Lesson plan on perineal care procedure

1. J.G COLLEGE OF NURSING,
AHMEDABAD.
SUBJECT : Nursing Foundation
TOPIC : Procedure on Perineal Care
SUBMITTED TO: SUBMITTED BY:
MS.SOMA DAS. PATEL SONAL P.
ASST. PROESSOR, F.Y M.SC NURSING,
J.G COLLEGE OF NURSING, J.G COLLEGE OF NURSING,
AHMEDABAD. AHMEADABAD.

2. LESSON PLAN ON PERINEAL CARE
 Name : Patel Sonal P.
 Subject : Nursing Foundation
 Topic : Perineal care
 Group : First Year B.Sc(N) Students
 Time : 1 Hour
 Name of The College : J.G College Of Nursing, Ahmedabad.
 Method of Teaching : Lecture Cum Discussion, Demonstration
 A.V. Aids : Demonstration
 Previous Knowledge of Group : Students having some knowledge regarding “Perineal Care”

3. OBJECTIVE
General objective: After the completion of class students will be able to understand about perineal care and will
develop positive knowledge, skill regarding Perineal care.
Specific objective:
 Introduce about the topic.
 Define the perineal care.
 Enumerate the purpose of perineal care.
 List out the indication of perineal care.
 Discuss the general instruction about the procedure.
 Discuss about preliminary assessment.
 Explain the articles.
 Explain the preparation of patient.
 Explain the procedure.
 Discuss the recording and reporting.

4. Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids use Evaluation
1. 6 min Introduce
about the
topic.
 Introduction:
Perineal injury is the most common maternal morbidity
associated with vaginal birth. Anal sphincter injury is a
major complication that can significantly affect
women’s quality of life. Perineal hygiene involves
cleaning external genitalia and surrounding area. The
perineal area is conductive to growth of pathogenic
organisms because so the pathogenic organisms enter
into body many orifice in situated in this area .it is less
ventilated. Since Delivery is the physical strengthen,
effort done by the mother during their delivery period
and suffer from birth canal injuries, episiotomy incision,
perineal tear laceration may be occur so staff nurses
provided perineal care to the patient in the hospital at
least minimum twice a day and try to recover the patient
in early healing.
Discussion Ask about
what is
perineal
care?
2 4 min Define the
perineal care.
DEFINITION:
 Perineal care is an aseptic irrigation of the vulva
and perineum after voiding or defecation in
specified period following delivery or an
operation of birth canal, perineum, urinary meats
or anus.
 cleansing the area between the anus and vulva in
female, or the anus and scrotum in male;
promotes comfort and prevents odor kin
excoriation, and infection. usually given along
Lecture cum
discussion
What is
perineal
care?

5. Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids use Evaluation
2 4 min Define the
perineal care.
with a complete bed bath, but may have to do
more often (e.g. incontinent of urine or feces)
 Perineal care is the term applied to the external
irrigation or cleansing of the vulva and perineum
region as a means of prevent infection, promote
healing of the stitched perineum and making the
patient comfortable.
 Cleansing procedure prescribed for the genital
and anal areas as part of the daily bath or after
various obstetrical and gynecological
procedures.
Lecture cum
discussion
What is
meaning of
Perineal
Care?
3. 2 min Enumerate
the purpose
of perineal
care.
 PURPOSE
1. To clean the skin and mucous membrane of the
vulva and perineum.
2. To eliminate the bacterial growth by application
of antiseptic solution.
3. To increase the healing of perineal tissues.
4. To relieve itching, pain, discomfort of the
perineal area.
5. To prevent the infection in to the genital area.
6. To minimize pain, tenderness and edema due to
operational trauma after Episiotomy
7. To observe the colour, nature and characteristics
of lochia.
Lecture cum
discussion
What are the
purpose of
perineal
care?

6. Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids use Evaluation
4 2 min List out the
indication of
perineal care.
 Indication Of Perineal Care:
1) Postpartum patients especially with stitches in
the perineum.
2) Persons with surgery of the genitourinary tract.
3) Patients with lesions, ulcer or surgery of the
perinea area or rectum.
4) Patient having indwelling catheter.
5) Patients having excessive vaginal discharges.
6) Patients with incontinence of urine or stool
7) Patient should not perform the perineal care by
herself.
Lecture cum
discussion
What is
indication of
perineal
care?
5. 6 min Discuss the
general
instruction
about the
procedure.
 General Instruction:
1) Maintain strict aseptic technique during the
procedure.
2) Provide privacy to the mother.
3) Observe the colour, nature and characteristics of
lochia.
4) Don’t touch inner area of the sterile tray.
5) Use the one swab for each stock from upward to
downward.
6) If the glove is soil before procedure change it.
7) To observe the patient for discomfort during
procedure.
8) Discard all the swabs and pad in the paper bag or
dustbin
9) Used mild antiseptic solution or plain warm water
for perineal care.
Lecture cum
discussion
What are
point to keep
in mind?

7. Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids use Evaluation
6. 4 min Discuss
about
preliminary
assessment.
 Preliminary Assessment:
1) Identify the patient.
2) Check the doctor’s order for any specific
precautions.
3) Identify any specific contraindications present.
4) Any contra indications to the applications of
perineal care in the patient.
5) General condition of patient and ability to follow
instruction.
6) Check the articles available in patient unit.
Discussion Demonstration What are the
preliminary
assessment?
7. 5 min Explain the
articles.
 Preparation Of The Articles :-
Sr
no.
Articles
1 A CLEAN TRAY CONTAINING:
1.Sterile antiseptic lotion-2% dettol or savlon
2. Sterile normal saline in a bottle
3. Cheatle forceps
4. Antiseptic or antibiotic medication in ordered
5. Sterile sanitary pad
6. Kidney tray
7. Sterile gloves
8. Mackintos
Discussion Which
articles
require in
procedure?

8. Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids use Evaluation
7. 5 min Explain the
articles.
2. STEILE PACK OR TRAY CONTAINING
1.Artery forceps-1
2. Dissecting forceps-1
3. Cotton balls
4. Gauze piece
5. Sterile towel to wipe hands after surgical
scrub
3 ADDITIONAL ITEMS
1.Inrare light
2. Bedpan
3, jug with warm water
4. face mask
5. Curtain
6. plastic apron
7. Soap dish, towel
Demonstration
Discussion

9. Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids use Evaluation
8. 6 min Explain the
preparation
of patient.
 Preparation Of Patient And Environment:
1) Identify the patient with the name and explain the
procedure to the patient to win the confidence and
co-operation.
2) Advice the patient to empty the bladder and bowel.
3) Provide privacy.
4) Arrange the articles at the bed side locker
5) Position the patient in dorsal recumbent.
6) Place the mackintosh and towel under the patient to
protect the bed.
7) Provide adequate light by placing extra spot light.
8) Drape the patient and open only vaginal area.
9) Give extra pillows to raise the head.
10) Use the bed pan if you perform the procedure in bed.
(image of hand wash)
image of position of client)
How to
prepare
patient
before
procedure?
9. 10 min Explain the
procedure.
 PROCEDURE
STEPS RATIONAL
Explain the
procedure to the
patient.
To gain the confidence
and co-operation of the
patient.
Spread the
mackintosh and
draw sheet under the
buttocks.
To prevent soiling of bed.
Discussion
Demonstration
How to do
procedure?

10. Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids use Evaluation
9. 4 min Explain the
procedure.
Pour lotion into the
bowl
To clean the perineum
Hand wash To prevent cross infection
Wear the gloves To prevent cross
infection. To maintain
universal precaution
Holding the perineal
pad or dressing with
artery forceps and
observe
characteristics of
the secretion,
lochia, amount
colour, odour and
discard soil pad
To identify any
abnormality.
Hold the swab with
swab holder
To clean the perineum
Clean the perineum
with sterile wet
swab from upward
to downward.
To prevent Ascending
infection
First clean the
stitches and then
other area.
To prevent infection as
stitches consider more
sterile than the other area.
Clean vulva and
perineum using each
sponge once only
and start from
To clean the perineum
and to prevent infection.
Demonstration Which are
the steps of
perineal
care?

11. Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids use Evaluation
9. 4 min Explain the
procedure.
upward to
downwards making
as little pressure as
possible on the
tissue work from the
midline outward.
Inspect perinea
stitches for infection
To give the treatment
Turn the patient on
one side
Clean and dry the
buttocks
Apply antibiotics
ointment
To discourage of bacterial
growth
Apply the dressing
and avoid touching
the surface of
dressing that comes
in contact with vulva
and perineum.
To prevent contamination
of area this will come in
contact with the
perineum.
Apply dressing,
cotton pad and “T”
bandage.
To secure the pad
Demonstration
Discussion
Which are
the steps of
perineal
care?
Which are
the steps of
perineal
care?

12. Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids use Evaluation
10 8 min Discuss the
after care.
 After Care of The Patient And Articles:
1) Remove the mackintosh and bedpan.
2) Change the linen if necessary. Straighten the bed
Arrange the bed linen.
3) Give the comfortable position to the patient.
4) Take the bedpan to the sanitary use. Remove the
cotton swabs If any And empty the contents into
the toilet. Rinse the bedpan with cold water using
a brush. Immerse It In lotion to disinfect it.
5) Wash and dry well and keep it on the bedpan
rack. Ready for the next use.
6) Take all the articles to the utility room, clean it
and replace it.
7) Boil the forceps. Replace the articles.
8) Remove the screen and tidy up the unit.
9) Wash hands.
10) Record the procedure with date and time and the
observations made.
Discussion What to do
after care?

13. Sr.
no
Time Specific
Objectives
Content Teaching &
Learning
Activity
A.V Aids use Evaluation
11 4 min Discuss the
recording
and
reporting.
 Recording and Reporting:
Record the procedure in patient's chart.
1) Record amount, colour and odours of lochia.
2) Note consistency of uterus.
3) Record if dry heat is applied.
4) Record the condition of stitches.
5) Report any abnormality if observed.
Discussion
How to
record?
12 4 min Asking
question
about
Perineal
Care.
Summary:
After the completion of procedure patient feel
comfort and feel relief.
Also advise to do care in day 2 times
Lecture cum
Discussion
Asking
questions
about
Perineal
Care?

14. BIBLIOGRAPHY
a) Inamdar Madhuri, “Nursing Arts (Principles And Practice) Part-II”; 1st
edition,1998,Vora Medical Publication, Bombay,
Page No: 98-100
b) Sr. Nancy, “Principles And Practice Of Nursing”;Volume-1;5th
edition,reprinted
2001;N.R Publication, Indore,
Page No: 234-233
c) Spencer May and Tait Katherine M., “Introduction To Nursing”; 4th
edition,1978,Blackwell
scientificpublication, oxford London,
Page No: 87
d) Thresyamma C.P,“Fundamentalsof Nursing Procedur Mannual For General Nursing
And Midwifery Course”; 1st
edition, reprint 2004; Jaypee Brothers Medical
Publishers, New Delhi;
Page No: 392-395
e) Www.Photo perineal Care.Com

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