There is a lot of information nowadays about the personal hygiene, and the ways of maintaining it. However not so many experts say about the patients’ hygiene. So let us fill in this gap and take a closer look onto this problem.
In case the patient is allowed to walk then he or she washes oneself every day and takes hygienic bath once a week. Those patients staying in the bed should have their skin wiped. In order to perform this there should be disinfecting solution that includes camphor spirit. It should be heated with the stream of the warm water or by the warm heating unit before the use.
The important clauses of the normal activity of the human skin are its cleanness and safety. The function of the oil and sweat glands is very important to keep the elasticity, softness and flexibility of the skin. However fat and the sweat contribute to skin contamination when accumulated on its surface. Dust and microbes are accumulated on the skin surface along with the fat and sweat. Its contamination causes the itching feeling. And the itching leads to scratching and abrasions i.e. to the break of the skin safety and this in its order contributes various microbes from the skin surface to penetrate deep under it. Thus the skin care is aimed to provision its cleanness and safety.
The skin wipe technique is as follows. One end of the towel is wet with the disinfecting solution, and then it’s being outpressed and applied to wipe the skin on the neck, behind the ears, on the back, on the front surface of the breast and in the underarms. The wrinkles under the mammary glands should be considered more closely as obese women as well as too sweaty patients may get intertrigos here. Then the skin is wiped dry in the same order. The feet should be washed 1-2 times a week. Commonly a wash-basin is used for this and after the washing the nails are cut shortly.
Douching the patients. Douching is provided with the diluted potassium permanganate solution or any other disinfecting solution. The solution should be warm (30-40 degrees C). The following tools are required for the douching: the jug, forceps and sterile cotton balls.
The jug is taken into the left hand and the solution is poured onto the externalia and the cotton ball clutched into the forceps is directed from the externalia to the perineum (top-down direction), after this the skin is wiped with the dry cotton ball in the same direction in order not to bring the infection from anus into the urinary bladder. The douching may also be provided with the help of the Esmarch mug equipped with the vaginal tip. The stream of water is directed onto the perineum and at the same time the skin from externalia to anus is wiped with the cotton ball clutched in forceps.
Oral cavity care
Many microbes accumulate even in the mouth cavity of the healthy person and in case of the organism weakening the microbes may cause certain diseases and worsen the general condition. Thus the importance of the mouth cavity hygiene care in patients is quite clear.
The walking patients should brush their teeth everyday in the morning and in the evening and rinse the mouth with slightly salty water (1/4 spoon of the salt per the glass of the water) or diluted potassium permanganate solution. It is advised to use soft toothbrushes that do not injure the gums’ mucous coat. Toothbrushes should be washed with the clear water carefully.
Those seriously ill are unable to clean teeth on their own thus the nurse has to cleanse the patient mouth after each food intake. To perform this the nurse will have to take the cotton ball with the tweezers, wet it in the 5% boric acid solution or 2% sodium bicarbonate solution or dilutes potassium permanganate solution and then wipe first cheek teeth surfaces and then every tooth separately. After this the patient rinses the mouth. In case the tongue is covered with the thick deposit then it should be removed with the 2% solution of the soda and glycerin in fifty-fifty correlation. In case of lips parching and cracks on them the lips should be smeared with the glycerin or borated petrolate.
Seriously ill patients often get the inflammations on the mouth cavity mucous called – stomatitis. They cause painful feelings within the food intake, salivation, slight temperature rise. Medical treatment of stomatitis implies the use of applications and the mucous reflux with the soda solution.
The dentures should be taken off for the night, carefully cleansed with the toothbrush and toothpaste and then kept in the glass of the boiled water until the morning.
The care for the eyes of the seriously ill patients requires more attention as they get puss accumulated in the canthus every morning that may even turn into scab. Such patients should have their eyes washed everyday with the help of pipette or sterile gauze tampon. Wet the tampon with the 3% boric acid and then carefully lead it from the external eye canthus to the inner one (towards the nose).
Ears and the nose cavity care
In case the patient is unable to wash ears independently then the junior nurse is to wipe the external part of the ear with the gauze wet with the soapy water.
Commonly lots of slime and dust accumulates on the nose mucous thus complicating breathing and the patients’ condition. The slime is easily removed with the syringing of the nose cavity by the warm water. It is also possible to roll the gauze into tubule then wet it with the liquid paraffin and remover the scabs from the nose with the rotation movements.
The patients staying in the bed for a long time need in the constant hair care. It is required to look after the hair for there no dandruff or insects appeared. The males’ hairs are short cut and washed once a week during the hygienic bath. Those patients who are not allowed to take bath may have their hair washed while staying in the bed in case their condition permits to do so. But it is more complicated to look after the female hair cleanness especially in those women having long hair.
The hairs are to be combed everyday in order to remove dust and dandruff. To perform this you will need a tooth-comb (every patient has to have her own comb as it is strictly forbidden to use another’s one). Short hairs are being combed from roots to the ends and the long ones are divided into parallel locks and are slowly combed from ends to the roots trying not to pull them out. The combs are to be kept clean and periodically wiped with the spirit, vinegar and washed in the hot water with the soda or liquid ammonia. Various shampoos or baby soap should be applied for washing the head.
In case the patient’s condition permits so then the head is washed while the hygienic bath, but it is also possible to wash the head while staying in the bed by placing the wash-basin at the head end of the bed onto a height and by throwing back the patients head. While soaping it is required to rub the skin under the hair thoroughly after this the hairs are being swilled, wiped dry and then combed. After washing the head the woman should put on kerchief.
And finally after washing the nurse cuts or helps to cut the nails on the hands and feet of the patient.