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Lesson 25. Skin Care

2-25. SKIN CARE

a. The unconscious patient should be given a complete bath every other day. (This prevents drying of the skin.) The patient's face and perineal area should be bathed daily.

(1) The skin should be lubricated with moisturizing lotion after bathing.

(2) The nails should be kept short, as many patients will scratch themselves.

b. Provide oral hygiene at least twice per shift. Include the tongue, all tooth surfaces, and all soft tissue areas. The unconscious patient is often a mouth breather. This causes saliva to dry and adhere to the mouth and tooth surfaces.

(1) Always have suction apparatus immediately available when giving mouth care to the unconscious patient.

(2) Apply petrolatum to the lips to prevent drying.

c. Keep the nostrils free of crusted secretions. Prevent drying with a light coat of lotion, petrolatum, or water-soluble lubricant.

d. Check the eyes frequently for signs of irritation or infection. Neglect can result in permanent damage to the cornea since the normal blink reflex and tear-washing mechanisms may be absent. Use only cleansing solutions and eye drops ordered by the physician. One such solution, methyl cellulose (referred to as "artificial tears") may be ordered for instillation at frequent intervals to prevent irritation.

e. If the patient is incontinent, the perineal area must be washed and dried thoroughly after each incident.

(1) Change the bed linen if damp or soiled.

(2) Observe the skin for evidence of skin breakdown.

f. Skin care should be provided each time the patient is turned.

(1) Examine the skin for areas of irritation or breakdown.

(2) Apply lotion, prn.

(3) Gently massage the skin to stimulate circulation.

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