Topic: “Personal hygiene of the patient. Skin care

Caring for the skin and mucous membranes is one of the main points of caring for newborns.

Having unswaddled and carefully examined the child, the nurse washes him with warm water (37.5-38 °C). It is necessary to wash the child not only in case of contamination with fecal matter, but even with minor urination, since even an insignificant amount of urine remaining on the skin can cause irritation. It’s better to wash it with your hand, sometimes you can soap it. You should use neutral soap: “Children’s”, “Velvety”, “Sputnik”. Laundry soap should not be used to wash and bathe a child. It is absolutely unacceptable to wash children with standing water in a basin.

Girls should always be washed from front to back, holding them face up on the forearm. If there is discharge from the genital cleft in girls, a toilet is performed with a solution of potassium permanganate at a dilution of 1:8000 (light pink).

After washing the baby, dry the wet areas by carefully applying a diaper to them, especially carefully drying the folds of the skin; they are lubricated several times with sterile vegetable oil (vaseline oil can cause skin irritation) or fish oil.

The appearance of diaper rash indicates improper child care. Places of redness in the buttocks area are lubricated with fish oil. In case of diaper rash, the baby should be swaddled loosely, and the areas of diaper rash should be sprinkled with white streptocide powder. A good effect in these cases is obtained by irradiating the diaper rash areas with ultraviolet rays (in this case, the use of fatty lubricants is contraindicated) followed by aeration.

The child’s face and eyes are washed with sterile cotton wool soaked in boiled water or a solution of potassium permanganate. Each eye is washed with a separate swab from the outer corner to the inner one. The oral cavity is not wiped, since the mucous membrane is dry and easily injured. The external auditory canal should also not be cleaned. To clean the nose, use thin sterile cotton swabs soaked in a 2% solution of boric acid or a solution of potassium permanganate in the concentration indicated above. If crusts are present, clean the nose with a soft cotton swab dipped in vegetable oil, fish oil or an oil solution of vitamin D.

After the umbilical cord falls off, the child is bathed daily in boiled water, the bathing duration is no more than 5 minutes. The first bath of a newborn is carried out as follows. The bath (zinc or enamel) is thoroughly washed with hot water and soap, then doused with boiling water and drained. It is necessary to have a sufficient supply of boiled cold and hot water. Place a diaper folded several times at the bottom of the bath and pour in hot boiled water, which is diluted to 37-38 °C. The child is lowered into the bath slowly, holding the back of the head and back with the left hand, and the buttocks and thighs with the right hand. First, the buttocks are immersed in water, and then the whole body (Fig. 2). With the freed right hand, soap the body with a cotton swab and wash the head, neck, torso and limbs, especially thoroughly wash the folds in the neck, behind the ears, elbows, and groins Fig. 2. Newborn bath.

areas, under the knees, between the buttocks. Then the child is turned with his back up and doused with clean water, the temperature of which should be 1-2°C lower than the temperature of the water in the bath (Fig. 3). Then the child is wrapped in a warmed soft sheet and quickly dried by carefully applying it, after which, after lubricating the skin folds with sterile or boiled vegetable oil, the child is dressed and placed in a crib.

Equipment. Sterile: cotton pads, cotton balls, diaper, rubber gloves, petroleum jelly or vegetable oil; other: furatsilin solution 1:5000, pale pink solution of potassium permanganate, labeled kettle, boiled water at 37°C.

1. Wash your hands thoroughly and put on sterile rubber gloves.
2. Place a warm, sterile diaper on the changing table.

Toiletnasal passages

4. Take a cotton wool. Moisten with Vaseline or vegetable oil.
5. Insert the turunda into the nasal passage with careful rotational movements of 1-1.5 cm.
6. Repeat several times. Use a separate turunda for each nasal passage.

Remember! It is forbidden to clean the nasal passages with hard objects (matches, sticks with cotton balls).

Toilet eye

7. Take sterile cotton ball.
8. Moisten with boiled water or a solution of furatsilin 1:5000 (or a pale pink solution of potassium permanganate).
9. Rinse each eye with a separate cotton ball.
10. Repeat several times if necessary.
11. Dry each eye separately with cotton balls from the outer corner of the eye to the bridge of the nose.
12. Carry out disinfection used equipment.
13. Make a note about the toilet of the nasal passages and eyes in the medical documentation.

Skin care for newborns and infants

Equipment. Sterile: cotton balls, rubber gloves; other: a warm diaper, petroleum jelly or vegetable oil, a labeled kettle, boiled water at a temperature of 37°C.

1. Wash your hands, put on sterile rubber gloves.
2. Wash the child with warm, boiled water. Girls to wash from the pubic symphysis to the anus. In a hospital setting, use a labeled kettle for washing.
3. Place on the changing table and dry the skin with a clean diaper.
4. Treat skin folds with a cotton ball moistened with sterile petroleum jelly or vegetable oil to prevent diaper rash in the following sequence: behind the ear, cervical, axillary, elbow, wrist, popliteal, ankle, groin, buttock (the inguinal and buttock folds are the most contaminated, and therefore are processed last).
5. Dress the child and put him to bed.
6. Carry out disinfection used equipment.
7. Make a note about the care of your child’s skin in the medical documentation.

83.Toilet of the umbilical cord and umbilical wound

After birth, bacterial colonization of the umbilical cord and skin begins as a result of skin-to-skin contact. After umbilical cord crossings and applying the terminal to it begins leukocyte infiltration, which is one of the stages of the umbilical cord falling off. A small amount of cloudy mucus may be mistaken for pus. When exposed to air, the umbilical cord dries out, becomes hard and dark.

Physiological period of loss umbilical cord remnant from 5 to 15 days.

Staying together around the clock, using antiseptics and dressings are very important for physiological colonization with non-pathogenic microflora and preventing the child from becoming infected with microflora at the hands of medical personnel.

In the absence of early skin-to-skin contact between mother and child and subsequent separation of the child from the mother, in order to prevent colonization by hospital microflora, it is recommended to treat the umbilical cord with a 1% solution of brilliant green or a 5% solution of potassium permanganate. The child can be discharged home with the remainder of the umbilical cord, provided that the mother has mastered caring for him.

Equipment. Sterile: swabs with cotton balls, rubber gloves; other: 1% solution of brilliant green or 5% solution of potassium permanganate, disinfection accessories.

1. Wash your hands thoroughly and disinfect them. Wear an apron and sterile rubber gloves.
2. On baby changing table put on a warm sterile diaper.
3. Carefully take the baby and put it on the diaper.
4. Take a sterile swab with a cotton ball.
5. Moisten with 1% solution of brilliant green or 5% solution of potassium permanganate.
6. Carefully grab the ligature with your hand, lifting the umbilical cord up by it.
7. Treat the section of the umbilical cord residue with a stick with a cotton swab moistened with 70% ethyl alcohol, and then the entire remainder from top to bottom towards the base. (When the umbilical cord remains mummified, treat the base first, and then the entire remainder from bottom to top.)
8. Using the same stick, treat the skin around the umbilical cord from the center to the periphery.
9. Change the stick, moisten it in a 1% solution of brilliant green or a 5% solution of potassium permanganate and treat the umbilical cord residue in the same sequence, without touching the skin of the abdomen.
10. Keep the umbilical remnant dry and clean.
11. Carefully monitor for signs of infection: hyperemia, swelling, purulent or sanguineous discharge, unpleasant odor.
12. Do not cover the umbilical cord with a diaper.
13. Disinfect the changing table, apron and rubber gloves.
14. Make a note in the documentation about toileting the umbilical cord.

Remember! If the umbilical cord remains are contaminated (residues of urine, feces, etc.), you must immediately wash it with warm boiled water and soap and dry it thoroughly with a clean diaper or napkin.

Provided that early skin-to-skin contact between mother and child is ensured, followed by staying together, there is no need to treat the umbilical cord with antiseptics and antibacterial agents.

The birth of a baby is both a joyful and important event. The health and good mood of the baby depends entirely on the attentiveness of the parents and proper care. That is why, from the first day of the child’s life, the mother must carry out daily hygiene procedures, the list of which necessarily includes cleaning the nose and mouth. Today we'll talk about how to ensure proper care of the skin and mucous membranes of a newborn.

Newborn nose care

Breasts breathe through their noses during feeding, so if congestion or an accumulation of dry crusts occurs, it not only becomes difficult for the child to breathe, but also to eat. New mothers need to pay special attention to the condition of the baby’s nose after regurgitation, because some of the milk may enter the nasopharynx, make breathing difficult and promote the development of bacteria. For the baby’s comfort, hygiene procedures should be carried out at least once a day. It is allowed to use special solutions to clean the nasal passages.

• Saline solution. You can buy it at a pharmacy for a small price, and its quantity will last for a long time. The saline solution contains water and sodium chloride.
• Saline solution. Budget option for saline solution. One teaspoon of salt is required for one liter of warm purified water. The salt must be free of impurities and completely dissolved.
• Various types of seawater sprays. There are a large number of options for sprays and drops in pharmacies: aquamaris, aqualor, morenasal.

To clean your baby's nose, you need to:

• put the child in a horizontal position or hold him in his arms and tilt his head slightly back;
• drop two drops of one of the above solutions into each nasal passage and wait at least a minute. The mucous membrane will moisten and the crusts will soften;
• take a pre-prepared cotton wool(a twisted cotton wool flagellum), insert into the spout no more than 1.5 cm and gently twist. Make a separate turund for each nasal passage.

Caring for a newborn's nose should include control of indoor humidity. If the air is very dry, then crusts can often form in the nose. To avoid this, after cleaning it is advisable lubricate the spout with a couple of drops of peach oil applied to the turundum. In situations where the child has severe nasal congestion, special nasal aspirators, which delicately remove excess mucus.

Before using the aspirator all parts of the device must be doused with boiling water. Before inserting the nozzle into your baby's nostril, test the suction strength on your hand. This will help avoid strong pressure on the mucous membrane. The nozzle should not be inserted vertically, but at an angle, pointing the tip towards the back wall of the nasopharynx.

Advice! Pull out the snot slowly, inhaling calmly and trying to get into the baby’s breathing rhythm: your inhalation together with his exhalation.

In order to prevent your child from having a stuffy nose and crusts from appearing, you need to follow the basic rules:

• monitor the level of humidity in the room, too dry and hot air contributes to crusts, and very humid air leads to a physiological runny nose;
• carry out wet cleaning to remove dust;
• Walk more often and ventilate the room.

Caring for a newborn's mouth

It would seem, why care for a baby’s mouth if he doesn’t have teeth yet and doesn’t eat anything except mother’s milk. There is no need to wipe your newborn's mouth every day, but you should monitor the condition of the oral cavity daily.

The fact is that during regurgitation and feeding with milk, residues can accumulate on the baby’s tongue and inner cheeks, which can cause a white coating - fungus of the genus Candida. This fungus can create discomfort in the baby during feeding and even cause intestinal dysbiosis. If plaque appears, you should consult your pediatrician.

Important! To prevent oral thrush in a newborn, you need to carry out basic hygiene procedures: wash the breast before feeding, disinfect all toys and objects that the child puts in his mouth.

If a white coating appears, the baby should undergo cleaning procedures at least three times a day. To do this, you can use special preparations recommended by your doctor or a soda solution (1 teaspoon of soda per 250 ml of warm boiled water).

Wrap your little finger in two layers of bandage and soak it in the solution of your choice, then, without applying too much pressure, wipe your baby's mouth. The course of treatment is usually 5-10 days, depending on the strength of the raid. All daily hygiene procedures take a little time, but allow the child to explore the world around him with a feeling of comfort.

Proper care of a newborn’s oral cavity, skin and nasal mucous membranes– excellent prevention of many ailments. You can watch the following video to learn how to properly clean your nose and what equipment is needed for this:

Caring for the skin and mucous membranes is one of the main points of caring for newborns.

Having unswaddled and carefully examined the child, the nurse washes him with warm water (37.5-38 °C). It is necessary to wash the child not only in case of contamination with fecal matter, but even with minor urination, since even an insignificant amount of urine remaining on the skin can cause irritation. It’s better to wash it with your hand, sometimes you can soap it. You should use neutral soap: “Children’s” or other products. Laundry soap should not be used to wash and bathe a child. It is absolutely unacceptable to wash children with standing water in a basin.

Girls should always be washed from front to back, holding them face up on the forearm. If there is discharge from the genital slit in girls, a toilet is performed with a solution of potassium permanganate at a dilution of 1: 8000 (light pink).

After washing the baby, dry the wet areas by carefully applying a diaper to them, especially carefully drying the folds of the skin; they are lubricated several times with sterile vegetable oil (vaseline oil can cause skin irritation) or fish oil.

The child’s face and eyes are washed with sterile cotton wool soaked in boiled water or a solution of potassium permanganate. Each eye is washed with a separate swab from the outer corner to the inner one. The oral cavity is not wiped, since the mucous membrane is dry and easily injured. The external auditory canal should also not be cleaned. Thin sterile cotton swabs are used to clean the nose. If crusts are present, clean the nose with a soft cotton swab dipped in vegetable oil, fish oil or an oil solution of vitamin B.

The child is bathed daily in boiled water, the bathing duration is no more than 5 minutes. Bathing is carried out as follows. The bath is thoroughly washed with hot water and soap, then doused with boiling water and drained. A diaper folded several times is placed at the bottom of the bath, and hot boiled water is poured in, which is diluted to 37-38°C. The child is lowered into the bath slowly, holding the back of the head and back with the left hand, and the buttocks and thighs with the right hand. First, the buttocks are immersed in water, and then the whole body. With the freed right hand, soap the body with cotton wool and wash the head, neck, torso and limbs, especially thoroughly wash the folds in the neck, behind the ears, in the elbow, groin areas, under the knees, between the buttocks. Then the child is turned back up and doused with clean water, the temperature of which should be 1 - 2 ° C lower than the temperature of the water in the bath. Then the child is wrapped in a warmed soft sheet and quickly dried by carefully applying it, after which, after lubricating the skin folds with sterile vegetable oil, the child is dressed and placed in a crib.

Proper care of the skin and mucous membranes is of great importance for the health of the newborn. Therefore, in addition to general toilet baths, the child should be washed with warm running water after each urination and bowel movement. In the absence of a centralized water supply, boiled water from a washstand is used for washing.

You need to wash your child with a soapy hand. The girl is washed from front to back to avoid infection in the external genitalia. If any discharge is noted from the girl’s genital slit, she is given a toilet with a slightly pink solution of potassium permanganate. After washing, the child is carefully and thoroughly dried by applying a warm and soft diaper, and then the folds of the skin are lubricated with sterilized (boiled) vegetable oil or sterile fish oil.

Full toileting of the child is carried out daily- in the morning before feeding and in the evening before bed. Eyes, ears, nose and oral cavity require special care.

The toilet is performed as follows: An adult, having washed his hands well, uses a sterile cotton swab dipped in warm boiled water or a slightly pink solution of potassium permanganate to wipe the child’s face, neck, ears and hands, after which he dries everything with a towel. During this procedure, care is taken to ensure that water does not enter the external auditory canal.

When using the toilet, you must follow the following sequence: First, the child’s face is washed, then the eyes, nose and ears are treated, and then the skin of the torso and perineum. Each child's eye must be washed with a separate moistened ball of cotton wool in the direction from the outer corner of the eye to the bridge of the nose. The external auditory canals and nose are carefully cleaned with cotton wool soaked in a 2% solution of boric acid or petroleum jelly and squeezed well.

“Care, nutrition and vaccine prevention of a child”, F.M. Kitikar

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