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

Perform hand hygiene and put on gloves.
Explain the procedure to the patient and ask for his assistance in following directions. Provide privacy.
Fill a basin with warm water. Ensure the water is a comfortable temperature.
Raise the bed to a comfortable working height.
Gently clean around the perineal area, including the inner thighs and the scrotum.
Rinse the entire area with a clean washcloth. Pat dry with a bath towel.
If the resident is uncircumcised, retract the foreskin to expose the tip of the penis.
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.
Rinse and dry the penis in the same pattern.
If present, return the foreskin to its original position.
Assist the resident onto his side to expose the buttocks.
Wash the buttocks and the anal area. Rinse and pat dry.
If needed, change the linens and/or place a clean waterproof pad underneath the patient.
Assist the resident into a comfortable position and lower the bed.
Place all used washcloths, towels, and linens into a bag for soiled laundry.
Dispose of the water and clean the washbasin.
Remove gloves and perform hand hygiene.
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

Offering the Bedpan

When a resident is bed-bound, they must use a bedpan to urinate and defecate. This can be embarrassing for the resident, so it should be done with sensitivity to the resident’s privacy and dignity. There are two types of bedpans. A regular bedpan is the deeper and more rounded of the two. A fracture pan has a relatively flat upper end with a trough at the lower end. Fracture pans are used for residents who have difficulty, or restrictions against, moving their hips and/or backs.

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.

Indwelling Catheter Care

Indwelling catheters allow urine to drain from the bladder. They are used when residents are unable to urinate on their own or when the process of cleaning the resident after urination would be difficult for the resident to tolerate (such as during end of life care). Caring for the catheter appropriately is a vital part of preventing infection and skin breakdown.

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.

Performing the Heimlich Maneuver

The Heimlich Maneuver, also known as abdominal thrusts, is used to remove an object that is blocking a resident’s airway and preventing air from reaching the lungs. It only takes four to six minutes for brain damage to occur from lack of oxygen, so prompt action is vital.

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.