Perineal Care Checklist

A16626-26.qxd

6/13/02

10:39 AM

Page 183

Previous

Next

Name_______________________ Date___________ Instructor’s Name_____________________________

Performance Checklist: Skill 26-2 Providing Perineal Care S

U

NP

Comments

1. Identify clients at risk for developing infection of genitalia, urinary tract, or reproductive tract.

_____

_____

_____

______________________________

2. Assess client’s cognitive and musculoskeletal function.

_____

_____

_____

______________________________

3. Apply disposable gloves and assess genitalia _____ for signs of inflammation, skin breakdown, or infection. Discard gloves. (Option: examine genitalia as care is administered.)

_____

_____

______________________________

_____

_____

_____

______________________________

5. Explain procedure and its purpose to client. _____

_____

_____

______________________________

6. Prepare necessary equipment and supplies. _____

_____

_____

______________________________

_____

_____

_____

______________________________

8. Raise bed to comfortable working position. _____ Lower side rail, and assist client in assuming side-lying position, placing towel lengthwise along client’s side and keeping client covered with bath blanket.

_____

_____

______________________________

_____

_____

_____

______________________________

10. If fecal material is present, enclose in a fold of underpad or toilet tissue and remove with disposable wipes. Cleanse buttocks and anus, washing front to back. Cleanse, rinse, and dry area thoroughly. If needed, place an absorbent pad under client’s buttocks. Remove and discard underpad, and replace with clean one.

_____

_____

_____

______________________________

11. Change gloves if soiled.

_____

_____

_____

______________________________

4. Assess client’s knowledge of importance of perineal hygiene.

7. Pull curtain around client’s bed, or close room door. Assemble supplies at bedside.

9. Apply disposable gloves.

A16626-26.qxd

6/13/02

10:39 AM

Page 184

S

U

NP

Comments

12. Fold top bed linen down toward foot of bed, and raise client’s gown above genital area. _____ _____ _____ ______________________________ a. “Diamond” drape female client by placing bath blanket with one corner between client’s legs, one corner pointing toward each side of bed, and one corner over client’s chest. Tuck side corners around client’s legs and under hips. For male client, expose only genital area, using towels or bath blankets to cover client’s chest and upper legs. _____ _____ _____ ______________________________ b. Raise side rail. Fill washbasin with warm water. _____ _____ _____ ______________________________ c. Place washbasin and toilet tissue on over-bed table. Place washcloths in basin. 13. Provide perineal care. a. Female perineal care (1) Assist client to dorsal recumbent position. (2) Lower side rail, and help client flex knees and spread legs. Note restrictions or limitations in client’s positioning. (3) Fold lower corner of bath blanket up between client’s legs onto abdomen. Wash and dry client’s upper thighs. (4) Wash labia majora. Use nondominant hand to gently retract labia from thigh; with dominant hand, wash carefully in skinfolds. Wipe in direction from perineum to rectum (front to back). Repeat on opposite side using separate section of washcloth. Rinse and dry area thoroughly. (5) Separate labia with nondominant hand to expose urethral meatus and vaginal orifice. With dominant hand, wash downward from pubic area toward rectum in one smooth stroke. Use separate section of cloth for each stroke. Cleanse thoroughly around labia minora, clitoris, and vaginal orifice. (6) If client uses bedpan, pour warm water over perineal area. Dry perineal area thoroughly, using front-to-back method. (7) Fold lower corner of bath blanket back between client’s legs and over perineum. Ask client to lower legs and assume comfortable position.

_____

_____

_____

______________________________

_____

_____

_____

______________________________

_____

_____

_____

______________________________

_____

_____

_____

______________________________

_____

_____

_____

______________________________

_____

_____

_____

______________________________

_____

_____

_____

______________________________

A16626-26.qxd

6/13/02

10:39 AM

Page 185

S

U

NP

Comments

_____

_____

______________________________

_____

_____

______________________________

_____

_____

______________________________

_____

_____

______________________________

_____ _____

_____ _____

______________________________ ______________________________

_____

_____

______________________________

_____

_____

______________________________

_____ 14. If client has had urinary or bowel incontinence, apply thin layer of skin barrier containing petrolatum or zinc oxide over anal and perineal skin.

_____

_____

______________________________

15. Remove disposable gloves, and dispose in proper receptacle.

_____

_____

_____

______________________________

16. Assist client in assuming a comfortable position, and cover with sheet.

_____

_____

_____

______________________________

_____ 17. Remove bath blanket, and dispose of all soiled bed linen. Return unused equipment to storage area.

_____

_____

______________________________

18. Inspect surface of external genitalia and surrounding skin after cleansing.

_____

_____

_____

______________________________

19. Ask if client feels sense of cleanliness.

_____

_____

_____

______________________________

b. Male perineal care (1) Lower side rails, and assist client to _____ supine position. Note restriction in mobility. (2) Fold lower corner of bath blanket up _____ between client’s legs and onto abdomen. Wash and dry client’s upper thighs. _____ (3) Gently raise penis, and place bath towel underneath. Gently grasp shaft of penis. If client is uncircumcised, retract foreskin. If client has an erection, defer procedure until later. (4) Wash tip of penis at urethral meatus _____ first. Using circular motion, cleanse from meatus outward. Discard wash-cloth, and repeat with clean cloth until penis is clean. Rinse and dry gently. (5) Return foreskin to its natural position. _____ (6) Wash shaft of penis with gentle but _____ firm downward strokes. Pay special attention to underlying surface of penis. Rinse and dry penis thoroughly. Instruct client to spread legs apart slightly. _____ (7) Gently cleanse scrotum. Lift it carefully, and wash underlying skinfolds. Rinse and dry. (8) Fold bath blanket back over client’s _____ perineum, and assist client in turning to sidelying position.

A16626-26.qxd

6/13/02

10:39 AM

Page 186

S

U

NP

Comments

20. Observe for abnormal drainage or discharge from genitalia.

_____

_____

_____

______________________________

21. Record procedure and presence of any abnormal findings.

_____

_____

_____

______________________________

22. Record appearance of suture line, if present. _____

_____

_____

______________________________

_____ 23. Report any break in suture line or presence of abnormalities to nurse in charge or physician.

_____

_____

______________________________ Copyright © 2003, Mosby, Inc. All rights reserve d