Promoting Personal Hygiene &

Promoting Rest & Sleep

 Definition of Hygiene
• Hygiene means those practices that promote
health through personal cleanliness , such as
performing bathing , oral care , cleaning and
maintaining fingernails and toenails clean ,
hair shampoo , grooming hair also personal
hygiene can be through cleaning hearing aids ,
eye glasses and eye contact in order to ensure
proper functioning , Hygiene practices
different according to the age , skin , culture..
What is the integumentary system
• Means the covering cover the surface of the
body and its opening include skin , mucous
membrane , hair , nails and teeth

• The mouth or oral cavity which is lied with

mucous membrane contain teeth , will be
coved in the personal hygiene
 Skin
• Consists of the epidermis , dermis and
subcutaneous layers
• Epidermis or outmost layer contains dead skin
cells that form a tough protein called :
KERATIN
• Keratin protects the layers and structure
within the lower portions of the skin
• Epidermis are shed continually and replace by
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• Dermis : or true skin which contains most of
the secretory glands : table 17-1 page 354
• Subcutaneous layer: separates the skin from
skeletal muscles contains fat cells , blood
vessels , nerves and the roots of hair follicles
and glands
• Skin structures carry out the following
functions : POINTS page 354
 Mucous Membranes
• -Mucous Membrane : Continuous with the skin
and line body passage such as the digestive
system , urinary , and reproductive systems , also
mucous membrane lines the conjunctiva of the
eyes. Goblet cells secrete mucus keep membrane
soft and moist
• -Hair : made by Keratin ( Protein) , normal
distribution of the hair all over the body except
the sole and hands and depend on male and
female , infant , adult , and ethic group
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• Sebaceous gland in the hair follicles release
sebum an oily secretion that adds weight an
oily hair attract dust and debris
• -Nails : Fingernails and toenails also made of
Keratin which gives them tough texture give
some protection to the digitals , normal nail
are thin , pink and smooth
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• -Teeth : the enamel of which is a keratin
structure are present beneath the gums at
birth
• Exposed portion of the each tooth is referred
as crown the portion within the gum is the
root
• The teeth begins around 6 months of age
continue for 2 or 2.5 more years.
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• Adults have 28 to 32 permanent teeth
depending whether molar wisdom is present
• Healthy teeth are firmly fixed with the gum
• Teeth color are white changes may due to
coffee or tea , separate or drugs
• Integrity of the teeth depend on personal
hygiene , general health , saliva
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• Plaque : is substance composed of mucin and
other gritty substance in saliva support the
growth of tooth bacteria
• Caries (cavities) is the combination of sugar
and bacteria
• Tartar : hardened plaque is more difficult to
remove lead to GINIVITIS inflammation of the
gums
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• Periodontal Disease: a condition that results in

the destruction of the tooth-supporting
structures and bones that make up the jaw.
 Hygiene Practices
• The integument contains many secretory
glands that produce odors and attract debris
and the teeth prone to decay if not cleaning
well
• Therefore hygiene are beneficial to maintain
cleanliness and healthy teeth
• Hygiene practice : perform bathing , shaving ,
brushing teeth , shampoo and nail caring
 Hygiene Practices : Through
• Bathing , in which the person uses cleansing
agent such as soap and water bathing ha s
several benefits are :
• Eliminating body odor
• Reducing the potential for infection
• Stimulating circulation
• Providing a refreshed and relaxed feeling
• Improving self-image
 Types of Bathing
• tub bath or shower
• Partial bath : means washing only those body
area subject to greatest soiling or that sources
of body odor such as face , hands , axillae ,
genital area , can be done in the sink or with
the basin at the beside of the patient
• When providing perineal care , nurses must:
• (points page 368)
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• Bed bath : client who cannot take a tub bath

or shower independently may be given any
one of three types of baths : bed bath , towel
bath or bag bath
• Bed bath skills 17-3 page 376
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• Towel bath : the nurse uses a single large
towel to cover and wash a client , towel or
bath sheet no basin or soap
• The towel itself is moisten with heated water
beginning fro the feet and moving upward of
the client with fold towel sheet , then the back
and buttocks
• When towel bath is completed the nurse
changes the bed linens
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• Bag bath : commercially use the package
“Disposable” cloths in a plastic bag container
• Photo 17-6
• The cloths contain no-rinse surfactant which is
a substance that reduces surface tension
between the skin and surface contamination
• Emollient moisture the skin but no soap
 Uses of Bah Bag
• The nurse warms the container in a
microwave
• Then in a contain of warm water before the
use
• At the beside the nurse uses separate cloths
to wash each part of the client’s body
• Rinsing is not required air-drying need for a
towel
 Shaving
• Is the remove of unwanted body hair
• Nurse respect cultural differences
• Shaving uses electrical machine or razor
• Points contraindication to use safety razor
page 360
• When the client cannot shave the nurse do
• Guidelines page 361 recommended to study
• Page 361
 Oral Hygiene

Oral Hygiene practices used to clean the

mouth , especially brushing and flossing the
teeth, dentures and bridges require special
cleaning and care
 Oral Hygiene
• 1- Tooth brushing & Flossing : client how can
attend their oral hygiene by brushing to
his/her bed the necessary equipment
• A- toothbrush B- Toothpaste
• C – glass of water D- emesis basin and floss
• Discussion page 362
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• 2- Oral care for Unconscious Clients :
unconscious needs more oral care than
conscious
• Sordes : is a dried crusts containing mucus ,
microorganisms and epithelial cells shed from
the mucous membrane
• Aspirating the fluid the nurse avoid or make
sure that suction is ready: skills 17-4 pg 380
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• 3- Denture Care : artificial teeth

• See figure 17-7 page 363 to remove denture
• Explain denture cleaning
 Hair Care
• Sometimes clients need assistance with
grooming or shampoo their hair
• Hair Grooming ( points page 364)
• Shampooing : hair shampoo skills : 17-5 page
382
 Nail care
• Involve fingernails and toenails clean and
trimmed
• If the patient diabetic or has nail problem
better to consult podiatric a person with
special training for nail caring
• No contraindication the nurse cares for the
patient as follow page 364
• Visual & Hearing devices : students
presentation 365-368
Nursing Diagnosis related to Personal
Hygiene

• Self-care deficit , bathing/hygiene

• Self-care deficit dressing / Grooming
• Activity intolerance
• Risk for impaired skin integrity
Promoting Comfort , Rest & Sleep
• Definition of Comfort : is a state of reduce
physical activity for the purpose of
refreshment
• Definition of Sleep : is a state of rest in which
the person has an alternation of
consciousness
How we can promote comfort , rest &
sleep
• 1-The client environment : his/her room ,
room color , floor , lighting , ventilation , room
furnishing , privacy , chairs over bed table…
• 2-Sleep & Rest : Functions of SLEEP
• Reducing fatigue
• Stabilizing mood
• Improving blood flow to the brain
• Increasing protein synthesis
• Maintaining the disease-fighting mechanisms
of the immune system
• Promoting cellular growth and repair
• Improving the capacity for learning and
memory storage
• CIRCADIAN RHYTHMS : are Biological clocks ,
complete a full cycle every 24 hours
 Sleep Phases

• Researches reveals that there are 2 major

stages of sleep
• 1-Non-Rapid Eye Movement (NREM)
• 2-Rapid Eye Movement (REM)
• (Discuss the photocopy)
 Sleep Cycle
• Normally during sleep cycles a person passes
through 4 stages of sleep NREM , then there is
reversed from stage VI to stage III to stage to
stage II and instead of reentering stage I and
awaken the person enters into REM stage of sleep
then reenter to stage II , IV.. Awaken occurs
• Sleep Requirement : Requires 8 hrs of sleep to an
adult , Infant requires 14-20 and growing children
10-14 hrs of sleep
 Factors affecting Sleep
• Nurses should be aware of the factors in order
to reduce or eliminate the cause :
• Light *Activity
• Environment *Motivation
• Emotions & Moods
• Food & Beverage
• Illness & Drugs
 Common Sleep Disorder
• 1-Insomnia : Characterized by difficulty of
sleep , intermittent sleep , insomnia is the
more common sleep disorder most people
how suffers from insomnia are
• Older people
• History of depression
• Change from normal environment
• Stress
 Signs & Symptoms of Insomnia
• Feeling tired
• Lethargic
• Irritable
• Difficulty to concentrate
• Treatment : Not necessary but if the insomnia
more than 3 to 4 weeks it is important to treat
the cause
• 2-Hypersomnia : is a condition characterized by
excessive sleep particularly during the day , work
, while eating during conversation
• Causes are :
• Apnea *Certain drugs
• Drug abuse or alcohol
• Head trauma * Depression
• Some disease such as Multiple sclerosis epilepsy
• 3-Narcolepsy : is a condition characterized by
uncontrolled desire to sleep , fall asleep
during standing , driving a car , conversation ,
while swimming
• Narcolepsy start with adolescence and
adulthood and continue through the life
• 4-Sleep apnea : absence of sleep during sleep
for 10 to 20 second more may lead to brain
damage , sometimes may be due to
obstruction of tonsils or adenoid or sinus
• 5-Restless Leg Syndrome : Unpleasant
creeping in the calf or ankle or thigh
• Treatment : Eliminate caffeine , analgesic
drugs , apply hot water
• 6-Parasomina : is another type of disorder the
person may experience waking during the
night or grinding the teeth or taking or
nocturnal enuresis
• Nursing Implication for the sleep disorders :
• When the nurse is aware here we can apply
relaxation through different kinds of bed-
making and back rub or massage (In the Lab)