Fall 2020 NU211- 01: Hygiene by Stephanie https://padlet.com/chungst/9meh6n4fry6hjkyl For your assigned topic please report on the Assessment of the body area, an appropriate Nursing diagnosis, Outcomes/Interventions, Goals, and any appropriate Client teaching en-us 2020-09-17 09:27:01 UTC 2025-12-03 15:17:12 UTC hello@padlet.com https://padlet.net/icons/png/1f485.png Assessment https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/754998489 SUBJECTIVE: Ask about...
-skin history
-prescriptions/medications
-allergies
-History of other factors that can cause skin problems.
OBJECTIVE: Inspect/Observe
-color
-texture
-rash/bumps
-skin integrity 
-burns]]> 2020-09-17 13:06:06 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/754998489 Nursing Diagnosis https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/754998939 Delayed surgical recovery  related to injury as manifested by observed unhealed wounds.]]> 2020-09-17 13:06:12 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/754998939 Outcomes/Interventions https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/754999585 Expected Outcomes:
-display healing of wound site.
- be free of infection
- Client can resume RDL activities without assistance.
Interventions:
-evaluate circulation and sensation in wound area.
- review client's medication record
- Note any preexisting conditions that may affect wound healing.]]> 2020-09-17 13:06:21 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/754999585 Goals https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755000913 -Prevent any cracks/ abrasions in the skin
-Be bale to properly perform effective skin care practices ie; moisturize, wash etc.

]]> 2020-09-17 13:06:38 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755000913 Assessment https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755001155 -conditions of teeth, cavities, gingivitis
-conditions affecting the mouth: stomatitis, glossitis, oral lesions/ malignancies
-Oral pain/discomfort 
-Bleeding
-Halitosis

]]> 2020-09-17 13:06:41 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755001155 Teaching https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755001311 -Inform patient of the importance of proper skincare & hydration. 
-Teach patient how to properly clean their skin.
-Inform patient on abnormal signs/symptoms to be aware of
-Be mindful of existing allergies

]]> 2020-09-17 13:06:43 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755001311 Assessment https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755001716 Subjective Data
  • history of health problems/current conditions
  • diseases/therapy affecting hair
  • factors influencing patient's ability to care for hair/scalp
  • use of special products
  • personal/cultural preferences
Objective Data
  • condition/cleanliness/texture/oiliness of hair
  • inspect scalp for dandruff/alopecia/etc
]]> 2020-09-17 13:06:48 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755001716 Nursing Diagnosis leximaurer20 https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755001785 There are no NANDA-I labels specific for hair
> Dressing Self-Care Deficit
> Bathing Self-Care Deficit
Examples:
> Risk for Impaired Skin Integrity related to secretions on the scalp
> Situational Low Self-Esteem related to alopecia secondary to chemotherapy]]> 2020-09-17 13:06:49 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755001785 Diagnosis https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755002263 -determining patients mental status/ inability to care for self
-Impaired oral Mucous Membrane Integrity r/t decrease in salvation
-Risk for infection r/e inefficient oral care]]> 2020-09-17 13:06:56 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755002263 Outcomes/Interventions leximaurer20 https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755002390 > Discuss potential hair loss and regrowth with the patient and family 
>Explore the potential impact on hair loss, interpersonal relationships, and self-image
>Prevent trauma to the scalp 
-have patient use sunscreen 
-lubricate the scalp with vitamin D and vitamin A ointment in order to decrease itchiness
>Use mild conditioner and shampoo 
-avoid excessive heat/combing of the hair 


]]> 2020-09-17 13:06:58 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755002390 Assessment https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755002834 Subjective Data:
- history of health
- current conditions/current nail care
- *ask about diet
Objective data:
- appearance of nails (color, texture, thickness)
- Lab values for electrolytes and vitamin levels  (iron, Magnesium, Vitamin B)
-clubbing 
-portal of entry for infection]]> 2020-09-17 13:07:03 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755002834 Outcomes/Interventions https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755003375 -Patient displays ability to care for own teeth and mouth freely and individually as evidenced by daily routine of brushing and flossing, and using mouthwash and fluoridation properly.
-Patient exhibits clean teeth, healthy gums, and mouth with a pleasant odor upon examination.
-Patient performs daily denture cleaning and care.]]> 2020-09-17 13:07:10 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755003375 Goals https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755004539 -preventing infection
-preventing oral discomfort
-maintain oral mucosa 
-maintenance of lips
-keep teeth free from plaque and debris
-create goals/ plans to maintain dental hygiene

]]> 2020-09-17 13:07:25 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755004539 Teachings https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755005259 -teaching good oral self-care
-denture care
-encouraging adequate nutrition intake
-acknowledgment of abnormal oral symptoms ]]> 2020-09-17 13:07:34 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755005259 Assessment https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755006152 -For example: cold, dusky, or pale feet may indicate impaired circulation or tissue perfusion secondary to peripheral vascular disease
-Subjective data:
  -What is your normal foot care routine?
  - What type of footwear do you usually wear? Observe what the patient is wearing
  -Have you had any foot problems; what treatments have you had for them?
- Do you examine your feet on a regular basis?
  -Do you have diabetes mellitus or peripheral vascular disease?
-Objective data: (compare findings for both feet)
  -Observe for cleanliness and skin integrity. Note open areas, drainage, or redness
  - Inspect welling, inflammation, or infection
  -palpate for edema
  -Check the skin between the toes for cracks or signs of a fungal infection 
  -Notice color and temperature  (provide data about circulation and oxygenation)
  -Check capillary refill
  -Note foot odors 

]]> 2020-09-17 13:07:47 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755006152 Diagnosis https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755006567 - Risk for infection r/t impaired skin integrity AMB observes sores/ abrasions 
- Risk for injury r/t lack of sensation in feet AMB numbness and tingling.
-Risk for infection r/t poor foot hygiene AMB observed cuts and inflammation
- Deficient knowledge r/t foot care and foot hygiene AMB observed poor foot hygiene

]]> 2020-09-17 13:07:52 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755006567 Outcomes/ Interventions https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755007169 -Discuss importance of Foot care/hygiene
-Daily Foot inspections
-Wash, rinse, and dry the feet well.
-Wear cotton or wool socks, which absorb perspiration
-IF diabetic, Avoid soaking the feet or if there is decreased circulation to the feet. 
-Smoking constricts arterioles and decreases circulation to the feet.
- Protect the feet with proper foot wear, shoes that fit, and shoes that don't impair circulation.
Seek medical attention when...
- you experience pain in the foot
-wounds or ulcers on feet
-Numbness or tingling, decrease in sensation, cold skin temperature, corns, ingrown toenails, and for trimming very thick nails—especially if you have diabetes
-Cuts and cracks on feet]]> 2020-09-17 13:08:00 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755007169 Goals https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755007711 - Clean feet!
- Wear shoes that fit properly 
- Inspects feet regularly ]]> 2020-09-17 13:08:07 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755007711 Teaching https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755007933 - Stress the importance of foot care to the client 
- Inform them about the types of risks they could face if they do not perform proper foot care
-  Daily foot inspections
- Hygiene for feet and nails
-Protecting feet ]]> 2020-09-17 13:08:10 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755007933 Diagnosis https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755009158 - there is no nursing diagnosis for specific nail care]]> 2020-09-17 13:08:27 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755009158 Outcome/Interventions https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755009671 - keep nails and hands dry and clean
-  do not bite nails
- limit use of nail polish 
-nurse cannot cut or clip nails*
-refer to podiatrist ]]> 2020-09-17 13:08:34 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755009671 Goals https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755010095 - Maintain proper hand hygiene
- limit risk of infection 
- patient displays an understanding of nail health and nail care]]> 2020-09-17 13:08:39 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755010095 Teaching https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755011159 - Inform patient that maintaining proper nail care is important in avoidance of possible infection 
- Inform patient that diet plays a role in nail health
- Inform patient of risks associated with nail biting (transfer of bacteria from hands to mouth)]]> 2020-09-17 13:08:53 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755011159 Goals https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755032554 Short term: Supervise the patient, while in care, to make sure they are using correct technique, and integrating hair care at least once a day.
Long term: The patient will be able to exhibit proper hair care with no supervision.]]> 2020-09-17 13:13:27 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755032554 Teaching https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755033261
  • How to properly brush hair
    • remove tangles, massage scalp, promote circulation, distribute oil
  • Importance of shampoo in cleaning scalp and hair
  • How to recognize common hair/scalp problems
  • If applicable: proper beard and mustache care

    • ]]>     2020-09-17 13:13:37 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755033261     Expected Outcomes chungst https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755078049 EYES:
    -Cleanliness
    -Proper eyesight maintained
    EARS:
    -Promote Hygiene
    -Prevent Hearing loss
    -Prevent infection
    -Maintain ability to communicate with others
    NOSE: 
    -Clear nasal airways
    -No obstructions blocking airways
    -Free from Infection  and Complications]]>     2020-09-17 13:22:51 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755078049     Interventions chungst https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755079395 EYES:
    -Clean In → Out
    -provide glasses
    EARS:
    -Clean with saline
    -Remove excess wax in ears
    -Wear protective equipment in noisy environments
    NOSE:
    -Have tissues by beside to release secretions + whenever they will be needed
    -Promote hydration to loosen secretions
    -Promote blowing nose to alleviate nose secretions]]>     2020-09-17 13:23:06 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755079395     Nursing diagnosis chungst https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755088478 There are no NANDA-I labels to describe nail problems. However, the following are examples of nursing diagnoses related to nail care:
    - Risk for Impaired Tissue Integrity related to ingrown nails secondary to trimming too close to the cuticle
       Risk for Infection related to loss of skin integrity secondary to hangnails, cracked cuticles, or trauma from using sharp scissors or nail clippers
    ]]>     2020-09-17 13:24:53 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755088478     md64357 https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755131110 2020-09-17 13:33:08 UTC https://padlet.com/chungst/9meh6n4fry6hjkyl/wish/755131110