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

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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.

Sim’s Position

The position a patient is placed in is often ordered by the physician, or recommended by a speech, occupational, or physical therapist. The position dictates whether a patient is sitting, lying, standing; or if they are on their side, back, or prone (face-down). Positioning is also determined by the patient’s current needs, such as: Are they eating? Sleeping? Having surgery on their back? Are they receiving nutrition through a nasogastric tube?

Assisting the Resident to Transfer from the Bed to a Chair or Wheelchair

It is important to remember on which side to place the chair when assisting a patient in transferring. Putting the chair on the resident’s unaffected side allows the resident to lead with his or her strong extremity. This eases the procedure for the resident and reduces the risk of falling.

Axillary Temperature with Electronic Thermometer

Compared to other temperature measurement methods, the axillary measurement is considered the least reliable. An axillary temperature measurement typically reads 0.5 to 1 degree Fahrenheit lower than an oral temperature reading [1]. For this reason, it is recommended to use this method only when other methods are contraindicated or when taking an axillary temperature is the safest method for the patient.

Measuring and Recording Output from a Urinary Drainage Bag

Accurate measurement of urination (aka, the output portion of intake and output) allows medical personnel to assess kidney and bladder function. Changes in output quantity or quality can reflect health status changes including new-onset infection or renal injury.

Transferring the Resident from a Bed with a Mechanical Lift

A mechanical lift is used to transfer residents who cannot support their own weight. When used properly, mechanical lifts prevent injuries for both residents and health care workers. It is important that a nurse’s assistant be trained to use the mechanical lift before attempting to operate it. Most facilities require at least two health care workers to assist when using a mechanical lift.