Unit 7 Bath care
Objectives
1. To clean skin and to eliminate dead skin cells. Otherwise,dead skin cells will lead to infection if impaired skin integrity occurs.
2. It’s essential to prevent body odor, because excessive perspirationinteracts with bacteria to cause odor.
3. Relaxation and improved circulation are benefits of bathingand play a therapeutic role in the care of clients on bedrest.
4. Bathing promotes a feeling of self-worth by improving aperson’s appearance. It meets the patients’ demands of comfort and cleaning.
5. The bath affords the nurse time to spend in communicationand assessment. Skin condition, mobility, self-care deficits, and state ofillness can be detected while bathing the client.
Types of bath
Bathing isaccomplished in a variety of ways, according to the client’s needs, condition,and personal habits. Various types of bath include:
1. Bed bath: the cwww.med126.com/hushi/lient, who is usually totally dependent, is bathed bythe nurse due to physical or mental incapacity. The client is encouraged tocomplete as much of his or her bath as possible.
2. Partial bath: face, axilla(腋窝)，hands, back and genital（生殖的)area are bathed insteadof the whole body.
3. Shower: preferred method of bath if client is ambulatory(能自理的).
4. Tub bath: used by ambulatory clients.
–Contraindication(禁忌症) of tub bath: in the followed cases,the persons can’t have tub bath in order to avoid genital system infection.
• Menstruating（月经期)
• Pregnancy（妊娠) more than 7 months
• Puerperal women（产褥期)
Bed bath
[Preparation]
1. Patient
a. Talk with patient about the plan and have his agreement.Usually, we also ask patient’s habits or requests of bath and meet his demands
b. Assess patient’s situation including skin condition,mobility, self-care deficits,医学全在线 and state of illness.
c. Apply bedpan and wash genital area as needed before thebath.
2. Environment
a. Appropriate room temperature is 24~25℃.
b. Close windows and door. Draw curtains or shelter with ascreen.
1. Equipment
Basin filled with warm water(50~52℃)
Towels
Bath blanket
Clean clothing
Soap
A piece of plastic
[Procedure]
1. Put equipment on suitable place.
2. Help client to the side of bed closest to you. Keep the siderail on the far side of the bed.
3. Fold a towel mitt(露指手套)
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Wrap one edge of towel Wrap towel around hand Tuck far edge of towel under
around palm and fingers and anchor with thumb edge inpalm of hand
4. Basic bathing steps: wash, rinse and dry.
5. Bathing sequence: begin bath at face and work downwardtoward feet.
（1) Bathe client’s face.
a. Wash around client’s eyes, with one corner of towel, wipefrom the inner canthus(眦) to the outer canthus.Using the other corner of towel repeat procedure on other eye.
b. Bathe client’s forehead, cheeks, nose, and area around lips.Use soap with client’s permission.
c. Bathe area behind and around the client’s ears.
（2) Remove client’s upperclothing. Wrap client with bath blanket.
（3) Bathe client’s neck.
（4) Bathe client’s upperbody.
a. Bathe both arms by elevating client’s arm and holdingclient’s wrist. Use gentle strokes from the wrist toward the shoulder,including the axillary area.
b. Bathe client’s chest, especially under breasts. Cover areasyou aren’t bathing with bath blanket.
c. Bathe client’s abdomen and umbilicus(肚脐).
（5) Help client turn to aside-lying position.
（6) Wash client’s hands bysoaking them in the basin. Clean nails and the areas between fingers.
（7) Change towel. Batheclient’s back, moving form the shoulders to the buttocks(臀).
（8) Assist client to dress inclean upper clothing and change back to supine position.
（9) Remove bath blanket underlower body. Take off trousers.
（10) Bathe legs, cleaning groin(腹股沟) carefully.
（11) Place the plastics on the bed between the client’s feet. Putbasin on it and wash feet.
（12) Remove basin and plastics, put on clean trousers.
6. Assist client to comfortable position. Replace equipment.
Principles
1. When the water is dirty, change it timely.
2. The order of two sides while doffing(脱) and donning（穿) the clothing：
a.General patients：the close side sleeve first while doffing; the far side sleevefirst while donning.
b.Wounded patients: the healthy side sleeve first whiledoffing; the wounded side sleeve first while donning.
3. Pay attention to skin folds, such as axilla, under breastsand groin. Clean these areas carefully.
4. Respect client’s privacy.
5. Keep warm. Don’t let the client get a cold during the bath.Notice temperatures of roomand water and don’t forget to cover the patient with bath blanket and quilt.
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