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® This PowerPoint file is a supplement to the video presentation. Some of the educational content of this program is not available solely through the PowerPoint file. Participants should use all materials to enhance the value of this continuing education program. Patient Care: Oral, Nail, Hair, and Skin Jamie Roney, MSN, BSHCM, RN-BC, CCRN Sepsis Coordinator Covenant Health System Lubbock, Texas Nurse Aide/Nurse Assistant I 41615 Oral Hygiene Purpose of Oral Hygiene Cleanliness of mouth and teeth Prevent mouth odor and infection Prevent dental disease and tooth loss Comfort Pleasant taste Improve taste of food When to Perform Oral Hygiene Upon awakening After each meal Bedtime If not eating, perform oral care at least every 2-4 hours Brush the teeth at least twice a day Be sure and provide moisturizer to inside and outside of the mouth Special Circumstances Unconscious – side-lying to prevent choking and aspiration Mouth breather Oxygen Nasogastric tube/intubated Unable to perform own oral care Standard Precautions with Oral Hygiene Contact with mucous membranes Gums may bleed Pathogens exist in mouth on gums and teeth Use appropriate oral care products Examine Oral Cavity Dry, cracked, swollen, blistered lips Redness, swelling, sores, white patches in mouth or on tongue Redness, swelling, or bleeding of gums Observed damage to dentures Loose, broken, or chipped teeth Patient complaints Dentures Use standard precautions for same reasons as oral hygiene To break suction from dentures, push down gently over upper rim of denture Put towel or washcloth in sink and fill with 2-3 inches of water to protect dentures from breaking Dentures should be stored in denture cup, clearly labeled with name, with cool water covering them Nail Care Done to prevent infection, injury, and odors Easier to clean after soaking in warm, soapy water Cut nails with clippers, not scissors, and prevent tissue damage; only with a doctor’s order Don’t trim diabetic patient’s nails NEVER trim toenails Report any redness or tenderness of fingertips, cuticles, or toes to licensed nurse Hair Care Important for identity and self-esteem Should be in style chosen by patient Medicinal shampoo – verify order and review procedure for application – standard precautions Hair Care Observations – scalp sores and flaking – lice – patches of hair loss – very dry or oily hair – how procedure was tolerated Shaving Important for comfort and self-esteem Never share blades between patients Electric versus safety razors Only trim or clip hair with electric clippers prior to surgery Shaving Safety razors can cause nicks or cuts – apply shaving cream to soften beard – pull skin taut, shave gently, using short and even strokes in direction of hair growth – rinse razor frequently – lather neck and shave upward – use with caution on a patient who is on anticoagulants or has bleeding problems – dispose of in sharps container Shaving Electric razors – check equipment – shave in direction of hair growth for underarms – shave upward from ankle with legs – wash shaved area and dry gently – apply aftershave lotion Maintain Healthy Skin Encourage well-balanced diet and fluids Skin care – bathe, rinse off soap thoroughly – apply lotion as necessary and massage skin – keep skin clean and dry Observe high-risk patients for potential problems Maintain Healthy Skin Pay close attention to bony prominences – turn and position correctly – keep pressure off of red or irritated areas Keep bed free from objects and WRINKLES Prevent friction and shearing Risk Factors for Skin Breakdown Mobility/sensory problems – paraplegic or quadriplegic – CVA (cerebrovascular accident) – peripheral vascular disease – bed rest or decreased mobility – COPD (chronic obstructive pulmonary disease) – decreased sensation Risk Factors for Skin Breakdown Elimination – incontinence – diarrhea – diaphoresis – dehydration – leaking tubes or drainage Risk Factors for Skin Breakdown Fluid status – edema – dehydration Nutritional status/body build – obese or thin – poor appetite – nutritional lab values low – poor fluid balance Risk Factors for Skin Breakdown Predisposing factors – circulatory problems – COPD • low oxygen level • Fowler’s position • medications Risk Factors for Skin Breakdown Predisposing factors – diabetes • arterial disease and neuropathy • poor circulation and healing – medications (prednisone) – cancer, anemia – splints, casts, prosthetic devices – age Conditions Leading to Decubitus Pressure leads to decreased blood flow and nutrition resulting in tissue loss Excessively wet or dry skin Moving patient, causing shearing Patient Care: Oral, Nail, Hair, and Skin If you have any questions about the program you have just watched, you may call us at: (800) 424-4888 or fax (806) 743-2233. Direct your inquiries to Customer Service. Be sure to include the program number, title, and speaker. Nurse Aide/Nurse Assistant I 41615 ® This information is intended for the private use of Health.edu subscribers. Any redistribution of this information without the express written permission of Health.edu is prohibited. 800-424-4888|www.ttuhsc.edu/health.edu Copyright 2014