FUNDAMENTALS OF NURSING- PERINEAL CARE- OBSTETRICAL NURSING

1. Perineal care
- Ms. Khyati Chaudhari

2. Definition
Perineal care is bathing the genitalia and surrounding area. Proper
assessment and care of the perineal area will need professional
clinical judgment.

3. Purposes
• To keep cleanliness
• To make him/her comfortable
• To prevent or eliminate infection, odor and promote healing
• Remove secretions, and provide comfort

4. Indications
• Patients who are unable to do self-care.
• Patients with indwelling catheter.
• Patients with incontinence of urine or stool.
• Patients having excessive vaginal discharge.
• Patients recovering from rectal or genital surgery.
• Following childbirth.

5. Principles
1. To clean the perineum from the cleanest to the less clean area.
2. Follow Standard Precautions.
3. Maintain patient’s privacy.
4. Proximal level of functioning.

6. Assess presence of :
• Irritation, excoriation, inflammation, swelling
• Excessive discharge
• Odor; pain or discomfort
• Urinary or fecal incontinence
• Recent rectal or perineal surgery
• Indwelling catheter

7. Equipments
A tray containing –
• Bowl -3 –
• 1 with plain water – 1 with betadine solution– 1 with cotton balls
• Artery forcep - 1
• Mackintosh and draw sheet
• Bath blanket/cover sheet/operation sheet

8. • Paper bag and kidney tray
• screen

9. Preparation of nurse
• Gather all the articles.
• Place it bedside.
• Collect client information.
• Remove ornaments if any.
• Hand washing.

10. Preparation of client
• Explain procedure and it’s purpose to client.
• Position the patient with leg spread apart.
• Uncover the client's perineal area.
• Place a mackintosh and towel
• Spread operation sheet/cover sheet that way so only perineal area you can
observe.
• Close the door to the room and place the screen

11. Procedure
• After explaining procedure and nurse-client preparation-
• Wash hands and done clean gloves.
• Assess presence for Equipments for example- Foley's catheter or condom
catheter.
• Assess genitelia for signs of inflammation, skin breakdown, infection or
contamination with fecal matter.

12. Female genitalia

13. Female client
• Tell patient to maintain position with knee flexed and legs apart.
• First take cotton ball with artery forcep.
• Deep it into betadine solution.
• Clean labia majora of both side by using non-dominant hand. (one stroke
one time.)
• Separate labia with non-dominant hand & go for labia minora of both side.

14. • And after that clean vulva.
• Same steps do with use of plain water.

15. Male genitalia

16. Male client
• Give him supine position.
• Clean top of the penis at urethral meatus first using circular motion, clean
from meatus outward.
• Clean shaft of penis with gentle but firm downward strokes.
• First with betadine solution and after that with plain water.

17. After care
• Help client to put on clothes.
• Give comfortable position.
• Replace all articles and discard waste.
• Documentation and report.