The nurse should initially discuss with Mrs Moohan her usual hygiene routine to assess her ability to meet her own hygiene needs. The nurse may at this time endeavour to ascertain Mrs Moohan's preference to a bath or shower or if she has any religious beliefs which may affect her choice. The nurse may recommend a therapeutic bath of 37ºC as this would not only clean the patient but also could reduce her temperature.
Before commencing the bath Mrs Moohan would be offered the opportunity have a cool drink as she is at risk of becoming dehydrated due sweating. Mrs Moohan may wish to use the toilet before having her bath, as she is likely to have a larger fluid intake due to thirst caused by hyperthermia, making her micturate more frequently.
The nurse would ensure Mrs Moohan's privacy is maintained by keeping the door closed when undressing and bathing. The environmental temperature should be warm, because shivering will cause a chill, which raises the patient's temperature higher. When wet the skin can loose more heat through convection (Potter and Perry 2001). The bath should be cleaned before use to prevent cross infection.
As Mrs Moohan is frail she will require nursing assistance throughout (Chandler 1991). If the nurse has to leave her momentarily a call bell should be placed within easy reach.
She may need the aid of a hoist or bath chair if she has difficulty getting into the bath. Mrs Moohan would be encouraged to do as much for herself as she is able as this promotes her self-esteem (Roper et al 1996). The Nurse should talk to her patient to find out whether she uses soap, bubble bath and if she would like her hair washed. When bathing Mrs Moohan the nurse has good opportunity to assess her skin condition, as she may be more at risk from developing pressure sores due to poor nutrition (Brunner and