Bed bath assessment

Certifiable, BSN, RN · Mar 7, 2012

Well, nothing official... but I think it's a good thing to notice symetry, skin turgor, skin dryness, colour, pain, sores, moles....

Double-Helix, BSN, RN · Mar 7, 2012

When you're doing a skin assessment, you're looking for any areas of injury as well as general quality of the skin.

So ask you wash and dry each area, look for: areas of dryness, redness, open sores, cuts, lacerations, bruises, rashes and excoriation.

Especially important areas to check are pressure points (hips, elbows, heels, ankles, knees, sacrum, shoulder blades, and the back of the head). These areas are the most prone to developing pressure sores. Make sure that you position the patient with these areas padded (use pillows, elevate the heels, etc.) Also make sure you look in the arm pits and any folds of skin- particularly in the lower abdominal region and thighs. These areas are most likely to develop skin breakdown from moisture. Placing baby powder in these areas can help prevent this. Finally, be sure to look at the perianal area for any skin break down related to incontinence. Urine and feces are very damaging to the skin. Use a skin protectant cream in the perianal area if the patient is incontinent.

Edit: The above things are important for conducting a skin assessment while doing a bed bath. This is really the only area of the assessment that you need to complete while giving a bath. The other portions of your assessment you can do while the patient is clothed. This will be much more comfortable for the patient, whom I'm sure will not appreciate you trying to listen to their breath sounds and press on their belly while they are undressed and cold.

ghansen99 · Feb 21, 2013

do you look for capillary refill?

nurseprnRN, BSN, RN · Feb 22, 2013

do you look for capillary refill?

You can, of course.

You can also make sure that the conversation you hold while you bathe is going to be fruitful in understanding more about your patient.

"Tell me about where you live," can get you all sorts of info on safety, who'll be there to help after discharge, and may go off onto family issues, money worries, or a host of other things that will help you plan and target nursing care.

"How many steps do you have to climb?" may get you info on isolation, or previous falls, or the landlord won't fix the elevator....

"Do you have a shower or a tub at home?" can give you info on safety-- perhaps a tub transfer bench or shower stool would be safer, or maybe the landlord doesn't have any hot water.

"Who cooks at your house?" may give you info that says there's no one who cooks, so she gets meals on wheels three times a week, or she has six grandchildren to feed so she does, or...

See, this is the way to use purposeful communication. When you think, "Bed bath, boring, why doesn't the aide do them all?" this is one reason why. Because the RN is held to a higher standard.