You are caring for Mrs. Little, a 57-year-old woman who has been experiencing severe arthritic pain for the past 2 years. She rates her pain at an 8 or 9 on a 10-point pain-rating scale. During your assessment, you notice that Mrs. Little has a moderate body odor, long and untrimmed fingernails and toenails, oily hair, and unshaven legs and axillae. Mrs. Little readily admits that she has neglected her hygiene practices.

a.    What is the first hygiene-related nursing diagnosis (problem and etiology) that comes to your mind for Mrs. Little?

b.    What data do you have to support a diagnosis of Self-Care Deficit: Bathing? What data do you have to support an etiology of “immobility secondary to pain”?

c.     With the information in the scenario, how would you rate her Self-Care Deficit: mild, moderate, severe, or total?

d.    Anything you could do to help relieve Mrs. Little’s pain would facilitate her self-care abilities. However, to plan interventions in which you will assist with her hygiene care, what further patient data do you need?

e. Suppose you assess Mrs. Little further and determine that she has arthritis in multiple joints, including her hands, shoulders, back, knees, and feet. You also determine that she will need a complete bath, either tub or shower, but that she can brush her own teeth if someone provides the necessary supplies. Could you delegate her morning hygiene care to an experienced unlicensed assistive personnel (UAP)? If so, what instructions would you give the UAP?