HYGIENE AND SKIN INTEGRITY

• Hygiene


  The science of health
• Hygienic care


  • Promotes cleanliness
  • Provides for comfort and relaxation
  • Improves self-image
  • Promotes healthy skin
• Skin


  Largest organ of the body
• Functions of the skin

  • 1st line of defense- injury and infection
  • Maintains body temp
  • Secretory organ
  • Sensory organ
  • Produces; absorbs vit.D thru u.v. rays which activate vit. D.precursorpresent in the skin
• Client hygiene


  An extension of providing client safety and protecting the client's defense mechanisms
• Nurses are responsible for assuring that the client's hygienic needs are met
• Types of sweat glands

  • Apocrine glands
  • Eccrine glands
• Common skin problems


  • Abrasion
  • Excessive dryness
  • Acne
  • Erythema
  • Hirsutism
  • Hyperhidrosis
  • Bromhydrosis
  • Vitiligo
• Types of skin lesions

  • Primary - macule, patch, papule, plaque, nodule, tumor, vesicle, bulla, pustule, wheal, cyst, telangiectasia, petechiae
  • Secondary - scale, crust, fissure, erosion, excoriation, atrophy, scar, ulcer, lichenification
• General guidelines for skin care

  • An intact, healthy skin is the body's first line of defense
  • The degree to which the skin protects the underlying tissues from injury depends on the amount of subcutaneous tissues and the dryness of the skin
  • Moisture in contact with the skin promotes bacterial growth
  • Body odors are caused by resident skin bacteria acting on the body secretions. Cleanliness is the best deodorant
  • Skin sensitivity to irritation and injury varies among individuals and in accordance with their health
  • Agents used for skin care have selective actions and purposes. E.g. soap, detergent, bath oil, cream, lotion, powder, deodorant, and antiperspirant
• Factors Influencing Hygienic Practices


  • Body image
  • Social and cultural practices
  • Personal preferences
  • Socioeconomic status
  • Knowledge
  • Religion
  • Environment
  • Developmental level
  • Health and energy
• Body Image


  The client's subjective belief about his or her own physical appearance. Body image is associated with the client's emotions, mood, attitude, and value.
• A client's body image directly affects the type of personal hygiene practiced; this may change if the client's body image is altered because of illness or surgical procedures.
• Social and cultural practices

  Directly influence hygienic practices. Clients are socialized to their hygienic practices by family practices in early childhood. As a person ages, hygienic practices are influenced by maturational development and socialization with people outside of the family. In later adulthood, hygienic practices may be influenced by coworkers and social networks.
• Personal preferences


  Influence when bathing occurs, what products are used, and what type of bath is performed
• Socioeconomic status


  May affect the type, frequency, and extent of hygiene practiced due to limited economic resources
• Knowledge


  Influences the client's understanding about the relationship between hygiene and health. Clients must be motivated and believe that they are capable of self-care.
• Religion


  Some religions practice ceremonial washings
• Environment


  May affect the availability of facilities for bathing and supplies for hygienic care
• Developmental level


  Children learn hygiene in the home. Practices vary according to the individual's age.
• Health & Energy


  Ill people may not have the motivation or energy to attend to hygiene. Some clients may not have the neuromuscular ability to perform hygienic care.
• How health status affects self-care ability

  • Pain
  • Limited mobility
  • Sensory deficits
  • Cognitive impairment
  • Emotional disturbances
• Clients who suffer dizziness, weakness, or mental confusion should not be allowed to take stand showers. Obese clients may find it difficult to maneuver into the bath tub & might risk falling. A sit down shower chair is more appropriate.
• Types of Scheduled Hygienic Care

  • Early morning
  • Morning
  • Hours of sleep (HS) or PM
  • As needed (prn)
• Early morning care


  • Urinal or bedpan
  • Washing face and hands
  • Oral care
• Morning care


  • Elimination
  • Bath or shower
  • Perineal care
  • Back massage
  • Oral, nail, and hair care
• Steps for Identified Hygienic-Care Procedures

  • Assessment
  • Planning
  • Implementation
  • Evaluation
• Purposes of Bathing


  • Remove transient microorganisms, body secretions and excretions, and dead skin cells
  • Stimulate circulation
  • Produce a sense of well-being
  • Promote relaxation and comfort
  • Prevent or eliminate unpleasant body odors
• Methods of bathing


  • Tub bath
  • Stand-up shower
  • Sit down shower with shower-chair
  • Bed bath
• Categories of Baths


  • Cleansing baths
  • Therapeutic baths
• Types of Cleansing Baths

  • Complete bed bath
  • Self-help bath
  • Partial bath
  • Bag bath
  • Tub bath
  • Sponge bath
  • Shower
• Bed-making should provide a smooth, wrinkle-free bed foundation, leave the bed in the appropriate position, raise side rails, and place items within easy reach of the client.
• Hygienic care


  • Bed bath
  • Back rub
  • Perineal-genital care
  • Foot care
  • Nail care
  • Mouth care
  • Hair care
  • Eye, ear, nose care
• Hygiene


  The science of health
• Hygienic care


  • Promotes cleanliness
  • Provides for comfort and relaxation
  • Improves self-image
  • Promotes healthy skin
• Skin


  Largest organ of the body
• Functions of the skin

  • 1st line of defense- injury and infection
  • Maintains body temp
  • Secretory organ
  • Sensory organ
  • Produces; absorbs vit.D thru u.v. rays which activate vit. D.precursorpresent in the skin
• Client hygiene


  An extension of providing client safety and protecting the client's defense mechanisms
• Nurses are responsible for assuring that the client's hygienic needs are met
• Types of sweat glands

  • Apocrine glands
  • Eccrine glands