Perineal care

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Slide 1:

Perineal care Kiran Randhawa ARMY COLLEGE OF NURSING

Perineal Care :

Perineal Care Cleansing of the external genitalia, perineum, & surrounding area. Perineal care is also referred to as “peri-care” or “perineal-genital” care. Perineal care involves washing the external genitalia with soap & water or with water alone or in combination with any commercially prepared periwash.

Cont……………………..d:

Cont……………………..d It may be carried out as part of the pt’s bath or as a separate procedure. The perineal area is conductive to the growth of pathogenic organism because it is warm ,moist & is not well ventilated. There are many orifices ( urinary meatus ,vaginal orifice & anus) situated in this area ,the pathogenic organism can enter into the body. So cleanliness is essentail to prevent bad odor & to promote comfort.

The purpose of perineal care :

The purpose of perineal care care are to prevent or eliminate infection & odor,promote healing, remove secretions, &provide comfort

Principle :

Principle The most important principle for the perineal care is to clean the perineum from the cleanest to the less clean are.

Pt’s who requires special attention to perineal care:

Pt’s who requires special attention to perineal care Pt’s who are unable to do self care Pt’s with genito-urinary tract infections. Pt’s with incontinence of urine & stool Pt’s with excessive vaginal drainage. Pt’s with indwelling catheters. Postpartum patients. Pt’s after surgery on the genito urinary system Pt’s with injury ,ulcers or surgery on the perineal area.

Preliminary assessment ( for female) :

Preliminary assessment ( for female) Assess the condition of the perineal skin —any itching ,irritation ,ulcers ,edema ,drainage etc. Assess need & frequency of perineal care. Assess whether perineal care should be done under an aseptic technique or a clean technique. Check the physician’s order for any specific instructions Assess the pt ability for self care.

Cont……………d:

Cont……………d Assess the pt’s mental state for self care. Check the articles available in the pt’s unit.

Preparation of articles :

Preparation of articles Mackintosh & drawsheet A jug with warm water. Sterile gauze pieces with antiseptic lotion Artery forcep & thumb forcep in antiseptic lotion Kidney tray Clean linen To protect the bed. To clean perineum. To clean the perineum. To hold swabs for cleaning. To receive the waste To make the bedding clean.

Cont…………….d:

Cont…………….d Pads & dressing Bedpan Dry rag pieces Drape sheet & screen To keep the pt clean to clean the perineum or it can also be used if the pt has a need of passing urine or stool. To dry the perineum. To maintain the privacy of the pt.

Preparation of pt:

Preparation of pt Explain procedure to the pt. Provide privacy by screens & drapes. Remove all articles that may interfere with the procedure e.g air cushion. Give extra pillow to raise the head. Roll the draw sheet to opposite side to prevent soiling when bedpan is placed under buttocks over drawsheet. Offer the bedpan. Untie the pads ,if any observe the discharge its color ,odor ,amount etc. Arrange the articles conveniently on bedside table

Steps of procedure :

Steps of procedure Wash hands Spread mackintosh & drawsheet. Maintain dorsal recumbent position to female client. Wear gloves Adjust the bedpan under the pt buttocks Pour water over perineum. To prevent cross infection. To prevent bed soiling. For proper access of perineum. To prevent cross contamination To clean the perineum. To wash off the discharge from the perineal area.

Cont……………..d:

Cont……………..d Clean the perineum using the sterile swabs: Hold the swab with artery forcep and clean the perineum. Use one swab for one swabbing. Clean the perineum from the midline outward in following order: To prevent the entrance of bacteria from the colon into urinary tract.

Cont……………d:

Cont……………d The vulva The labia majora on both sides The labia minora on both sides Clean clittoris ,clittoris to vaginal orifice ,vaginal orifice to abnal orifice d) Clean the perineal region & anus thoroughly. To prevent contamination.

Cont………………d:

Cont………………d Remove the bedpan by supporting the hip as before. Turn the the pt to one side & dry the buttocks with dry rag pieces. Apply the clean pad if the pt is mensturating & or having lochia. To dry the moist skin of the genitals.

After care :

After care Apply the medicine & pad if necessary. Remove the mackintosh Change the linen if necessary . Make the pt comfortable Take the bedpan to the sanitary remove cotton swabs & empty the content into toilet. Clean all articles.

Cont……….d:

Cont……….d Boil forceps Replace articles Remove screen & tidy up the unit Wash hands Record the procedure with date & time and observations made.

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