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Perineal Care of the Male Resident

Written by Hollie Finders, RN
Hollie Finders is a registered nurse with years of experience working in the health care field. She has degrees in both biochemistry and nursing. After working with patients of all ages, Hollie now specializes in pediatric intensive care nursing. Hollie’s LinkedIn

Procedure

Equipment needed: gloves, washbasin, soap, washcloths, bath towel, waterproof pad, and bag for soiled laundry

  1. Perform hand hygiene and put on gloves.
  2. Explain the procedure to the patient and ask for his assistance in following directions. Provide privacy.
  3. Fill a basin with warm water. Ensure the water is a comfortable temperature.
  4. Raise the bed to a comfortable working height.
  5. Gently clean around the perineal area, including the inner thighs and the scrotum.
  6. Rinse the entire area with a clean washcloth. Pat dry with a bath towel.
  7. If the resident is uncircumcised, retract the foreskin to expose the tip of the penis.
  8. Using a circular motion, begin washing at the tip and work down and around the shaft of the penis until you reach the base. Use a clean section of the washcloth for each stroke.
  9. Rinse and dry the penis in the same pattern.
  10. If present, return the foreskin to its original position.
  11. Assist the resident onto his side to expose the buttocks.
  12. Wash the buttocks and the anal area. Rinse and pat dry.
  13. If needed, change the linens and/or place a clean waterproof pad underneath the patient.
  14. Assist the resident into a comfortable position and lower the bed.
  15. Place all used washcloths, towels, and linens into a bag for soiled laundry.
  16. Dispose of the water and clean the washbasin.
  17. Remove gloves and perform hand hygiene.
  18. Document the procedure in the patient’s chart and report any changes in the patient’s condition to the nurse.

Important Information

Perineal care should be performed during a bath, after using the bedpan, and/or after incontinence. Special care should be used when performing perineal care on an uncircumcised male. Failure to retract and wash the area under the foreskin can result in infection. Failure to return the foreskin to its normal position can result in paraphimosis. This condition causes discomfort, swelling, and possible necrosis of the tip of the penis [1].

It is important to be respectful and professional when providing this care. Many patients find this procedure awkward and uncomfortable. If a patient is able to perform this care independently, then allow him to do so and provide him with privacy.

References

1. https://www.ncbi.nlm.nih.gov/pubmed/7755835

More Resources

Putting on Personal Protective Equipment

Personal protective equipment is worn to protect the mouth, nose, eyes, clothing, and skin from unwanted pathogens. In the health care setting, a patient’s condition often prompts the use of personal protective equipment; however, a health care worker is able to wear personal protective equipment whenever he or she deems it is necessary (e.g., during procedures with the potential for excessive contact with bodily fluids).

Removing Personal Protective Equipment

It is important to follow the correct procedure while removing personal protective equipment to avoid contaminating your skin or clothing. The most common source of contamination in this process stems from improper removal of gloves. Gloves are often the most soiled piece of equipment. To avoid contaminating your skin or the other equipment worn, gloves should always be removed first. Then remove the goggles, gown, and mask, in that order.

Performing Ostomy Care

Residents who have had a portion of their intestines removed due to illness or trauma may have a temporary or permanent ostomy, which is an opening in the abdomen that is created for the elimination of urine or feces. The portion of the intestine that is connected to the abdominal wall and is visible is called the stoma. A pouch is placed over the stoma to collect feces.

Dressing and Undressing a Patient

Patients who have suffered a stroke or have weakness or injury to one side of their body may struggle with dressing and undressing. In order to help these patients regain their strength and independence, it is important that the nurse’s aide only assist them as needed. The nurse’s aide may need to teach patients how to dress and undress safely with their limitations.

Orthopneic Position

Patients with respiratory illnesses such as chronic obstructive pulmonary disease (COPD) find ways to help themselves breathe more easily. This can include sleeping with extra pillows to keep them propped up or leaning forward to ease the work of breathing. The orthopneic position is one forward-leaning position used to help patients breathe comfortably when they are having difficulty.

Rectal Temperature with Electronic Thermometer

A rectal temperature provides the most accurate core body temperature reading compared to other non-invasive methods. This makes a rectal temperature desirable; however, this procedure comes with more patient discomfort and more safety risks (bowel perforation, mucosal damage, and/or vagus nerve stimulation) than the other temperature measurement methods.

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