Perineal Care

Perineal Care

 It means washing the genitals and anal area.

 Peri care can be done during a bath or as a
separate procedure.
 Peri care prevents skin breakdown of perineal
area, itching, burning, odor, and infections.
 Purpose
 To remove normal perineal secretions and odor.
 Assessment:
 - irritation, excortiation, inflammation, swelling
 - excessive discharge
 - odor, pain or discomfort
 - urinary or fecal incontinence
 - recent rectal or perineal surgery
 - indwelling catheter
 Determine:
 Perineal-genital hygiene practices
 Self-care abilities
 Equipment
 Bath towel  Wash cloth
 Bath blanket  Cotton balls or swabs
 Clean gloves  Bedpan to receive
 Bath basin with water rinse water
at 43 to 46C (110 to  Moisture-resistant
115F) or bag or receptacle for
 Solution bottle, pitcher used cotton swabs
or container filled with
 Perineal pad.
warm water or a
prescribed solution
 Bedpans-are made of
metal or plastic and come
in two sizes- pedia and
adult)
 Standard bedpan and
fracture pan
 Preparation
 Determine any discomfort in perineal-genital area
 Obtain and prepare the necessary equipment and
supplies.

 Performance:
 1. Explain to the client what you are going to do, why is
it necessary, and how she can cooperate, being
particularly sensitive to any embarrassment felt by the
client.
Draping the patient for perineal-genital
care
2. Wash hands and observe other appropriate infection
 control procedures.
 3. Provide client privacy by drawing the curtains
around the bed or closing the door to the room.
Some agencies provide signs indicating the need for
privacy. Hygiene is a personal matter.
4. Prepare client:
 Fold the top bed linen to the foot of the bed and fold
the gown up to expose the genital area
 Place a bath towel under the client’s hips. The bath
towel prevents the bed from becoming soiled.
 5. Position and drape the client and clean the upper
inner thighs.
6. Position the female in a back-lying position with
the knees flexed and spread well apart.
 Cover the body and legs with the bath blanket.
 Drape the legs by tucking the bottom corners of the
bath blanket under the inner sides of the legs.
 Minimum exposure lessens embarrassment and helps to
provide warmth.
 Bring the middle portion of the base of the blanket up
over the pubic area
 Put on gloves, wash and dry the upper inner
thighs
 Clean the labia majora. Then spread the labia
majora and the labia minora.
 Secretions that tend to collect around the labia
minora facilitate bacterial growth.
 Use separate quarters of the wash-cloth for each
stroke, and wipe for pubis to the rectum.
 For menstruating women and clients with indwelling
catheters, use clean wipes, cotton balls, or gauze.
 Take a clean ball for each stroke. Using separate
quarters of the washcloth or new cotton balls or
gauzes prevents the transmission of microorganisms
from one area to the other.
 Wipe from the area of the least contamination
( pubis) to that of greatest( rectum).
 Rinse the area well. You may place the client on a
bedpan and use a periwash or solution bottle to
pour warm water over the area.
 Dry the perineum thoroughly, paying particular
attention to the folds between the labia.
 Moisture supports the growth of many
microorganism.
 7. Inspect perineal orifices for intactness
 • Inspect particularly around the urethra in clients
with indwelling catheters. A catheter may
cause excoriation around the urethra.
 8. Clean between the buttocks.
 • Assist the client to turn onto the side facing
away from you.
 • Dry the area well.
* For post-delivery or menstruating females, apply a
perineal pad as needed from front to back. This
prevents contamination of the vagina and urethra from
the anal area.
 Evaluation
 Place the client in her best comfortable position.
Place call bell on the readily accessible area and
appreciate the client for her cooperation.
 Dispose used supplies and arrange equipment in
their proper place.
 Documentation
 Document any unusual findings such as redness,
excoriation, skin breakdown, discharge or drainage and
any localized areas of tenderness.
 Report significant deviations from normal to the
physician

 Reference:
 https://www.youtube.com/watch?v=8JdtbrVqg4g
 Infrared Perilamp:
Perilight/ Perilamp
 Perilite/perilamp
 Perilite Exposure
– application of dry heat to perineal area
in order to provide comfort and increase
blood circulation and hasten wound
healing by means of perineal lamp.
- 20-50 centimeters or 18-24 inches away
from the body to be exposed.
 IMPORTANCE
 1. Relief of pain and muscular spasm
 -provides comfort by relief pain
 -it relaxes muscles and capillaries making pain
tolerable
 2. Increases blood circulation
 3. Hastens wound healing following an
episiotomy repair-increases circulation of blood
 -increases supply of oxygen and nutrient
 which promotes wound healing
 4. Reduces edema and soreness
 -it releases dry heat and thus help reduce
 edema and soreness
 -alleviated by relax muscles and
capillaries
 Indication
 • Patients who have undergone rectal or
perineal surgery
 • Post-partum patients with episiotomy
wounds
 • Patients having vaginal inflammation or
bladder spasm
 • Patients with painful or local irritation from
 hemorrhoids
 Contraindication
 • Patients with cardiovascular condition
 • Presence of cyst or malignancy in the area
 • Patients with open wounds with
hemorrhage
 • Patients with burns or fracture at the
lower limbs
 • Heat lamps are contraindicated in pressure
ulcer care
 Heating Lamps
 Used to supply heat to the body parts.
 The distance between the exposed part
and the lamps depend upon the
wattage of the light bulb and heat
tolerance
 Duration of treatment is usually 20-30
mins.
Watt Bulb Distance from the
body part
25 35cm
40 45cm
60 60 to 75cm
 Materials Used:
 1. Perilite or heat lamp
 2. Blanket
 Procedure:
 1. Review physician's order.
 2. Gather equipment and check it for safety
factors i.e. frayed cords, bulb in place.
 3. Bring lamp to patient's room.
 4. Explain procedure to the patient.
 5. Wash hands and render perineal flushing. Dry
perineum thoroughly and remove bedpan.
 6. Place patient in a lithotomy position. Cover
 with blanket.
7. Place heat lamp under the blanket about 18-24
inches from the perineum to avoid burning the
patient.
8. Check for any discomfort, burning reaction or
untoward reaction.
9. Instruct patient not to change position nor touch
lamp during the entire procedure.
10. Remove lamp after 15 minutes or as ordered by the
physician. Check area for untoward reactions.
11. reposition patient for comfort.
12. Return equipment to proper storage area.
13. Chart results of procedure.
 INFRARED LIGHT
 Objectives:
1. Stimulate blood circulation,
2. Promote wound healing,
3. Relieve pain and edema at perineum
 Indication: Women with episiotomy wound
 Procedure:
 1. Explain procedure & rationale of using a
heat lamp.
 2. Instruct women to empty bladder, clean
perineum and apply clean peri-pad.
 3. Place mother in lithotomy or side-lying
position on the bed, with appropriate
drape as needed.
 4. Place infra red lamp 50 cm away from the
perineum.
 5. Routine lamp use: 3-5 minutes/ once a day.
 6. Instruct women to apply a clean peri-pad
after dry heat.
 7. Assess and report to mother about
episiotomy site when treatment is
completed.
 References:
Patricia Bentz, _____Modules for Basic Nursing Skills
https://www.youtube.com/watch?v=8JdtbrVqg4g