Nursing, Personal Care Attendant (PCA)

Special Bath Situations

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Special Bath Situations for Diabetic clients: Diabetic clients must be given gentle and through foot care. Clean with a gentle soap on all areas of the foot such as between the toes and in any folds or creases. Rinse thoroughly, leaving no soap residue. Look for and report any discoloration, skin abrasions, blisters, pressure point redness, or open wounds. Nail beds should be pink. If they are lavender, bluish, or white there may be a problem that needs to be reported. Diabetic clients have compromised circulation. Their feet and lower legs are usually the first places that show signs of diabetes complications. The PCA should not trim the toenails of a diabetic client. Check the care plan for special care or orders before beginning care for your client.


Special Bath Situations for fall risk clients: Clients who are a fall risk should be transported to the shower from their room with a shower chair that has wheels. Being able to wheel the client directly into the shower stall greatly reduces the risk of a fall and minimizes the extra assistance you would otherwise need with your client. Utilize warm bath blankets for client privacy on the way to and from the shower.


Special Bath Situations for client with indwelling catheter: A client who has an indwelling catheter can still benefit from a warm, soothing shower. The bag can hang on the shower chair as long as it is kept below the level of the bladder. Otherwise, shower as usual.


Special Bath Situations for client with an IV site: If your client has an IV site, it must be kept dry. This can be accomplished by using a latex glove with the hand cut out or a plastic baggie, and tape. Consult the care plan for specific instructions for your client, or call your supervisor.


Special Bath Situations for an uncooperative client: An uncooperative client is a special challenge. You are responsible for making sure your client is clean and healthy, but you cannot abuse client rights by forcing them into a bath or shower. When you have a client who refuses a bath or shower record it and report it to the nurse or your supervisor. Your documentation should quote exactly what the client said or did to indicate refusal of care.


Special Bath Situations for a client that refuses a bath: If you have a client that refuses a bath, but then decides to bathe, document and state specifically why they decided to accept the care. This can help other caregivers know how to provide care to the uncooperative client.