EYE CARE

✓generally part of a patient’s bath

✓NSS or a special solution or eye drop may be prescribed by the physician.

✓Wipe with a piece of cotton from inner to outer canthus. EYE CARE FOR COMATOSE PATIENTS

OBJECTIVE: to keep the areas of cornea that are exposed to the air moist, thereby prevent inflammation and ulceration

FREQUENCY: PRN EQUIPMENT EYE CARE FOR COMATOSE PATIENTS PROCEDURE 1. Don gloves. 2. Clean eyelids. 3. Instill ophthalmic ointment or solution. 4. Close eyelids and put a small amount of mineral oil on outer eyelids. 5. If client’s corneal reflex is absent, keep the eyes closed by placing an eye pad soaked in the saline solution over each eye. 6. Document: - time and type of care provided- assessment findings WIPING THE EYE FROM THE INNER TO THE OUTER CANTHUS

❖ Best time for cleaning with cotton pledget: after a bath. ❖ (+) wax plug (impacted cerumen): - lubricate with baby oil -use ear syringe prn -(-) use bobby pins ❖ Visible cerumen can be loosened and removed by retracting the auricle up and back. VISIBLE CERUMEN

EQUIPMENT

tissue paper mineral / cotton seed oil cotton applicator ❖ best way to clean the nose: blow gently with both nostrils open

❖ dried secretions encrusted on the external nares should be cleaned with a cotton-tipped applicator moistened with saline or water.

❖Insert applicator not beyond the length of the cotton tip, because it cause injury to the mucosa.

ORAL HYGIENE INCLUDES

1. Daily stimulation of gums 2. Mechanical scrubbing of teeth 3. Flushing of the mouth PURPOSES:

1. To prevent bacterial infection 2. To prevent formation of sores 3. To promote cleanliness, comfort and health 4. To enable the patient to articulate distinctly thus requiring less effort to make himself understood. Drinking glass tube or straw EQUIPMENT Toothpaste

Asepto syringe or rubber irrigating bulb

Paper bag Toothbrush Cotton tip applicator

tongue depressor

Curved kidney basin Mineral oil

Gloves Towel PROVIDING ORAL HYGIENE FOR AN ABLE PATIENT Place in sitting position

Arrange articles conveniently for use

After care PROVIDING ORAL HYGIENE TO A PATIENT REQUIRING ASSISTANCE 1. Introduce yourself 2. Prepare needed equipment 3. Wash hands 4. Provide privacy 5. Move patient to near side of the bed 6. Place towel under side of head and chin 7. Place basin under side of jaw PROCEDURE

8. Wet brush and apply toothpaste. 9. Offer mouthwash /water to rinse 10.Brush teeth slowly, upper teeth downward and lower teeth upward 11.Give mouthwash thru straw, Irrigate with asepto syringe 12.Wipe mouth with towel 13.Rinse toothbrush under running water 14.Empty basin & cup. Discard disposable articles 15.Wash hands BRUSHING AND FLOSSING TEETH SKILL PROVIDING ORAL HYGIENE TO A COMPLETELY UNABLE PATIENT ▪Introduce yourself ▪Prepare needed equipments ▪Wash hands ▪Provide privacy ▪Prepare the client in a side lying position ▪Place towel under side of head and chin, curved basin under the jaw ▪Dip applicator in mouthwash solution PROCEDURE

▪Open patient mouth ▪Cleanse teeth, tongue & inner surfaces of mouth ▪Use tongue blade to direct position of the tongue ▪After cleansing moisten mouth with swab dipped in plain ▪Wipe mouth with towel ▪Apply lanolin on lips (applicator) ▪After care of equipment ▪Wash hands ORAL CARE FOR THE UNCONSCIOUS CLIENT:

Please see and read this in your book on p. 722 (Kozier… ) CLEANING ARTIFICIAL DENTURES

EQUIPMENT:

DENTURE CONTAINER PROCEDURE

Position the patient Don gloves Remove dentures & place in denture container Take denture container to a sink & place washcloth in the bowl of sink . Scrub gently with cleaning agent & tepid water If stained, soak in a cleaner PROCEDURE

Observe dentures for rough, sharp, or worn areas Inspect mouth Offer mouthwash return dentures & asses the fit of dentures Wipe hands and mouth with towel Remove gloves and discard Document ARTIFICIAL DENTURES SKILL CRITICAL ELEMENTS OF CLEANING ARTIFICIAL DENTURES

Wear gloves Place washcloth in the bowl of sink Use tepid water Avoid soaking dentures with metal parts for lengthy periods Inspect dentures for rough /sharp areas Assess oral mucosa & gums Provide labeled container to store dentures Purposes:

✓Prevents injury ✓Provide comfort MATERIALS:

Nail clippers ( nail cutter) Orange stick

Emery board /nail file Wash basin with water

Bath blanket

Towel

Hand lotion mineral oil Polish remover PROCEDURE

Assess nails Position client Remove nail polish Soak client's hands & feet if nails are thick and dry Towel dry Start with the thumb or large toe, cut or file straight across the nail beyond the end of finger /toe PROCEDURE

Shape the fingernail with file rounding corners Clean under the nail using the point end of orange stick Gently push the cuticle back around the base of the nail Proceed with the next finger or toe Massage hands with lotion Document assessment CRITICAL ELEMENTS OF CLEANING & TRIMMING NAILS

Assess client for impaired circulation to the extremities Determine agency policy regarding nail care with impaired circulation of extremities Soak thick nails before trimming /filing them Trim nails across & shape with a file for patient with impaired circulation