PERINEAL CARE EQUIPMENTS NEEDED:

PURPOSES • Disposable gloves

• To remove normal perineal secretions and odors • Pitcher or container with 500 ml water (43-46ºC or
110-155ºF)
• To prevent infections
• Pick up forceps
• To promote client’s comfort
• Cotton balls / swabs
• To promote healing
• Soap / feminine wash / prescribed solution

• Bed pan / urinal

PERINEAL CARE IS GIVEN TO:
• Under pad / perineal pad
• People who are immobilized or ill may have
increased need for perineal care or will need • Linens
assistance with it

• Patients with urinary or bowel incontinence

MATERIALS NEEDED
• Patient that has an indwelling catheter

• Patients who have undergone rectal or genital

surgery

• Those who have undergone childbirth

Principles to be observed in performing Perineal

Care:

• Observe infection control throughout the

procedure for the patient’s protection as well as
the nurse

• The procedure is embarrassing for the patient and • Lochia

also for the nurse. Maintain a straightforward
• The uterine discharge of blood, mucus, and
attitude and respect patient’s privacy.
tissue after childbirth

• It contains decidual tissues, including

ASSESSMENT FOCUS: erythrocytes, epithelial cells and bacteria

• Presence of irritation, excoriation, inflammation, • Lochia is assessed according to:

swelling, excessive discharges, odor, pain,
– Amount
discomfort
– Color
• Presence of urinary or fecal incontinence
– Odor
• Recent rectal or perineal surgery
– Change with activity and time
• Presence of indwelling catheter

• Perineal / genital hygiene practices

• Self care abilities

 Characteristics Lochia Rubra Lochia Serosa Lochia Alba
Duration 3 days after delivery 4-10 days after 10-17 days after
delivery delivery,
Minimal discharge at
day 14
Amount Small to moderate Lighter in amount Lighter in amount
than Lochia Rubra than Lochia Serosa
Color Bright red color Water pink or brown Whitish yellow
tinge creamy discharge
Consistency Decidual tissue and Serous fluid, Mixture of
bloody content leukocytes, leukocytes, decidual
erythrocytes and tissue and
decidual tissue decreasing fluid
content

Other characteristics:

• Odor – menstrual like musky or fleshy smell.

Lochia Serosa has the strongest odor, which
increases if mixed with perspiration.
 STEPS IN PERINEAL CARE
I. Assessment
a. Identifies the patient chart correctly.
b. Determines the patient diagnosis,
current condition medication &
treatment.
c. Checks out for specific instructions.
II. Planning
a. Checks patient’s readiness/ Explain
procedure to patient.
b. Gathers the materials needed and
arranges conveniently at bedside
c. Provides privacy
d. Washes hands
III. Implementation
Performs the actual procedure
a. Loosen the top sheet
b. Places the underpad under patient’s buttocks
c. Removes underwear and / or perineal pad.
d. Places client in a dorsal recumbent position/
supine
e. Offers urinal or place patient on bedpan keeping
him drape at all times.
f. Allows the patient to void, then empties bedpan/
urinals content
g. Drapes the patient (diagonal technique) exposing
only the perineal area.
h. Puts on the clean gloves.
Cleanses the Perineal Area : For FEMALE
a. Separates the labia with one hand and pours warm
water gently over vulva.
b. Open labia majora Using the forceps with wet
cotton balls soaked with perineal solution., cleanse
one side using gentle downward strokes.(Rule of 7)
c. Cleanse the other side and middle of the vulva
using fresh cotton balls for each stroke.
d. Rinse thoroughly ( using the Rule of 7 )
e. Removes and discard contents of bedpan
f. Position patient to supine
Cleanses the Perineal Area : For Male
a. Hold the shaft of the penis with one hand and
bathe with the other beginning at the tip and working
in a circular motion from the center to the periphery
b. Soaps and washes the body of the penis using
downward strokes towards the scrotum
c. Rinses thoroughly
d. Removes and discard contents of the bedpan
e. Position the patient to supine
AFTER CARE PROCEDURE
a. Changes/replaces the bed linens and make patient
comfortable
b. Washes all used equipment and dry
c. Discards properly all disposable supplies
used
d. Returns the equipments in its designated place
DOCUMENTATION
a. Record the kind of procedure done
b. Records pertinent observation like description of
perineal skin & any odor or discharge noted. And
patients response to the procedure.