Bathing questions

•You are assigned to dress a rehab patient that doesn’t like to assist you in dressing them. To try and get their assistance, you should:
Explain to them that showing they can help will play a part in them being able to go home

Rationale: Rehab patients aren’t discharged home until the doctor feels the patient can perform all of the activities of daily living by themselves, or with very minimal help. Getting dressed is a basic activity that the patient must be independent in doing before being discharged.

•You should not do which of the following when bathing a patient:
Leave the patient to answer a call light

Rationale: Patients who need help bathing often feel embarrassed or ashamed and privacy should be respected. Communicate with the patient and tell them what you will be washing next. Never leave the patient alone in the middle of bathing. Instead, have someone else answer your call lights while you are bathing your patient.

•Mouth care should be performed on a patient:
Several times a day

Rationale: Mouth care should be done on patients every morning, afternoon and evening. This is often overlooked, but is one of the most important parts of patient care. Mouth care includes brushing the teeth, wiping the mouth, using mouthwash and possibly even flossing.

•You are dressing a patient with right arm weakness. Which side do you start dressing first?
The right side

Rationale: Because the patient’s right arm is weak and they won’t be able to assist as much with that side, start with that side first because it will be easier to maneuver. They will be able to assist you in putting their left arm through a sleeve hole much easier. This will be the most comfortable for the patient, too.

•Patients should be bathed:
Everyday

Rationale: Patients should be bathed everyday. This includes either a shower or bed bath. Clean skin prevents infection and skin breakdown and promotes confidence in patients. Patients usually have an assigned shower schedule which may only allow for 2-3 showers a week. Nursing assistants can be found negligent and lose their license if they do not bath patients daily.

•A patient’s hair should be brushed:
After getting them ready for the day

Rationale: A patient’s hair should be brushed every morning after they are dressed for the day, or after a shower. Keeping a patient well-groomed can help them be confident and socialize with other patients. If it is not a shower day, wet the hair and comb it to prevent pulling it.

•Peri-care should be provided:
During bathing and after each episode of incontinence

Rationale: Peri-care prevents patients from getting urinary tract infections and yeast infections. It should be performed each time a patient is bathed and after each episode of bowel and/or bladder incontinence. Nursing assistants can use a washing cloth with gentle soap and warm water, or with a special wipe made specifically for peri-care.

•The following should be done after a patient is bathed:
Put lotion on the patient to prevent any dryness or skin breakdown

Rationale: Unless there is a restriction, lotion should always be put on a patient after bathing to prevent skin breakdown. Never send the patient to an activity in a robe or gown unless it is their wish to go that way, and never leave them alone in the bathroom unless they are an independent patient.

•The best way to get a patient to participate in getting dressed is:
Let them make decisions about what to wear

Rationale: Patient’s will cooperate best and be more helpful in getting dressed if they can make decisions about what to wear and how to put on the clothes. Threatening them or doing the work for them does not foster independence.

•The following is NOT appropriate when bathing a patient:
Using the same washcloth throughout the bath

Rationale: Several washcloths should be used during bathing to prevent the spreading of bacteria to openings in the body such as the mouth, or genital area. Using a bath blanket to provide privacy is a must, covering all areas of the body that aren’t currently being washed. When bathing, start with the face first, working your way down, leaving the peri-area for last.