Chapter 20

Grooming

LEARNING OUTCOMES:

· Define the key terms and key abbreviations listed in this chapter

· Explain why grooming is important

· Identify the factors that affect hair care

· Explain how to care for matted and tangled hair

· Describe how to shampoo hair

· Describe the measures practiced when shaving a person

· Explain why nail and foot care is important

· Describe the rules for changing clothing and gowns

· Perform the procedures described in this chapter

Ø Grooming measures:

• Are important to many people

• Prevent infection and promote comfort

• Affect love, belonging, and self-esteem needs

Ø People differ in their grooming measures.

Ø The person should tend to his or her own grooming measures to the extent possible.

Ø The person may use adaptive devices for hair care and dressing.

˜ HAIR CARE

Ø How the hair looks and feels affects mental well-being.

Ø You assist with hair care whenever needed.

Ø The nursing process reflects:

• The person’s culture

• Personal choice

• Skin and scalp condition

• Health history

• Self-care ability

Ø Skin and scalp conditions

• Alopecia means hair loss.

† Male pattern baldness occurs with aging.

† Hair thins in some women with aging.

† Other causes include cancer treatments, skin diseases, stress, poor nutrition, pregnancy, some drugs, and hormone changes.

• Hirsutism is excessive body hair.

† It occurs in women and children from heredity and abnormal amounts of male hormones.

• Dandruff is the excessive amount of dry, white flakes from the scalp.

• Pediculosis (lice) is infestation with wingless insects.

† Pediculosis capitis is the infestation of the scalp with lice.

† Pediculosis pubis is the infestation of the pubic hair with lice.

† Pediculosis corporis is the infestation of the body with lice.

† Report signs and symptoms of lice to the nurse at once:

– Complaints of a tickling feeling or something moving in the hair

– Itching

– Irritability

– Sores on the head or body caused by scratching

– Rash

• Scabies is a skin disorder caused by a female mite.

† The female mite burrows into the skin and lays eggs.

† The person has a rash and intense itching.

† Scabies is highly contagious.

† Persons at risk include those living in crowded living settings and those with weakened immune systems.

Ø Brushing and combing hair

• Encourage patients and residents to do their own hair care.

† Assist as needed.

• Perform hair care for those who cannot do so.

• The person chooses how to brush, comb, and style hair.

• Brushing and combing prevent tangled and matted hair.

• When brushing and combing hair, start at the scalp. Then brush or comb to the hair ends.

• Do not braid hair without the person’s consent.

• Never cut hair for any reason.

• Special measures are needed for curly, coarse, and dry hair.

• The person’s hair care practices and hair care products are part of the care plan.

Ø Shampooing

• Many factors affect frequency, including:

† The condition of the hair and scalp

† Hairstyle

† Personal choice

• Do not shampoo a person’s hair unless the nurse tells you to do so.

• The nurse tells you what method to use.

• The shampoo method depends on:

† The person’s condition

† Safety factors

† Personal choice

• Shampoo methods include:

† Shampoo during the shower or tub bath

† Shampoo at the sink

† Shampoo on a stretcher

† Shampoo in bed

• Hair is dried and styled as quickly as possible after the shampoo.

• Check with the nurse before curling or rolling up hair.

˜ SHAVING

Ø Many men shave for comfort and mental well-being.

Ø Many women:

• Shave their legs and underarms

• Shave coarse facial hair

• Use other hair removal methods

Ø Safety razors or electric shavers are used.

• Follow agency policy for cleaning electric shavers.

Ø Safety razors are not used on persons:

• Who have healing problems

• Who take anticoagulant drugs

Ø Soften the beard before using an electric shaver or safety razor.

Ø Mustaches and beards need daily care.

• Ask the person how to groom his mustache or beard.

• Never trim a mustache or beard without the person’s consent.

˜ NAIL AND FOOT CARE

Ø Nail and foot care prevents infection, injury, and odors.

Ø Hangnails, ingrown nails, and nails torn away from the skin cause skin breaks.

Ø Long or broken nails can scratch skin or snag clothing.

Ø Dirty feet, socks, or stockings harbor microbes and cause odors.

Ø Injuries occur from:

• Stubbing toes

• Stepping on sharp objects

• Being stepped on

• Shoes that fit poorly

Ø Poor circulation prolongs healing.

• Infections or foot injuries are very serious for older persons and persons with circulatory disorders.

Ø Trimming and clipping toenails can easily result in injuries.

• Use nail clippers to cut fingernails.

† Never use scissors.

• Some agencies do not let nursing assistants cut or trim toenails.

† Follow agency policy.

˜ CHANGING CLOTHING AND HOSPITAL GOWNS

Ø You may need to assist with changing clothes and hospital gowns.

• Follow these rules:

† Provide for privacy.

† Encourage the person to do as much as possible.

† Let the person choose what to wear.

† Remove clothing from the strong (unaffected) or “good” side first.

† Put clothing on the weak (affected) side first.

† Support the arm or leg when removing or putting on a garment.

Ø Changing hospital gowns

• Gowns are usually worn for IV therapy.

† Some agencies have gowns for IV therapy that open along the sleeve and close with ties, snaps, or Velcro.

† Sometimes standard gowns are used.

• If there is injury or paralysis:

† The gown is removed from the strong arm first.

† Support the weak arm while removing the gown.

† Put the clean gown on the weak arm first and then on the strong arm.