Nurs 230: Exam 1 Questions With Complete Solutions
care plan modification
- care plans should be updated regularly after evaluation of goals
- modifications are made based on effectiveness of interventions
to improve patient outcomes
- need to be continually evaluated
hygiene concepts
- hygiene MUST happen
- promotes cleanliness, health, and well-being/comfort
- important to encourage patient's participation to promote
independence and self-care
- provides opportunity for communication and range of motion
- consider patient's personal preferences and culture
- allows for assessment of cognitive functioning, skin integrity,
and hygienic practices
-- assess skin for signs of infection
-- provide patient education as needed
- includes bathing, perineal care, oral care, shaving, and foot and
hair care
assessment with hygiene
- before care, ask the patient about skin changes
- inspect the condition of the exposed skin
- observe for odors
- inspect hair for cleanliness and grooming
- inspect fingernails and toenails for peripheral vascular status
,- assess oral hygiene
- assess self-care abilities
planning with hygiene
- prioritize identified hygiene-related nursing diagnoses
according to patient needs and recognized risks
- develop a care plan for each nursing diagnosis
- make realistic short- and long-term goals (should be
established based on nursing knowledge and collaboration with
other health care professionals, patients, and families)
nursing hygiene interventions should focus on ...
- cleanliness
- comfort
- infection prevention
- prevention of skin breakdown
- patient preferences
types of hygiene interventions
- complete bed bath: cleaning everything when patient is
completely dependent
- partial bed bath: cleaning things that usually get dirty (armpits,
perineal area)
- sink bath
- shower
- chair shower
** make sure to provide privacy and comfortable room
temperature
bathing a patient serves what functions ...
, - provides routine hygienic care
- promotes circulation and blood flow
- reduces body odor
- provides range of motion
- provides comfort and relaxation
- strengthens a general feeling of health and wellness
- provides nurse with the opportunity to assess skin and build a
therapeutic relationship
hygiene can be delagated ...
- to a UAP (nursing assisstant)
- they must know ...
-- appropriate documentation
-- how to perform it
-- any specificities for the patient
purpose of perineal care
- prevents infection by removing the buildup of secretions
- prevents skin breakdown and odor
- provides comfort
- strengthens a general feeling of health and wellness
types of perineal care
- male: inner thigh, inguinal area, tip of penis, shaft, testicles
- females: inner thigh, inguinal area, labias from top to
bottom/front to back
- sitz bath: tube in bucket on toilet that splashes water on
perineum
- urinary catheter: clean first 4 inches closest to perineum
care plan modification
- care plans should be updated regularly after evaluation of goals
- modifications are made based on effectiveness of interventions
to improve patient outcomes
- need to be continually evaluated
hygiene concepts
- hygiene MUST happen
- promotes cleanliness, health, and well-being/comfort
- important to encourage patient's participation to promote
independence and self-care
- provides opportunity for communication and range of motion
- consider patient's personal preferences and culture
- allows for assessment of cognitive functioning, skin integrity,
and hygienic practices
-- assess skin for signs of infection
-- provide patient education as needed
- includes bathing, perineal care, oral care, shaving, and foot and
hair care
assessment with hygiene
- before care, ask the patient about skin changes
- inspect the condition of the exposed skin
- observe for odors
- inspect hair for cleanliness and grooming
- inspect fingernails and toenails for peripheral vascular status
,- assess oral hygiene
- assess self-care abilities
planning with hygiene
- prioritize identified hygiene-related nursing diagnoses
according to patient needs and recognized risks
- develop a care plan for each nursing diagnosis
- make realistic short- and long-term goals (should be
established based on nursing knowledge and collaboration with
other health care professionals, patients, and families)
nursing hygiene interventions should focus on ...
- cleanliness
- comfort
- infection prevention
- prevention of skin breakdown
- patient preferences
types of hygiene interventions
- complete bed bath: cleaning everything when patient is
completely dependent
- partial bed bath: cleaning things that usually get dirty (armpits,
perineal area)
- sink bath
- shower
- chair shower
** make sure to provide privacy and comfortable room
temperature
bathing a patient serves what functions ...
, - provides routine hygienic care
- promotes circulation and blood flow
- reduces body odor
- provides range of motion
- provides comfort and relaxation
- strengthens a general feeling of health and wellness
- provides nurse with the opportunity to assess skin and build a
therapeutic relationship
hygiene can be delagated ...
- to a UAP (nursing assisstant)
- they must know ...
-- appropriate documentation
-- how to perform it
-- any specificities for the patient
purpose of perineal care
- prevents infection by removing the buildup of secretions
- prevents skin breakdown and odor
- provides comfort
- strengthens a general feeling of health and wellness
types of perineal care
- male: inner thigh, inguinal area, tip of penis, shaft, testicles
- females: inner thigh, inguinal area, labias from top to
bottom/front to back
- sitz bath: tube in bucket on toilet that splashes water on
perineum
- urinary catheter: clean first 4 inches closest to perineum
