14.

16: Providing Perineal CareDEFINITIONeansing the patie:tient's external genitalia and surrounding
skin using antiseptic solution.PURPOSES1. To cleanse the perineal skin.

To reduce chances of infection of episiotomy wound.

3, To stimulate circulation.

To reduce body odor and improve self-image.

5, To promote the feeling of wellbeing.EQUIPMENT1. A clean tray containing:

a. Sterile antiseptic lotion-2% dettol or savlon.

b. Sterile normal saline in a bottle.

C. Cheatle forceps.d. Antiseptic or antibiotic medication if ordered.

e. Sterile sanitary pad.

Kidney tray.

Sterile gloves.

h. Mackintosh. Sterile pack or tray containing

a. Artery forceps-1.

b. Dissecting forceps-1.

C. Cotton balls.Sterile towel to wipe hands after surgical scrub.

ed. Gauze pieces.3. Additional itemsBedpan (if procedure is done at bedside).

Jug with warm water.

Receptacle for used perineal pad

d.

e. Face mask.a. Infrared light.

b.Rationale

PROCEDURENursing actionExplain the procedure to patient, the purpose and how she has
to1.COoperate.Accemble articles at the bedside or in the treatment room.
22 Ask the patient to empty her bowel and bladder and wash the perinealarea before coming for
perineal care.4, Screen the bed or close the doors as appropriate.5. a. Assist the patient to assume
dorsal recumbent position with knees

bend and drape the area using diamond draping method.b. For patients confined to bed: Place patient
on bed pan, remove theperineal ped, place in the receptacle and pour warm water over the

perineum.

Nursing action6. Open sterile tray, arrange articles with cheatle forceps and pour

6.antiseptic solution in the sterile gallipot in tray.Adjust the position of the infrared light so that it shines
on the perineum

7.at a distance of 45-50 cm.8. Scrub hands and dry with the sterile towel.Put on sterile gloves.

9Take the cotton swabs with artery forceps, dip in savlon and squeeze

10.excess lotion with dissecting forceps into the kidney tray.11.With the swab clean from urethra
towards anus. Clean the area frommidline outward in the following order until clean and discard the
swab

after each stroke. Strokes are to be in the following order:

a. Separate the vestibule with nondominant hand and clean vestibule

starting from clitoris to fourchette.

b. Inside of labia minora downward, farther side first then nearer sideC. Take off the nondominant
hand.d. Labia majora downward farthest side and then nearer side.

e. Discard the used forceps (if a second one is available).

f. Using the second forceps clean the episiotomy wound from center

outwards and outside of episiotomy both sides.Wipe all traces of antiseptic away with sterile normal
saline swabs in the

12.same manner as described above using thumb forceps.13. Dry the episiotomy with gauze pieces. Do
not use cotton balls for thispurpose.14. Provide perineal light/infra red light for 10 minutes if
indicated.15.Put prescribed medication on a gauze piece and apply to the episiotomy.16. Place sanitary
pad from front to back. Do not shift position of the pad

16.once it is applied.Discard gloves and used items in the kidney tray, wash forceps and trayy

and keep ready for sterilization.17.18.Replace other articles in designated places.19Make the patient
comfortable and Ileave the unit clean.20Record procedure in the patient's chart including details
regarding statusof lochia and condition of episiotomy wound.
SPECIAL CONSIDERATIONS1. Ifa sitz bath is prescribed, give it before perineal care.

2. If patient has urinary catheter, provide catheter care along with perineal care.elves,Studies have
shown that healing takes place effectively even when patients practice perineal hygiene by themselu