Perineal Care for a Male Client (Nursing)

by Samantha Rhea, MSN, RN

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    00:00 Now, let's take a look at perineal care for a male. So at this point we've already explained the procedure, donned our gloves, performed hand hygiene, and we've provided privacy for our patient. So when we start cleansing, we're going to hold the shaft of the penis with one hand. Now, it's important to gently cleanse the head of the penis beginning from the tip and working in a circular motion towards the center outwards. Now this is really important here because if your patient is uncircumcised, we really want to make sure we gently retract the foreskin to clean and then replace the foreskin. So this is really important because a lot of times if a patient's uncircumcised there can be some really bad skin breakdown in this area, so we want to pay close attention if this care is needed. Also one other important note if the patient is not circumcised, then we need to make sure that we fold that skin back so we can make sure for comfort for our patient and circulation. Now when we're cleaning, make sure you use a clean portion with each stroke when we're cleaning the head of the penis to make sure it's thoroughly clean, pat the area dry if needed. And again make sure you're using a new cloth or a clean portion of the cloth to clean the shaft of the penis, the top and sides of the scrotum as well. Now, we want to use a new cloth for a new portion and we want to clean the bottom of the scrotum and anal area moving from front to back, and pat the area dry if needed. And again, if we're using a cleansing cloth, usually this is really okay that you let it air dry, but if you're using a towel or a washcloth with mild soap and water make sure you pat the area dry. And again, if there are lots of incontinent episodes, stool or feces, make sure you apply barrier cream to protect the skin. Now at this point, we've completed our perineal care. Now it's important now to make sure we reposition the client for comfort and when we were doing the care, more than likely the blankets or the gowns were soiled so let's make sure we remove those and replace them with fresh linens. Now before we leave the room, make sure for safety you always return the bed to the lowest position.

    02:24 Now we have soiled articles such as those cleansing cloth and we really want to make sure we get those out of the room and dispose of those properly. Now, we want to remove our gloves and make sure we perform hand hygiene thoroughly and document our procedure.

    02:39 Now, let's take a look at perineal care for the male client. So as soon as I've entered my room, I've done my hand hygiene and I've don my gloves. So before I start, obviously I've explained the procedure thoroughly to our patient and assisted them in a comfortable position. So one thing I want you to know as you notice before we get started and cleanse the peri area, we try our best to provide patient privacy. So, I've just used a bath blanket or like a towel here for example. The other great thing about this as you can imagine hospital rooms are cold, it's chilly in there, this is also going to help prevent shivering for your client as well when you're doing care for your patient. So, before we get started as well, let me show you what I have on my table too. So, these are bath wipes and these are great. So most of your facilities are going to have these. These are just really gentle cleansing cloth and they've got a little bit of a mild cleanser in them. So the nice thing when you use these, these usually just evaporate and dry very quickly. So these are great for like incontinent urinary episodes for example and maybe even a small bowel episode. So, sometimes though you may have a larger incontinent episode and it's really more pertinent to use maybe a bath basin, some lukewarm or warm water for your client, and also some towels and washcloths as well. Okay, so let's go ahead and get started and for this demonstration I'm going to use the cloth itself. Okay, so now I've got my patient in a comfortable position. So now I'm going to go ahead and expose my client so I can clean, and you notice I want to try to keep as much of them covered as possible, and again to help prevent chilling and to keep them comfortable and provide privacy. So now I'm going to use my cloth. Now there are multiple cloths in this pack, and I just want to show you these briefly. These are really nice, they're pretty heavy duty. You can kind of tell there are some wet and some cleanser on there and we just want to make sure every time we clean we're going to clean with a clean portion of the cloth. Okay, so now once we get started, I'm going to hold the shaft of the penis and then I'm going to take my cloth and go from the top and go down and clean out in a circular motion. So one thing I want you to know is once I've done that, I'm going to make sure I use a clean portion of the cloth. So I'm just going to reverse that and use a clean portion. I'm going to do this again and do another stroke with also a clean portion of the cloth so I can dispose of that one. I'm going to gather another cloth then I'm going to make sure I clean the shaft of the penis as well and the underneath side, and toss that cloth. And I'm going to grab another cloth, we're going to clean the top of the scrotal area and also underneath. So it's really important to make sure that we clean our client appropriately because incontinent episodes can reach many parts of their skin and we want to ensure there's no skin breakdown, so clean skin is really important. Okay, so let's talk about one little thing before we go. Now, you may have a patient that is an uncircumcised patient. So, this unfortunately is really an area of skin on the patient that can be neglected. So if that's the case and you have a patient that's uncircumcised, you want to make sure that you retract the skin back, take your cleansing cloth and clean around that area and making sure we're using clean portions to clean around that area. Now, it's really important as well because we don't want excess moisture to build up here, we may want to take a dry cloth and just pat dry gently.

    06:51 Now be careful to make sure you return the client's foreskin back down over the tip of the penis.

    06:59 Now, if we do not do this, this can cause really, really, intense discomfort and some circulation issues for your client, so please make sure that you remember to clean under the foreskin and return the foreskin back over the tip of the penis for your client.

    07:16 Now that we finish cleansing, I wanna make sure I provide privacy for my client.

    07:21 Now with the cleansing cloth again these really evaporate very quickly, but if you are using maybe a basin with mild soap and water, make sure you pat dry that skin.

    07:33 That way there's no excessive moisture that stay on the skin and promote skin breakdown.

    07:38 So now that we've finished out perennial care for a male, now I can make sure I position my patient back to their comfortable position, the bed in the lowest position for safety before I leave the room, remove my gloves, and perform hand hygiene.

    About the Lecture

    The lecture Perineal Care for a Male Client (Nursing) by Samantha Rhea, MSN, RN is from the course Perineal Care (Nursing).

    Included Quiz Questions

    1. For an uncircumcised client, retract the foreskin to clean.
    2. For an uncircumcised client, gently clean the top of the foreskin.
    3. For all clients, hold the glans of the penis to clean.
    4. For all clients, don't hold the penis; clean the glans with one hand.
    1. Use separate cloths for the head and shaft of the penis.
    2. Wipe the head of the penis in a circular motion outward to the center.
    3. Clean the scrotum and anus from back to front.
    4. Leave the area wet to keep it moist.
    1. Put the foreskin back into its original position.
    2. Leave the foreskin in the retracted position.
    3. Encourage the client to void.
    4. Ensure the client is in low Fowler's position.
    1. Position the bed in the lowest position
    2. Remove gloves
    3. Perform hand hygiene
    4. Position the bed in the highest position
    5. Leave the client's penis in a urinal

    Author of lecture Perineal Care for a Male Client (Nursing)

     Samantha Rhea, MSN, RN

    Samantha Rhea, MSN, RN

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