Personal Hygiene

By :
Tina Handayani
Nasution
 What is it???

• Hygiene : Health

• Personal hygiene :
the self care
measures people use
to maintain their
health

Tina Handayani Nasution/FN II 2

 PURPOSE OF NURSE
PROVIDED HYGIENE
• Remove
microorganisms
• Do physical
assessment
• Increase circulation
– Distal to proximal
– Return to heart
• Improve self image
• Provide comfort

Tina Handayani Nasution/FN II 3

Factor Affecting
Personal Hygiene

???
 SOCIOCULTURAL
FACTORS
• Bathe daily; not all cultures do
• Economics
• Some cultures wear items not to be
removed in bath
– examples: wigs, head dressings, amulets
(jimat), turbans, religious medals or shawls
• Male nurse only or female nurse only
may be necessary in some cultures

Tina Handayani Nasution/FN II 5

 SOCIOCULTURAL
FACTORS
• Male relative may not allow male
nurse alone with woman patient
• Autonomy of patient is important; in
others, family makes decisions for
care
• Level of education
• Nurse accepts all who lovingly
participate

Tina Handayani Nasution/FN II 6

 KNOWLEDGE
• Pengetahuan tentang pentingnya
kebersihan dan motivasi untuk
melakukan perawatan diri
• May need teaching regarding:
– Front to back perineal care
– Special foot care for circulatory
problems (DM)
– Skin inspections by dermatologist

Tina Handayani Nasution/FN II 7

DEVELOPMENTAL LEVEL:
NEWBORNS
• Do not place under
running faucet (kran)
• Do not submerge
(merendam) until
umbilical cord drops off
• Dry carefully,
especially the head
• Place cap after bath

Tina Handayani Nasution/FN II 8

 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 with
soft cloth
• Demonstrate on teddy bear

Tina Handayani Nasution/FN II 9

 CHILDREN
• Children may have
natural parents,
stepparents, four sets
of grandparents

• For decision making,

some cultures must
ask father, some
must ask
grandmother
Tina Handayani Nasution/FN II 10
ADOLESCENTS

• Modesty essential
• Normal clothes, not
gowns
• Bed pans not
acceptable
• Allow decision
making

Tina Handayani Nasution/FN II 11

 OLDER ADULTS

• Heat insensitivity;
can burn easily

• Foot care

• Skin very fragile

Tina Handayani Nasution/FN II 12

 Personal Preferences
• In providing hygiene, may find
very personal details, for examples :
time to shave before or after bath,
select different product
• Decide together on what to take
further
• Must break personal preferences if
signs of abuse
Tina Handayani Nasution/FN II 13
 Physical Condition
• Patient receiving chemotherapy
– Special mouth care (nausea, stomatitis
– Special hair care
– Rest periods
• Unconscious patient
– Move during bath
– ROM frequently
– Mouth care in lateral position, with head
lower
Tina Handayani Nasution/FN II 14
 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/toilet, wash hands/face
• Evening care: Elimination, wash hands and
face, oral care, linen straightening, back rub

Tina Handayani Nasution/FN II 15

HYGIENE includes:
• Care of the skin
• Care of the feet and
nails
• Oral hygiene
• Hair care
• Care of the eyes, ears,
and nose
• Client’s room
environment

Tina Handayani Nasution/FN II 16

Care of Skin

Tina Handayani Nasution/FN II 17

 SKIN
• Regulates body temperature
• First line of defense against harm
• Antibacterial and antifungal
• Transmits sensations
• Signs of problems
• Redness (erythema)
• Wet or damp
• Not intact

Tina Handayani Nasution/FN II 18

PATIENTS AT RISK FOR SKIN
PROBLEMS
• Altered level of consciousness
• Altered nutrition
• Immobility
• Dehydration
• Altered sensation
• Secretions on skin
• Mechanical devices, restraints
• Altered venous circulation
Tina Handayani Nasution/FN II 19
 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

Tina Handayani Nasution/FN II 20

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

Tina Handayani Nasution/FN II 21

 Continue…
Intervention :
 Bathe client daily

 Dry skin thoroughly

after each cleansing

 Apply lotion to skin

after bathing

Tina Handayani Nasution/FN II 22

NURSING ASSESSMENT
WHILE BATHING

• Color and condition of

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

Tina Handayani Nasution/FN II 23

 PERINEAL CARE
• Professionalism always
• Female
– Always sterile to contaminated (urethra to
rectum)
• Male
– Assess for circumcision
• If not, cleanse under foreskin and replace

Tina Handayani Nasution/FN II 24

Care of the feet and nails

Tina Handayani Nasution/FN II 25

Common Foot & Nail Problems
 Callus
 Tinea pedis
 Ram’s horn nails
(curved nails)
 Inflammation of
tissue
 Foot odors
 Ingrown nails ( nails
inward into soft
tissue)
Tina Handayani Nasution/FN II 26
 Nursing Diagnosis
• Pain related to callus formation, ingrown
toenails

• Impaired physical mobility related to painful

foot lesion

• Impaired skin integrity related to improper

nail-cutting practices, friction of shoes, injury
to nail

Tina Handayani Nasution/FN II 27

 FOOT CARE
• Soak(rendam) feet as part of bath
• Clean toes and toenails
• Teach as you go
• Range of motion of legs
• Feet of diabetic patients and patients with
vascular disease are inspected carefully;
Never cut toenails of these patients

Tina Handayani Nasution/FN II 28

 NAIL CARE
• Observe circulation; color, capillary
refill time
• Observe color, sensation, and
movement (CSM)
• Cut nails straight across and file
smooth; Do not go down into corners
• Assess for rings too tight or too loose

Tina Handayani Nasution/FN II 29

Oral hygiene

Tina Handayani Nasution/FN II 30

 Oral Hygiene
 Common oral problems :
– Dental caries
– Periodontal diseases (inflammation of
tissue around the tooth)

 Nursing Diagnosis :
 Altered oral mucous membrane related to
radiation of oral cavity
Tina Handayani Nasution/FN II 31
 MOUTH CARE
• Examine with gloves and light,
especially smokers
• Use only water soluble lubricants
• Unconscious patient has no gag
reflex, position on side for care
• Teach about brushing and flossing

Tina Handayani Nasution/FN II 32

Hair care

Tina Handayani Nasution/FN II 33

 Hair and Scalp Problems
• Dandruff
• Pediculosis (Lice)
– Pediculosis Capitis (Head Lice)
– Pediculosis Corporis (Body Lice)
– Pediculosis Pubis (Crab Lice)
• Hair Loss (Alopecia)

Tina Handayani Nasution/FN II 34

 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 scalp
laceration

Tina Handayani Nasution/FN II 35

Nursing Interventions

• Combing (menyisir)
• Shampooing
• Shaving
• Mustache (kumis)
and beard (jenggot)
care

Tina Handayani Nasution/FN II 36

Care of the eyes, ears, and nose

Tina Handayani Nasution/FN II 37

 Nursing Diagnosis
• Sensory perceptual alterations (visual,
auditory, or olfactory) related to
obstruction in ear canal, nasal
obstruction, inflammation of eyes or
local eye infection

• Risk injury related to decrease of visual,

auditory, or olfactory function

Tina Handayani Nasution/FN II 38

 EYE CARE
• Contact lenses usually removed
• Stored in saline liquid; case labeled
• Also label and safeguard glasses in drawer (laci)
• 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

Tina Handayani Nasution/FN II 39

 EARS
• Allow nothing sharp in ears
• Hearing aids now miniscule in size –
don’t lose! Label case
• Cerumen in ears may need softening
and removing
• Speak directly to patient’s face

Tina Handayani Nasution/FN II 40

Continue…

Tina Handayani Nasution/FN II 41

Client’s room environment

Tina Handayani Nasution/FN II 42

BEDMAKING

• Make bed for patient

comfort
• If incontinent, wash,
rinse, dry, change
linen
• Position as ordered

Tina Handayani Nasution/FN II 43

 NURSE SAFETY IN
BEDMAKING
• Raise bed to working
height
• Face patient
• Bend knees
• Conserve steps
• Don’t lift alone
• Side rails as ordered
• Lower bed and place
call bell when leaving
Tina Handayani Nasution/FN II 44
Any Questions ???

Tina Handayani Nasution/FN II 45