Bed Bath

Question 1

Bed Bath Definition

Answer 1

It is a bath given to a patient.
It is assisting a bedfast patient to maintain his personal hygiene during the period of bed rest. (Directorate of nursing affairs - general nursing procedures.

Question 2

Purposes

Answer 2

1. Cleanse, refresh, and give comfort to patient who must remain in bed.
2. Stimulate circulation and aid in elimination.
3. Provides an opportunity to inspect the patient’s body for any sign of abnormality.
4. Help the patient have some form of movement and exercises.
5. Provides an opportunity for nurse-patient interaction.

Question 3

Special Consideration 1

Answer 3

1. Avoid unnecessary exposure and chilling
   a. Expose wash, rinse, and dry only a part of tye body one at a time.
   b. Avoid draft.
   c. Use correct temperature of water.

Question 4

Special Consideration 2

Answer 4

2. Observe the patient’s body closely for physical signs such as:
   Rashes, swelling, discoloration, pressure sores, burns, abnormal discharges, body lice, etc.

Question 5

Special Consideration 3

Answer 5

3. Give special attention to the following areas:
   Behind the ears, axillae, under the breast, umbillicus, pubic regions, groins and the spaces between the fingers

Question 6

Special Consideration 4-6

Answer 6

4. Do the bath quickly but unhurriedly, and use even but firm strokes.
5. Use adequate amount of water and change it as often as necessary.
6. If possible do such procedures as vaginal douche, enema, shampoo, oral care, etc.

Question 7

Preparation: Equipment

Answer 7

Assemble at the bedside and arrange according to use the following:
Bath basin (Basin or sink with warm water (43-46° Celsius)
Bed screen if in gener words
Bath towel
Face towels
Soap in soap dish
Linen for changing
Newspaper or a piece of rubber or plastic sheet
Pair of clean gloves
Gowns and pajamas

Question 8

Optional equipment

Answer 8

Deodorant
Talcum powder
Rubbing alcohol or body lotion

Question 9

Preparation: Patient and Unit (1-4)

Answer 9

1. Inform the patient about the procedure.
2. Screen the bed if in general ward.
3. Adjust the temperature and ventilation of the room.
4. Remove unnecessary articles on the bed and clear up the working area.

Question 10

Preparation: Patient and Unit (5-7)

Answer 10

5. Arrange all needed articles within reach. Line a chair or table with a newspaper or a piece of rubber or plastic sheet where the basin will be placed.
6. Lower the back and knee rests depending on the needs and comfort of the patient.
7. Offer the bed pan or urinal as desired.

Question 11

Step 1 + rationale

Answer 11

Loosen the top sheet. (This may be replaced by a bath blanket)

• A loosened top sheet will facilitate draping and change of patient’s position. It also provides warmth and privacy.

Question 12

Step 2 + rationale

Answer 12

Assist the pstient to the side of the bed for convenience and ease in working.

• Working close to the patient prevents overreacting which will cause muscle strain.

Question 13

Step 3 + rationale

Answer 13

Ask the client to grasp & hold the top of the bath blanket while pulling linen to the foot of the bed.

• To maintain privacy.

Question 14

Step 4 + rationale

Answer 14

Fill the bed basin with one-half to two-thirds full of comfortably warm water. Check water temperature, and then have client place fingers in water to test temperature tolerance.

• Warm.water promotes comfort, relaxes muscles, and prevents unnecessary chilling. Testing temperature prevents accidental burns. Bathwater warms lotion for application to client.

Question 15

Step 5 + rationale

Answer 15

Place towel under client’s head. Wet the washcloth or face towel and squeeze out the excess water. Wrap the washcloth or face towel around the palm and fingers to form a “mitten”.

• A bath mitt retains water & heat better than a cloth loosely held & prevents ends of wash cloth from dragging across the skin.
  Squeezing out of the excess water prevents wetting of the bed linen.
  Arranging the wash cloth in this fashion prevents the corners from dragging over the patient.

Question 16

Step 6

Answer 16

With no soap on the washcloth, wipe one eye from the inner csnthus using a clean area or cloth for each eye. Ask if client prefers to use soap on face.

Otherwise, using circular strokes wash, rinse and dry forehead, cheeks, nose, neck, and ears without soap.

Rinse the area 2-3 times then pat it with towel to dry.

Question 17

Step 6 rationale

Answer 17

• Soap irritstes eyes and has a drying effect.
  Use of separste sections of mitt reduces infection transmission.
  Bathing eye gently from inner to outer canthus prevents secretions from entering nasolacrimal duct.
  Pressure can cause internal injury.
  Rinsing 2-3 times removes the soap, which, it left of the skin may cause itching and irritation.

Question 18

Step 7

Answer 18

Spread the towel lengthwise under the farther arm. Soap, rinse and dry, paying particular attention to the axillae. Use long firm strokes from distal to proximal (fingers to axilla). Raise and support arm above heads to wash, rinse, and dry axilla. Apply deodorant or powder if desired or needed.

Question 19

Step 7 rationale

Answer 19

Gentle friction stimulates circulation and muscles and helps remove dirt, oil, and organisms.
Long firm strokes from distal to proximal area promote circulation by increasing across blood return.
Soap lowers the surface tension of water and helps it to unite quickly with the oil and dirt in the skin.
Powder is not recommended for clients with respiratory alteration due to the potential respiratory adverse effect.

Question 20

Step 8

Answer 20

Exercise caution if an IV infusion is present & check its flow after moving the arm. Avoid submersing the IV site if the dressing site is not a clear, transparent dressing. Do the same with the nearer arm. Place the basin on the towel near the edge of the bed and wash tge hands in the basin and wash the hands in the basin, paying particular attention to the nails. Change the water.

Question 21

Step 8 rationale

Answer 21

A clear transparent dressing will keep water from an IV site.
Washing the hands in the water ensures a more thorough cleansing.
Changing the water as often as necessary ensures a goods rinsing and maintains the desired temperature.

Question 22

Step 9

Answer 22

Spread the towel across the patient’s chest and abdomen. Wash, rinse and dry, giving special attention to the area beneath the breast and umbillicus. Powder especially under the breast and neck.

Question 23

Step 9 rationale

Answer 23

Skin-fold areas may be sources of odor and skin breakdown if not cleansed and dried properly.

Question 24

Step 10

Answer 24

Expose the far leg of the patient. Place the towel under the far leg. Using firm strokes, wash, rinse, and dry the patient’s leg from ankle to knee and knee to groin.

Repeat the procedure on the near leg.

Question 25

Step 10 rationale

Answer 25

The towel protects linens and prevents the patient from feeling uncomfortable from a damp or wet bed. Washing from ankle to groin with firm strokes promotes venous return.

Question 26

Step 11

Answer 26

Fold a towel near the patient's feet area and place the basin on it. Place the patient's farther foot in the basin while supporting the patient's ankle and heel in your hands and the leg on your arm. Wash, rinse and dry, paying particular attention to the area between the toes. Do the same on the nearer foot. Change water.

Question 27

Step 11 rationale

Answer 27

Supporting the patient's foot and leg helps reduce strain and discomfort for the water. Is comfortable and relaxing and allows for a thorough cleaning of the feet and the areas between the toes and under the nails. Changing the water as often as necessary ensures a good rinsing and maintains the desired temperature.

Question 28

Step 12 + rationale

Answer 28

Assist the patient to a prone or side-lying position. Position the bath blanket and towel to expose only the back and buttocks. - Positioning of the towel and bath blanket protects the patient's privacy and provides warmth.

Question 29

Step 13

Answer 29

Wash, rinse, and dry the patient's back and buttocks area. Pay particular attention to cleansing between gluteal folds and observe for any indication of redness or skin breakdown in the sacral area.

Question 30

Step 13 rationale

Answer 30

Fecal material near the anus may be a source of microorganisms. Prolonged pressure on the sacral area or other bony prominences may compromise circulation and lead to development or decubitus ulcer.

Question 31

Step 14 + rationale

Answer 31

If not contraindicated, give the patient a backrub. Back massage may be given also after perineal care. - A backrub improves circulation to the tissues and is an aid to relaxation. A backrub may be contraindicated in patients with cardiovascular diseases.

Question 32

Step 15 + rationale

Answer 32

Refill basin with clean water. Discard washcloth and towel. - The washcloth, towel, and water are contaminated after washing the patient's gluteal area. Changing to clean supplies decreases the spread of organisms from the anal area to the genitals.

Question 33

Step 16 + rationale

Answer 33

Clean the patient's perineal area or set up the patients so that he or she can complete perineal self-care. - Providing perineal self-care may decrease embarrassment for the patient. Effective perineal care reduces odor and decreases the chance of infection through contamination.

Question 34

Step 17 + rationale

Answer 34

Help the patient put on a clean gown and attend to personal hygiene needs. - This provides for the patient's warmth and comfort.

Question 35

Step 18

Answer 35

Protect the pillow with a towel, and groom the patient's hair.

Question 36

Step 19 + rationale

Answer 36

Change bed linens. Remove gloves (if gloves were used) and perform hand hygiene. Dispose of bed linens according to agency policy. Return used equipment and leaves the unit in order. - These actions deter the spread of microorganisms.

Question 37

Step 20 + rationale

Answer 37

Record any significant observations and communication on the patient's chart. - A careful record is important for planning and individualizing the patient's care.