Nursing & Healthcare Programs

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

Supine Position

Supine position is a natural and comfortable position for most people. For this reason, it is a highly utilized position for nursing procedures. Unfortunately, this position puts pressure on many bony prominences that can lead to discomfort and/or pressure ulcers if the pressure is not relieved every so often (typically every two hours or less).

Passive Range of Motion Exercises

Range of motion exercises are used to help prevent or decrease contractures, improve flexibility of joints, and improve strength [1]. Bedridden patients as well as those with reduced mobility may greatly benefit from passive range of motion exercises. However, do not perform these exercises without an order to do so, as it may be contraindicated in certain situations.

Logrolling the Resident

Logrolling is a technique used to roll a resident onto their side without the resident helping, and while keeping the resident’s spine in a straight line. This is especially important for residents who have had spinal surgery or injury.

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.

Measuring Blood Pressure

Many factors can interfere with obtaining an accurate blood pressure. The most common mistakes that lead to inaccurate blood pressures are a result of improper technique, including: not supporting the patient’s arm, using the wrong sized cuff, positioning the cuff too low on the patient’s arm, improper positioning of the cuff’s artery marker, and attempting to measure blood pressure through clothing.

Tympanic Membrane Temperature with Electronic Thermometer

A tympanic membrane thermometer uses an infrared sensor to measure the temperature of the tympanic membrane (ear drum). This type of thermometer is considered an accurate and reliable predictor of a patient’s core temperature because the tympanic membrane’s blood supply is sourced from the carotid artery, which is the same artery that carries blood to the hypothalamus in the brain.