HYGIENE

PRESENTOR:
Pajaron,Edwin D.
Valdez, May ann
Batancilia, Jellian
Gozum, Juvy
HYGIENE

Is the science of health and its maintenance.

highly personal matter determined b individuals values and
practices.
ex: care of the skin, feet, nails, oral and nasal cavities, teeth, hair,
eyes, ears and perineal-genital areas.
PERSONAL HYGIENE

• is the “self-care” by which people attend to such

functions as BATHING, TOILETING, GENERAL BODY
HYGIENE AND GROOMING.
 TYPES OF HYGIENIC CARE
1. Early morning care – is provided to clients as they “awaken in the morning”.
Consist of:
 Providing A urinal or bedpan to the client confined to bed
 Washing the face and hands
 Oral care
2. Morning care – is often provided “after clients have breakfast”, although it may be provided “before
breakfast”.
• Providing elimination needs oral, nail and hair care
• Bath or shower bed making
• Perineal care
• Back massages
 CONT.’ TYPES OF HYGIENE
3. Hour of sleep – “pm care”, is provided t clients before they retire for night.
 Providing elimination needs
 Washing face and hands
 Oral care
 Back massage

4. As needed (prn) care – as required by the client

 Diaphoretic (sweating profusely) – may need more frequent bathing and change of clothes and linen.
 FACTORS INFLUENCING INDIVIDUAL HYGIENIC
PRACTICES

A. CULTURE
B. RELIGION
C. ENVIRONMENT
D. DEVELOPMENTAL LEVEL
E. HEALTH AND ENERGY
F. PERSONAL PREFERENCES
SKIN
 Is the largest organ of the body

5 major functions
1. It protects underlying tissues from injury by preventing the passage of microorganisms
2. Regulates the body temperature
3. It secretes sebum, an oily substance that softens and lubricates hair and skin
4. It transmits sensations through nerve receptors.
5. It produces and absorbs vitamin d in conjunction with uv rays from the sun.
 ASSESSMENT
Nursing health history to determine:
A. The client’s skin care practices
B. Self-care abilities
C. Past or current skin’s problem
Physical assessment of the skin (inspection and palpitation)
A. Collect data about – skin color, uniformity of color, texture, turgor temperature, intactness
and lesions.
Identification of clients at risk for developing skin impairments.
 DIAGNOSING
• Self-care deficit- used for clients who have problems performing hygiene care.
Nanda’s 4 self-care deficit:
1. Self-care deficit: bathing/hygiene – inability to wash the body or body parts, to
obtain or get water source and to regulate water temperature or flow.
2. Self-care deficit: dressing/grooming – inability to obtain, put on, take off, fasten, or
replace articles of clothing and to maintain appearance at satisfactory level
3. Self-care deficit: toileting – involves in difficulties getting to the toilet or sitting or
rising from it
4. Self-care deficit: feeding
 EXAMPLES OF ASSOCIATED DIAGNOSES INCLUDE
THE FOLLOWING:
1. Deficient knowledge related to:
a. Lack of experience with skin condition (acne) and need to prevent secondary infection.
b. New therapeutic regimen to manage skin problems.
c. Lack of experience in providing hygiene care to dependent person.
d. Unfamiliarity with devices available to facilitate sitting on or rising from toilet
2. Standard low self-esteem related to:
a. Visible skin problem ( eg. Acne or alopecia)
b. Body odor
 DIAGNOSING (client with skin problem)

SCENARIO:

Mark Drake, 15 years old has facial pustules and papules.

facial skin is inflamed. he states, “I hate going to school
anywhere looking like this. I don’t think any girl wants to go out
with me. can you do something to get rid of this?”.
 DIAGNOSING (client with skin problem)
Nursing Diagnosis Sample Desired Indicators Selected Sample NIC
Outcome Interventions Activities
Situational Low Self Self Esteem /  Verbalizations of Self-Esteem  Encourage client
Esteem related to Personal self-accept acne Enhancement / to identify
acne/ Development judgement of self-  Maintenance of Assisting a client to strengths
of negative worth grooming/hygiene increase his/her  Convey
perception of self-  Description of personal judgement confidence in
worth in response to success in social of self-worth. client’s ability to
a current situation groups handle situation.
 Assist client to
reexamine
negative
perceptions of
self-worth
 PLANNING
Planning to assist client personal hygiene includes consideration of the client’s
personal preferences, health and limitations; the best time to give the care; and
the equipment, facilities and personnel available.
Another consideration for the nurse is to assess the client’s comfort level with the
gender caregiver.
To provide continuity of care, it is important that the nurse assess the client’s
family’s abilities for care and the need for referrals and home health services
 FEET

Are essential for ambulation and merit attention even when

people are confined to bed.
Each foot contains 26 bones, 107 ligaments, and 19
muscles. These structures function to gather for both
standing and walking.
 ASSESSING
• Assessment of the client’s feet includes a nursing health history, physical assessment of the feet,
and identifying clients at risk for foot problems.
1. Nursing health history should determine:
 Normal nail and foot care practices
 Type of footwear worn
 Self-care abilities
 Presence of risk factors for foot problems
 Any foot discomforts
 Any perceived problems with foot mobility.
2. Physical assessment – each foot and toe is inspected for shape, size an presence of lesions and is
palpated to assess areas of tenderness, edema and circulatory status
 DIAGNOSING

 Self-care deficit: Hygiene related to:

• Visual impairment
• Impaired hand coordination.
 Risk for impaired skin integrity related to:
• Altered tissue perfusion: peripheral (associated with edema, inadequate arterial circulation).
• Poorly fitting shoes.
 Risk for infection related to:
• Impaired skin integrity (ingrown toenail, corn, trauma)
• Deficient nail or foot care.
• Deficient knowledge (diabetic foot care) related to
• *Lack of teaching/learning activities about diabetic foot care.
 SCENARIO

Kyle Stevens, 14 years old, lives with his mother and eight
sisters and brothers in a three-room walk-up. Bathroom down
the hall is shared with other tenants in the building, shoes are
ragged and fit poorly. States “I can’t get new ones”.
Nursing Diagnosis Sample Desired Indicators Selected Sample NIC
Outcome Interventions Activities
Risk for Tissue Not Skin  Monitor skin for
Impaired Skin Integrity: Skin Compromised Surveillance/ areas of redness
Integrity related & Mucous *Skin Collection and and breakdown
to poorly fitting Membranes/ intactness analysis of client  Monitor skin for
shoes and Structural data to maintain excessive
limited access intactness and skin and dryness and
to bathing normal mucous. moisture.
facilities / At physiologic membrane  Institute
risk for skin function of skin integrity measures o
being adversely and mucous prevent
altered. membranes. deterioration of
the skin.
 Instruct client
and family about
signs of skin
breakdown.
 PLANNING

Identifying nursing interventions that will help the client maintain or

restore healthy foot care practices
Establishing desired outcomes for each client. Interventions may
include teaching the client about correct nail and foot care, proper
footwear, wearing the correct size and ways to prevent potential foot
problems.
 NAILS

• NAILS ARE NORMALLY PRESENT AT BIRTH.

• THEY CONTINUE TO GO THROUGH-OUT LIFE AND CHANGE VERY LITTLE UNTIL PEOPLE ARE
ELDERLY.
• THE NAILS OF AN OLDER PERSON NORMALLY GROW LESS QUICKLY THAN THOSE YOUNGER
PERSON AND MAY BE RIDGED AND GROOVED.
 ASSESSING

• DURING THE NURSING HEALTH HISTORY, THE NURSE EXPLORES THE CLIENT’S USUAL NAIL CARE
PRACTICES, SELF-CARE ABILITIES, AND PROBLEMS ASSOCIATED WITH THEM.
• PHYSICAL ASSESSMENT INVOLVES INSPECTION OF THE NAILS. (E.G., NAIL SHAPE AND TEXTURE,
NAIL BED COLOR, AND TISSUES SURROUNDING NAILS).
 DIAGNOSING

• NURSING DIAGNOSES RELATED TO NAIL CARE AND NAIL PROBLEMS INCLUDE SELF-CARE
DEFICIT AND RISK FOR INFECTION.
• SELF-CARE DEFICIT: GROOMING RELATED TO
• A. IMPAIRED VISION
• RISK FOR INFECTION AROUND THE NAIL BED RELATED TO
• A. IMPAIRED SKIN INTEGRITY OF CUTICLES
• B. ALTERED PERIPHERAL CIRCULATION
 DIAGNOSING (CLIENT WITH FOOT PROBLEM)

SCENARIO:
SALLY BROWN, AN 83-YEAR OLD WIDOW, LIVES ALONE. HAS HOME-MAKER SERVICES TWICE A
WEEK AND MEALS ON WHEALS SERVICE DAILY. MANAGES TO SHOWER ONCE A WEEK WITH
DAUGHTERS HELP. HAS PRONOUNCED HAND TERRORS AND OBVIOUS CATARACTS. STATE, “I
CAN’T SEE WELL ENOUGH TO CUT MY NAILS AND EVEN IF I COULD SEE, MY HAND SHAKES SO
BADLY.”
 DIAGNOSING (CLIENT WITH FOOT PROBLEMS)
Nursing Diagnosis Sample Desired Indicators Selected Interventions Sample NIC Activities
Outcome
Self-Care Deficit: Self-care: Hygiene Severely compromised: Foot care • Inspect skin for
Hygiene (Foot Care) (0305)/Ability to • Cares for nails (1660)/Cleansing and irritation, cracking,
related to impaired maintain own personal inspecting the feet for lesions, corns,
hand coordination and cleanliness and kempt the purposes of calluses, or edema
visual appearance relaxation, cleanliness, • Instruct family on
impairment/impaired independently with or and healthy skin the importance of
ability to perform or without assistive device foot care
complete • Cut normal-thickness
bathing/hygiene toenail clipper and
activities for oneself using the curve of
the toe as a guide
• Refer to podiatrist
for trimming of
thickened nails, as
appropriate
 PLANNING

• THE NURSE IDENTIFIES MEASURES THAT WILL ASSIST THE CLIENT TO DEVELOP OR MAINTAIN
HEALTHY NAIL CARE PRACTICES.
• A SCHEDULE OF NAIL CARE NEEDS TO BE ESTABLISHED.
 MOUTH

• EACH TOOTH HAS THREE PARTS:

• THE CROWN – IS THE EXPOSED PART OF THE TOOTH, WHICH IS OUTSIDE THE GUM.
• THE ROOT – IS EMBEDDED IN THE JAW AND COVERED BY A BONY TISSUE CALLED CEMENTUM
• THE PULP CAVITY – THE CENTER OF THE TOOTH CONTAINS THE BLOOD VESSELS AND NERVES.
• TEETH USUALLY APPEAR 5-8 MONTHS AFTER BIRTH.
 ASSESSING

• ASSESSMENT OF THE CLIENT’S MOUTH AND HYGIENE PRACTICES INCLUDES A NURSING

HISTORY, PHYSICAL ASSESSMENT, AND IDENTIFICATION OF CLIENTS AT RISK FOR DEVELOPING
PROBLEMS.
• 1. NURSING HEALTH HISTORY, THE NURSE OBTAINS DATA ABOUT:
• CLIENT’S ORAL HYGIENE PRACTICES
• CLIENT’S SELF-CARE ABILITIES
• PAST OR CURRENT MOUTH PROBLEMS
• 2. PHYSICAL ASSESSMENT
DIAGNOSING (CLIENT WITH ORAL CAVITY PROBLEMS)

• SCENARIO:
• JOE KWAN, 46 YEARS OLD, WAS ADMITTED WITH A FRACTURED FEMUR. TEETH STAINED FROM
HEAVY SMOKING. ONE LARGE CAVITY EVIDENT IN 2ND LOWER LEFT MOLAR, TARTAR BUILD UP
ALONG GUM MARGINS, AND PRONOUNCED HALITOSIS. GUMS ARE REDDENED IN SOME
AREAS AND BLEED WHEN FLOSSED. STATES , “I CAN’T REMEMBER WHEN I LAST SAW A
DENTIST.”
 DIAGNOSING
Nursing Diagnosis Sample Desired Indicators Selected Sample NIC Activities
Outcome Interventions

Impaired Oral Mucous Oral Hygiene Not Compromised: Oral Health • Use a soft toothbrush for
Membrane related to (1100)/Condition of • Cleanliness of Restoration removal of dental debris
ineffective oral the mouth, teeth, teeth (1730)/Promotion • Use toothettes or disposable
hygiene/Disruption of gums, and tongue • Cleanliness of of healing for a foams swabs to stimulate
the lips and soft tissue gums client who has an gums and clean oral cavity
of the oral cavity • No: Halitosis oral mucosa or • Encourage flossing between
• Bleeding dental lesion teeth twice daily with
unwaxed dental floss, if
platelet levels are above
50,000/mm3
• Discourage smoking
• Reinforce oral hygiene
regimen as part of discharge
teaching.
 PLANNING
• IN PLANNING CARE, THE NURSE AND IF APPROPRIATE, THE CLIENT AND/OR FAMILY SET OUTCOMES FOR EACH
NURSING DIAGNOSIS.
• THE NURSE THEN PERFORMS NURSING INTERVENTIONS AND ACTIVITIES TO ACHIEVE THE CLIENT OUTCOMES.
• DURING THE PLANNING PHASE, THE NURSE ALSO IDENTIFIES INTERVENTIONS THAT WILL HELP THE CLIENT
ACHIEVE THESE GOALS. SPECIFIC , DETAILED NURSING ACTIVITIES TAKEN BY THE NURSE MAY INCLUDE THE
FOLLOWING:
• MONITOR EVERY SHIFT FOR DRYNESS OF THE ORAL MUCOSA.
• MONITOR FOR SIGNS AND SYMPTOMS OF GLOSSITIS (INFLAMMATION OF THE TONGUE) AND STOMATITIS
(INFLAMMATION OF THE MOUTH).
• ASSIST DEPENDENT CLIENTS WITH ORAL CARE.
• PROVIDE SPECIAL ORAL HYGIENE FOR CLIENTS WHO ARE DEBILITATED, ARE UNCONSCIOUS, OR HAVE LESIONS
OF THE MUCOUS MEMBRANES OR OTHER ORAL TISSUES.
• TEACH CLIENTS ABOUT GOOD ORAL HYGIENE PRACTICES AND OTHER MEASURES TO PREVENT TOOTH DECAY.
• REINFORCE THE ORAL HYGIENE REGIMEN AS PART OF DISCHARGE TEACHING.
 HAIR

• THE APPEARANCE OF THE HAIR OFTEN REFLECTS A PERSON’S FEELINGS OF SELF-CONCEPT AND
SOCIOCULTURAL WELL-BEING.
• THE HAIR MAY ALSO REFLECT STATE OF HEALTH (E.G., ENDOCRINE CHANGES CAN AFFECT THE
PATTERN OF HAIR GROWTH, AND COLOR CHANGES MAY REFLECT AGING.
• NEWBORNS MAY HAVE LANUGO THE FINE HAIR ON THE BODY OF THE FETUS, ALSO REFERRED
TO AS DOWN OR WOOLLY HAIR) OVER THEIR SHOULDERS, BACK, AND SACRUM.
• IN OLDER ADULTS, THE HAIR IS GENERALLY THINNER, GROWS MORE SLOWLY, AND LOSES ITS
COLOR AS A RESULT OF AGING TISSUES AND DIMINISHING CIRCULATION.
 ASSESSING

• ASSESSMENT OF THE CLIENT’S HAIR, HAIR CARE PRACTICES, AND POTENTIAL PROBLEMS
INCLUDES A NURSING HEALTH HISTORY AND PHYSICAL ASSESSMENT.
• NURSING HISTORY – THE NURSE ELICITS DATA ABOUT USUAL HAIR CARE, SELF-CARE ABILITIES,
HISTORY OF HAIR SCALP PROBLEMS, AND CONDITIONS KNOWN TO AFFECT HAIR.
• PHYSICAL ASSESSMENT – PROBLEMS INCLUDE DANDRUFF, HAIR LOSS, TICKS, PEDICULOSIS,
SCABIES, AND HIRSUTISM.
 DIAGNOSING
• NURSING DIAGNOSES RELATED TO HAIR HYGIENE AND HAIR AND SCALP PROBLEMS INCLUDE SELF-CARE DEFICIT: GROOMING, IMPAIRED SKIN,
RISK FOR INFECTION, AND DISTRIBUTION BODY IMAGE.
• SELF-CARE DEFICIT: GROOMING RELATED TO
• A. ACTIVITY INTOLERANCE
• B. IMPOSED IMMOBILITY(BED REST)
• C. PAIN UPPER EXTREMITIES
• D. ALTERED LEVEL OF CONSCIOUSNESS
• LACK OF MOTIVATION ASSOCIATED WITH DEPRESSION
• IMPAIRED SKIN INTEGRITY RELATED TO
• A. SCALP LACERATION
• B. INSECT BITE
• RISK FOR INFECTION RELATED TO
• A. SCALP LACERATION
• INSECT BITE
• DISTURBED BODY IMAGE RELATED TO
• ALOPECIA
 DIAGNOSIS
Nursing Diagnosis Sample Desired Selected Sample NIC Activities
Outcome[NOC#]Defin INDICATORS Interventions[NIC#]Definiti
ition on
Self-Care Deficit: Self-Care: Shampoos hair Hair Care Wash hair, as needed
Dressing/Grooming/Im Grooming Combs or brushes [1670]/promotion of neat, and desired
paired ability to [0304]ability to hair clean, attractive hair Dry hair with hair
perform or complete maintain kempt Maintains net dryer
dressing and grooming appearance appearance Brush/comb hair daily
activities for self or more frequently, as
needed
Monitor scalp daily
Braid or otherwise
arrange hair as client
wishes
Use hair care products
of client’s preference,
as available
 EYES

• ASSESSING
• > ASSESSMENT OF THE CLIENT’S EYES INCLUDES A NURSING HEALTH HISTORY AND PHYSICAL
ASSESSMENT.
• NURSING HEALTH HISTORY – DURING THE NURSING HISTORY, THE NURSE OBTAINS DATA ABOUT
THE CLIENT’S EYEGLASSES OR CONTACT LENSES, RECENT EXAMINATION BY AN
OPHTHALMOLOGIST, AND ANY HISTORY OF EYE PROBLEMS AND RELATED TREATMENTS.

PHYSICAL ASSESSMENT – ALL EXTERNAL EYE STRUCTURES ARE INSPECTED FOR SIGNS OF
INFLAMMATION, EXCESSIVE DRAINAGE, ENCRUSTATIONS OR OTHER OBVIOUS ABNORMALITIES
 EYES

• DIAGNOSING
• NURSING DIAGNOSES RELATED TO EYE PROBLEMS MAY INCLUDE SELF CARE DEFICIT, RISK FOR
INFECTION AND RISK FOR INJURY. EXAMPLES OF THESE DIAGNOSES AND POSSIBLE
CONTRIBUTING FACTORS FOLLOW:
• * SELF-CARE DEFICIT (CONTACT LENS INSERTION, REMOVAL AND CLEANING) RELATED TO:
• A. DEFICIENT KNOWLEDGE
• B. IMPAIRED VISION ASSOCIATED WITH CATARACTS
 EYES

• DIAGNOSING
• RISK FOR INFECTION RELATED TO:
A. IMPROPER CONTACT LENS HYGIENE
B. ACCUMULATION OF SECRETIONS ON EYELIDS

• RISK FOR INJURY RELATED TO:

A. PROLONGED WEARING OF CONTACT LENSES
B. ABSENCE OF BLINK REFLEX ASSOCIATED WITH UNCONSCIOUSNESS.
 PLANNING

• IN PLANNING CARE, THE NURSE IDENTIFIES NURSING ACTIVITIES THAT WILL ASSIST THE CLIENT
TO MAINTAIN THE INTEGRITY OF THE EYE STRUCTURES OR A PROSTHESIS AND TO PREVENT EYE
INJURY AND INFECTION.
-NORMAL EARS REQUIRE MINIMAL HYGIENE. EARS

-CLIENTS WHO HAVE EXCESSIVE CERUMEN (EARWAX) AND DEPENDENT CLIENTS WHO HAVE HEARING AIDS MAY REQUIRE ASSISTANCE
FROM THE NURSE.
-HEARING AIDS USUALLY REMOVE BEFORE THE SURGERY.

CLEANING THE EARS

-THE AURICLES OF THE EAR ARE CLEANED DURING THE BED BATH.
-CLIENTS NEED TO BE ADVISED NEVER TO USE BOBBY PINS , TOOTHPICKS, OR COTTON TIPPED APPLICATORS
TO REMOVE CERUMEN.

TYPE OF HYGIENE CARE

1. BEHIND THE EAR BTE, OR POSTAURAL AID .

-THE HEARING AID CASE IS WHICH HOLDS THE MICROPHONE
-AMPLIFIER AND RECEIVER , IS ATTACHED TO THE EARMOLD
BY A PLASTIC TUBE
2. IN THE EAR AID (ITE , OR INTRA-AURAL)
HOME CARE CONSIDERATIONS
SUPPORTING A HYGENIENIC
THREE TYPE OF EQUIPMENT
ROOM TEMPERATURE
NOISE