Oral Care & Hair Shampoo

Hygiene Measures:
Oral Care & Hair Shampoo
Prepared by:
Aleli R. Cheng, RN,MAN

Oral Care
Mouth
Loss of teeth occurs mainly because of periodontal
disease (gum disease) rather than dental caries
(cavities)
Equipment
• Brushing and Flossing
• Towel
• Clean gloves
• Curved basin (emesis basin)
• Toothbrush (soft bristle)
• Cup of tepid water
Toothpaste
• Mouthwash
• Dental floss, at least two pieces 20 cm (8 in.) in length
IMPLEMENTATION
Preparation
•Assemble all the necessary equipment
•Performance
• Prior to performing the procedure, introduce self and verify the
client’s identity. Explain to the client what you are going to do, why
it is necessary, and how he or she can participate.
• Perform hand hygiene and observe and wear clean gloves).
Rationale: Wearing gloves while providing mouth care prevents the
nurse from acquiring infections. Gloves also prevent transmission
of microorganisms to the client.
• Provide for client privacy by drawing the curtains around the bed or
closing the door to the room. Some agencies provide signs
indicating the need for privacy. Rationale: Hygiene is a personal
matter.
Prepare the client.
•Assist the client to a sitting position in bed, if health permits. If not, assist the
client to a side-lying position with the head turned. Rationale: This position
prevents liquid from draining down the client’s throat.
Prepare the equipment.
• Place the towel under the client’s chin.
• Apply clean gloves.
• Moisten the bristles of the toothbrush with tepid
• water and apply the toothpaste to the toothbrush.
• Use a soft toothbrush (a small one for a child.
• For the client who must remain in bed, place or hold the curved basin
under the client’s chin, fitting the small curve around the chin or neck.
• Inspect the mouth and teeth.
• Brush the teeth.
• Hand the toothbrush to the client, or brush the client’s teeth as
follows:
a. Hold the brush against the teeth with the bristles at a 45-degree
angle. The tips of the outer bristles should rest against and penetrate
under the gingival sulcus. The brush will clean under the sulcus of two
or three teeth at one time. Rationale: This sulcular technique removes
plaque and cleans under the gingival margins.
b. Move the bristles up and down gently in short strokes from the
sulcus to the crowns of the teeth.
c. Repeat until all outer and inner surfaces of the
teeth and sulci of the gums are cleaned.
• Clean the biting surfaces by moving the brush back and forth over them
in short strokes.
• Brush the tongue gently with the toothbrush.
Rationale: Brushing removes bacteria and freshens breath. A coated
tongue may be caused by poor oral hygiene and low fluid intake. Brushing
gently and carefully helps prevent gagging or vomiting.
• Hand the client the water cup or mouthwash to rinse the mouth
vigorously. Then ask the client to spit the water and excess dentifrice into
the basin. Some agencies supply a standard mouthwash. Alternatively, a
mouth rinse of normal saline can be an effective cleaner and moisturizer.
Rationale: Vigorous rinsing loosens food particles and washes out already
loosened particles.
• Repeat the preceding steps until the mouth is free of dentifrice and food
particles.
• Remove the curved basin and help the client wipe the mouth.
CLIENTS WITH SPECIAL ORAL HYGIENE NEEDS
 For the client who is debilitated or unconscious or who has
excessive dryness, sores, or irritations of the mouth, it may be
necessary to clean the oral mucosa and tongue in addition to
the teeth.
Mouth care for unconscious or debilitated people is important
because their mouths tend to become dry and consequently
predisposed to tooth decay and infections.
Xerostomia - Dry mouth; This condition can be caused by side
effects of certain medications (e.g., antihistamines,
antidepressants, antihypertensives).
Equipment
• Towel
• Curved basin (emesis basin)
• Clean gloves
Bite-block to hold the mouth open and teeth apart (optional)
• Toothbrush
Cup of tepid water
Mouthwash
Rubber-tipped bulb syringe
Suction catheter with suction apparatus when aspiration is a
concern
Foam swabs and cleaning solution for cleaning the mucous
membranes
Performance
•Prior to performing the procedure,introduce self and verify the
client’s identity Explain to the client and the family what you are
going to do and why it is necessary.
•Perform hand hygiene and wear clean gloves.
•Provide for client privacy by drawing the curtains around the bed
or closing the door to the room. Some agencies provide signs
indicating the need for privacy. Rationale: Hygiene is a personal
matter.
• Prepare the client.
• Position the unconscious client in a side-lying
position, with the head of the bed lowered. Rationale: In this
position, the saliva automatically runs out by gravity rather
than being aspirated into the lungs. This position is chosen for
the unconscious client receiving mouth care.
If the client’s head cannot be lowered, turn it to one side.
Rationale: The fluid will readily run out of the mouth or pool in
the side of the mouth, where it can be suctioned.
Place the towel and the kidney basin under the client’s chin and
lower cheek to receive the fluid from the mouth.
Hair Shampoo
Hair Problems:
1. Dandruff. Often accompanied by itching, it appears as a
diffuse scaling of the scalp.
2. HairLoss. -Some permanent thinning of hair normally occurs
with aging. Baldness, common in men, is thought to be a
hereditary problem for which there is no known remedy.
3. Ticks. Small gray brown parasites that bite into tissue and suck
blood, ticks transmit several diseases to people, in particular
Rocky Mountain spotted fever, Lyme disease, and tularemia.
4. Pediculosis (Lice). Lice are parasitic insects that infest
mammals. Infestation with lice is called pediculosis.
Pediculus capitis is found on the scalp and tends to stay hidden
in the hairs;
Pediculus pubis stays in pubic hair.
Pediculus corporis tends to cling to clothing, so that when a
client undresses, the lice may not be in evidence on the body;
these lice suck blood from the person and lay their eggs on the
clothing.
5. Scabies. is a contagious skin infestation by the itch mite. The
characteristic lesion is the burrow produced by the female mite
as it penetrates into the upper layers of the skin. Burrows are
short, wavy, brown or black, threadlike lesions most commonly
observed between the fingers, creases of the wrists and elbows,
beneath breast tissue and in the groin area .
6. Hirsutism. The growth of excessive body hair
Equipment
•Comb and brush
•Kelly pad
•Two bath towels
•Shampoo
•Washcloth or pad
•2 Pails (1 with water)
Implementation
1.Check for doctor’s order.
2.Determine the best time of day for the shampoo. Discuss this with the
client. A person who must remain in bed may find the shampoo tiring.
Choose a time when the client is rested and can rest after the procedure.
Performance
1.Prior to performing the procedure, introduce self and verify the client’s
identity. Explain to the client what you are going to do, why it is
necessary, if appropriate, and how he or she can participate.
2.Perform hand hygiene and wear clean gloves.
3.Provide for client privacy by drawing the curtains around the bed or
closing the door to the room.
4. Position and prepare the client appropriately.
•Assist the client to the side of the bed from which you will work.
•Remove pins and ribbons from the hair, and brush and comb it to
remove any tangles.
5. Arrange the equipment.
• Put the plastic sheet or pad on the bed under the
head. Rationale: The plastic keeps the bedding dry.
• Remove the pillow from under the client’s head, and
place it under the shoulders unless there is some underlying
condition (e.g., neck surgery, arthritis of the neck). Rationale:
This hyperextends the neck.
• Tuck a bath towel around the client’s shoulders. Rationale:
This keeps the shoulders dry.
• Place the shampoo basin under the head 􏰁, putting a folded
washcloth or pad where the client’s neck rests on the edge of
the basin. Rationale: Padding supports the muscles of the neck
and prevents undue strain and discomfort.
6. Protect the client’s eyes.
•Place a damp washcloth over the client’s eyes.
Rationale: The washcloth protects the eyes from soapy water. A
damp washcloth will not slip.
7. Shampoo the hair.
• Wet the hair thoroughly with the water.
• Apply shampoo to the scalp. Make a good lather with
• the shampoo while massaging the scalp with the pads of your
fingertips. Massage all areas of the scalp systematically, for example,
starting at the front and working toward the back of the head.
Rationale: Massaging stimulates the blood circulation in the scalp. The
pads of the fingers are used so that the fingernails will not scratch the
scalp.
• Rinse the hair briefly, and apply shampoo again.
• Make a good lather and massage the scalp as before.
• Rinse the hair thoroughly this time to remove all shampoo.
Rationale:Shampoo remaining in the hair may dry and irritate
the hair and scalp.
• Squeeze as much water as possible out of the hair with your
hands.
8. Dry the hair thoroughly.
• Rub the client’s hair with a heavy towel.
9. Ensure client comfort.
• Assist the person confined to bed to a comfortable
position.
• Arrange the hair using a clean brush and comb. 10. Document any
assessments.
END 

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Hygiene Measures:

Oral Care & Hair Shampoo

Aleli R. Cheng, RN,MAN

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