CHAPTER 31 / Hygiene 735

Providing Culturally Competent Care CARE

The following terms may be used by some African American the scalp is still very important. Products are made espe- clients to describe hair condition and : cially for those with extensions that can be used to moistur- ■ Nappy/kinky. This means that the hair is very difficult to ize the hair and scalp.The hair can be shampooed when comb and is very curly, maybe even tangled at the root.The fixed in this style. Some place a stocking cap over the hair. hair “draws”up and appears shorter than it really is because of Others just shampoo the hair gently, use a towel to press ex- this extreme curliness. It may have a rough,“steel wool”ap- cess water from the hair, and keep it covered until the hair pearance. and scalp are completely dry. If the synthetic exten- ■ Pressed. The hair is straightened using a hot comb. However, sions need to be removed for some reason, care must be if it gets wet, for example, from sweating, high humidity, taken not to cut the client’s real hair. shampoo, or “getting caught in the rain,”it reverts back to be- ■ . Made popular by the Rastafarian religion, which ing kinky. reportedly originated in Jamaica. Not everyone who wears ■ Permanent. This is a chemical means of straightening the dreadlocks is a Rastafarian. Dreadlocks are worn by men, hair.The hair will remain straight for 4 to 6 weeks, even if it women, and children of all ages.The hair is not combed or gets wet.This is the major advantage of the permanent over picked—ever. Most people keep their locks extremely clean. using the hot comb. The locks attract lint. Use tweezers to remove lint that’s on ■ Grease. A client may request some “grease.”They are not ask- top of the hair.With long dreadlocks, removing lint from in- ing for vegetable shortening.This is a request to apply either side the lock can destroy it.The lint acts as a bonding ce- lotion to the skin or hair oil to the scalp. ment that holds the lock together. Since the hair is sham- ■ /extensions. Synthetic hair is braided into the person’s pooed often, this lint is clean. Gently shampoo the hair, real hair.The length is variable, usually shoulder length or taking care not to destroy the locks. Some individuals use a longer. If the braids are left hanging, the ends are burned with stocking cap, others just gently shampoo the hair. a small lighter to keep them from unraveling and a small rub- Dreadlocks take a long time to dry when wet. Protect the ber band applied.The braids should be left intact, but care of client from drafts until the hair is dry.

Note: From “The ABC’s of Black Hair and Skin Care,” by F. Jackson, 1998, The ABNF Journal, 9(5), p. 101. Reprinted with permission. braided for shampooing and washing. If, however, unbraid- coming too dry. Not all African American individuals have ing becomes necessary, the nurse should obtain the client’s curly or kinky hair. Some have naturally straight hair. permission to do so. Some African American clients need to Keeping the scalp and hair clean and oiled remains important oil their hair daily because it tends to be dry. Oil also pre- and necessary. Procedure 31–6 describes how to provide hair vents the hair strands from breaking and the scalp from be- care for clients.

Procedure 31–6 Providing Hair Care for Clients Purposes ■ To stimulate the blood circulation to the scalp ■ To assess or monitor hair or scalp problems (e.g., matted hair or ■ To distribute hair oils and provide a healthy sheen dandruff) ■ To increase the client’s sense of well-being

ASSESSMENT Determine ■ History of the following conditions or therapies: recent Assess chemotherapy, hypothyroidism, radiation of the head, unex- ■ Condition of the hair and scalp. Is the hair straight, curly, kinky? plained , and growth of excessive Is the hair matted or tangled? Is the scalp dry? ■ Usual hair care practices and routinely used hair care products ■ Evenness of hair growth over the scalp, in particular, any patchy (e.g., hair spray, shampoo, conditioners, hair oil preparation, hair loss of hair; hair texture, oiliness, thickness, or thinness; presence dye, curling or straightening preparations) of lesions, infections, or infestations on the scalp; presence of ■ Whether wetting the hair will make it difficult to comb. Kinky hirsutism hair is easier to comb when wet, however, it is very difficult to ■ Self-care abilities (e.g., any problems managing hair care). comb when it dries (Jackson, 1998, p. 102).

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