mobility related to painfulfoot lesion

Impaired skin integrity related to impropernail-cutting practices, friction of shoes, injuryto nail


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FOOT CARE Soak feet as part of bath Clean toes and toenails

Range of motion of legs Feet of diabetic patients and patients

with vascular disease are inspected

carefully; Never cut toenails of thesepatients


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NAIL CARE Observe circulation; color, capillary

refill time

Observe color, sensation, andmovement (CSM) Cut nails straight across and file

smooth; Do not go down into corners Assess for rings too tight or too loose


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4. Oral hygiene


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Oral HygieneCommon oral problems :

Dental caries (radang gigi)

Periodontal diseases (gusi berdarah ataubengkak)

Nursing Diagnosis :Altered oral mucous membrane related toradiation of oral cavity


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MOUTH CARE

Examine with gloves and light,especially smokers

Use only water soluble lubricants Unconscious patient has no gagreflex, position on side for care

Teach about brushing and flossing


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5. Hair care


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Nursing Diagnosis Impaired skin integrity related to scalp

laceration Pain related to scalp lesion, accumulated

secretions in hair Body image disturbance related to

unkempt physical appearance

Risk for infection related to scalplaceration


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6. Care of the eyes, ears, and nose


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Nursing Diagnosis Sensory perceptual alterations (visual,

auditory, or olfactory) related toobstruction in ear canal, nasalobstruction, inflammation of eyes orlocal eye infection

Risk injury related to decrease of visual,auditory, or olfactory function


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EYE CARE Contact lenses usually removed Stored in saline liquid; case labeled Also label and safeguard glasses in drawer Clean inner to outer canthus Patient must be able to blink to protect cornea Never use cotton near eyes Treat each eye separately Eyes considered sterile


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EARS Allow nothing sharp in ears Hearing aids now miniscule in size

dont lose Label case Cerumen in ears may need softeningand removing

Speak directly to patients face


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Clients room environment


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BEDMAKING

Make bed for patientcomfort

If incontinent, wash,rinse, dry, changelinen

Position as ordered


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NURSE SAFETY INBEDMAKING

Raise bed to workingheight

Face patient

Bend knees Conserve steps Dont lift alone

Side rails as ordered Lower bed and placecall bell when leaving


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Any Questions ???

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