HYGIENE – the science that deals with the preservation of health.

It is a set of practices performed for

the preservation of health. Hygienic care promotes cleanliness, provides for comfort and relaxation,
improves self-image and promotes healthy skin.
Personal hygiene – is the self care by which people attend to such functions as bathing, toileting,
general body hygiene, and grooming. It involves care of the skin, hair, nails, teeth, oral and nasal
cavities, eyes ears, and perineal-genital areas.
Factors influencing hygienic practices:
1. Culture
2. Religion
3. Environment
4. Developmental level
5. Health and energy
6. Personal preferences
Types of hygienic care:
1. Early morning care – is provided to clients as they awaken in the morning.
2. Morning care – is often provided after clients have breakfast, although it may be provided
before breakfast
3. Hour of sleep ( HS ) or PM care – is provided to clients before they retire for the night.
4. As needed ( PRN ) care – is provided as required by the client.
BED BATH – is given to provide cleanliness and comfort to a client who is unable to be out of bed
because of physical or mental limitations.
PURPOSES:
 To remove transient microorganisms, body secretions and excretions and dead skin cells
 To stimulate circulatory to the skin
 To promote a sense of well-being
 To produce relaxation and comfort
 To prevent and eliminate unpleasant body odors
Two General Categories of Bath:
A. Cleaning bath – provided as routine client care; purpose is personal hygiene
B. Therapeutic bath – usually performed in a tub and lasts about 20 to 30 minutes; requires a
physician’s order (type of bath, temperature of water, body surface to be treated, and the type of
medicated solutions to use)
A. TYPES of CLEANING BATH:
1. Complete bed bath – given to a client who is unable to perform any of the baths; the nurse washes
the entire body of a dependent client in bed.
2. Self –help bed bath – used to provide hygienic care for clients who are confined to bed and are
able to bathe themselves with the help from the nurse for washing the back and perhaps the feet;
usually a complete bath; given to clients who are unable to take a shower or a tub bath but is able to
move freely in bed.
3. Tub bath – permits washing and rinsing in the tub; can also be a therapeutic bath.
- is generally use for cleaning purposes only although at times therapeutic agent can be
added. It should be given with Doctor’s order
4. Shower – given to most ambulatory clients; patient may take a standing shower or sitting in a chair
(shower chair)

5. Partial bed bath – only the parts of the client’s body that might cause discomfort or odor, if
neglected, are washed: FACE, HANDS, AXILLAE, PERINEAL AREA and BACK. Omitted are the arms, chest,
abdomen, legs and feet. The nurse provides this care for dependent clients and assists self – sufficient
clients confined to bed by washing their backs.
Nurse Responsibility:
 To provide the basin of water, bath blanket
  Assistance is needed for the feet and legs, back and buttocks
 Do not omit back rub
 Ensure privacy
 Adjust room temperature and temperature of water
 Do not allow client to soak longer than 20 minutes
B. THERAPEUTIC BATH
Types:
1. Hot or warm water tub baths – used to reduce or relieve muscle spasms, soreness and muscle
tension; have the potential for causing skin burns. Water should be deep enough for immersion. Water
should be warm to client’s comfort level.
2. Cool or tepid sponge baths – used to decrease fever or lower body temperature and to
reduce/relieve muscle tension. Nurse needs to prevent chilling and rapid temperature fluctuations;
water should be cool not cold (tap water) Ex. TSB
3. Soak baths – used to reduce pain, swelling or irritation or to soften or remove dead tissue
- can include the entire body or be limited to only one body part; consists of applying
water, with or without a medicated solution
4. Sitz baths – used to cleanse and decrease pain and inflammation in the perineal and anal areas;
commonly used for hemorrhoids or anal fissures and after rectal or perineal surgery
- Water should be warm to client’s level
- Check warmth by using elbow or back of hands
5. Oatmeal or Aveeno – to soothe irritated skin, softens and lubricates dry scaly skin
- 3 cups cooked oatmeal in a cheesecloth bag and place in tub of water
6. Cornstarch – to soothe skin irritation; dissolve 1 lb of cornstarch in cold water, then add boiling
water until mixture is thick and add to tub water
7. Sodium bicarbonate baths – soothes skin irritation
BEDRIDDEN – a term used to describe a person who is unable to leave due to illness or injury
Examples: Very elderly
Terminally ill
Those paralyzed as a result of an accident
Procedure:
Sponge starting always from FAR SIDE
(soap, rinse, tap dry)
1. Eyes – inner to outer cantus
2. Forehead, cheek, chin – figure of S
3. Ears – front then back
4. Forehead, nose, mouth
5. Neck – downward stroke
6. Far arm -->near arm --> hands
7. Chest--> navel area
8. Abdomen --> pubic bone/area
9. Far legs -->near legs-->foot
10. Genitalia (then turn the patient to prone position)
11. back of the neck--> back
12. Buttocks (massage-figure of 8)
13. Back rub
BACK RUBS and MASSAGES – stimulate the client’s circulation, relax muscles, and relieve muscle
tension; provides nurse with an opportunity for skin assessment
- Promotes relaxation and comfort which can help induce sleep; 4-6 minute
Contraindications:
1. Rib or vertebral fracture
2. Burn
 3. with open wounds
TYPES of STROKES:
1. Effleurage – long, smooth stroke, sliding over the skin, relaxing and soothing, 8-10x
2. 3 handed effleurage – smooth stroking motion that gives the client an impression of being rubbed
hands, relieves tension of the neck
3. Petrissage – kneading of the skin and underlying muscle/large quick pinch
- induces relaxation in tight or tense muscle and promote circulation
a. rainfall – with the use of fingertips
b. rolling knuckles – roll knuckles
c. friction strokes – tiny circle with both thumbs. The nurse massage the back from buttocks to the
shoulder (both side of the vertebral column)
d. thumb walk – make use of thumb
4. Tapottement – rhythmic percussion or tapping
- used particularly over tense muscle should be done gently
- little finger side of the hands is used in sharp hacking movement on the back
- do not apply on : a) elderly; b) patient who has decrease condition of the back
a. hacking – with side of the little finger
b. bronchial clapping – cupped hands
c. bronchial tapping – palms
5. Figure of eight – buttocks
Provide skin care (p. 742-747)
- Skin care provides cleansing and conditioning to promote the optimal functioning of the skin
- Consists of providing adequate nutrition, baths, perineal care and back rubs
Provide Foot and Nail Care (p. 763)
- Essential for ambulation and standing
- Purposes are to prevent infection and soft tissue trauma from ingrown or jagged nails and to
eliminate odor
- Consists of regular trimming of nails, cleaning under nails; cleaning ,rinsing, and drying feet and
nails; and wearing properly fitted shoes
Provide Oral care (p. 768)
- Essential to maintain the integrity of the mucous membranes, teeth, gums, and lips
- Consists of fluoride rinsing, flossing and brushing
- Common problems:
 Bad breath ( halitosis)
 Dental care (cavities)
 Plaque
 Periodontal disease (pyorrhea)
 Inflammation of the gums ( gingivitis)
 Inflammation of the oral mucosa (stomatitis)
Oral Care for the Unconscious Client (p. 772)
- Special care should be exercised to prevent client aspiration or injury to the nurse
Provide hair Care (p. 774-777)
Mustache an d Beard care (p.779)
- Consists of keeping the hair clean, trimmed and combed

Provide Eye, Ears and Nose Care (p. 780-785)

- Should included in routine hygienic care