maternal nursing

1. Supriya batwalkar

2.  Perineal care – also referred as “peri care” or
“perineal-genital care”.
 It is the cleansing of genital area, perineum
and surrounding area.

4.  The perineal area is conducive to the growth
of pathogenic organisms because it is warm,
moist and not well ventilated.
 There are many orifices situated in this area
 Urinary meatus
 Vaginal orifice
 Anus
 Pathogenic organisms can enter into the body
through these openings if cleanliness not
maintained.

5.  “Perineal care is defined as cleaning the
perineum from the cleanest to less clean
area, the urethral orifice to the anal orifice."

6.  To prevent sepsis.
 To remove discharges and prevent bad odor.
 To relieve itching.
 To promote healing of stitches.
 To promote comfort.

7.  The most important principle for the perineal
care is to clean the perineum from the
cleanest to less clean area.

8.  Patients who are unable to do self care.
 Patients with genito-urinary tract infections.
 Patients with incontinence of urine and stool.
 Patients with excessive vaginal discharge.
 Patients with indwelling catheter.
 Post partum patients.
 Patients after surgery on the genito-urinary
system.
 Patients with injury, ulcers or surgery on the
perineal area.

9.  Assess the condition of the perineal skin –any
itching, irritation, ulcers edema, discharge.
 Assess need and frequency of perineal care.
 Check physicians order for any specific
instructions.
 Assess patients ability for self care.
 Check the articles available in the patient’s
unit.

10.  Explain the procedure to the patient to gain
his/her cooperation.
 Provide privacy by screens and drapers.
 Remove all articles that may interfere with the
procedure like 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.
 Arrange the articles conveniently on bedside.

11.  Hand washing.
 Wear apron, facemask and gloves.

12. A tray containing
Articles Purpose
Mackintosh and drawsheet To protect bed linen.
Jug with warm water To clean the perineum.
Sterile gauze pieces with antiseptic lotion To clean the perineum.
Artery forcep and thumb forcep To hold the swab.
Dry gauze pieces To dry perineum.
Towel To dry the area.
Toilet paper To clean faecal matter if any present
Bed pan To wash the surrounding area
Bed linen To change if wet
Drape sheet and screen To maintain privacy of patient
Kidney tray To collect waste

13. Steps of procedure
Steps of procedure Rationale Scientific
principles
Nursing
principles
Wash hands thoroughly To prevent cross
infecction
Microbiology
Drape the patient To maintain privacy Psychology
Spread mackintosh and
drawsheet
To prevent bed
soiling
Microbiology
Maintain dorsl recumbent
position of the patient
For proper acess of
perineum
Body
mechanics,
Anatomy &
physiology
Comfort
Wear gloves To prevent cross
infection
Microbiology
Adjust the bed pan under the
patients buttocks
To clean the
perineum
Patient
safety
Pour water over perineum. To wash off the
discharge from the
perineal area.

14. Clean the perineum using
sterile swabs.
 Hold the swabs with
forceps and clean
from above.
 Use one swab for one
swabbing.
To prevent the
entrance of bacteria
from the colon into
urinary tract.
Microbiology Personal
Hygiene
Clean perineum from the
midline outward in following
order
a. The vulva
b. The labia
c. Inside of labia on
both sides.
d. Outside of labia on
both sides.
Anatomy &
physiology
Personal
Hygiene
Clean the perineal region and
anus thoroughly.
To ensure thorough
cleaning
Personal
Hygiene
Remove the bed pan by
supporting the hip as before.
Turn the patient to one side
and dry the buttocks with dry
rag piece.
To avoid friction Patient
safety

15.  Apply the medicine and pad if necessary.
 Remove mackintosh.
 Change linen if soiled.
 Make patient comfortable.
 Offer patient hot drink.

16.  Take out the bedpan, remove the content,
clean and replace.
 Remove screen and tidy up the unit.
 Clean all articles with soap and water,
disinfect them and replace back.
 Wash hands.
Recording and reporting
 Record the procedure with date and time and
observations made and report it.

17.  I clement, textbook of nursing foundation, 2nd edition, jaypee
publication, pp-97-98.
 TNAI, fundamental of nursing a procedure manual,1st edition 2016
(reprinted) pp-171-175
 Gerard tortora anatomy and physiology, India edition, 2016 , wiley
publication, pp-949-952.
 B. T. Basavanthappa Nursing Foundation, 1st edition, 2013, Jaypee
publication pp-391-395
 Potter perry basic nursing essential for practices 6th edition 2007
elsevier publication pp-728-740.
 https://www.canestar.com/perineal-care----a-simple-nursing-
procedure..html
 http://www.scielo.br/scielo.php?pid=S198314472016000500410&scrip
t=sci_arttext&tlng=en
 www.ijcrar.com

18.  What are the indications for giving perineal
care?
 Write the definition of perineal care.
 Enlist purposes of perineal care.
 Formulate a care plan with need of personal
hygiene.