LESSON PLAN

Subject : Obstetrics and gynaecological nursing

Topic : perineal care
Group : A.N.M 2nd year
Size : 40
Time : 11 pm to 12pm
Duration : 45 min
Date of presentation : 18.12.2023
Venue : A.N.M 2ND year classroom
Name of supervisor :
Name of teacher : Ms. Shweta yadav
Method of teaching : Lecture cum discussion
A.V. Aids : Powerpoint Presentation , black board .
Previous knowledge : Students has some knowledge about the perineal care
GENERAL OBJECTIVES
After the completion of the class students will be able to understand about the perineal care and will develope positive knowledge ,skill regarding perineal
care .

SPECIFIC OBJECTIVES
At the end of the students will able to introduce about the topic to other students-
 Introduction about perineal care
 Define the perineal care
 Enumerate the purposes of perineal care
 Lists out the indications of perineal care
 Discuss the general instructions about the procedure
 Discuss about preliminary assessment
 Explains the articles
 Explain the preparations of the patients
 Explain the procedure
 Discuss the recording & reporting.
S.No Time Specific Content Teaching A.V. Aids Evaluation
Objective Learning
Activity

1 30 sec Self Introduction

My self shweta yadav.student of M.sc Nursing 2nd year .

2 30 sec Introduction Ask about

Perineal injury is the most common maternal morbidity associated with what is
vaginal birth anal sphincter injury is a major complications that can perineal care?
significantly affects women’s quality of life .
Perineal hygiene involves cleaning external genitalia and surrounding area .
the perineal area is conductive to growth of pathogenic organisms because
so the pathogenic organisms enter into body many orifice in situated in this
area .it is less ventilated ,since delivery is the physical strengthen ,efforts
done by the mother during their delivery period and suffer from birth canal
injuries ,episiotomy incision ,perineal tear laceration may be occur so staff
nurses provided perineal care to the patient in the hospital at least minimum
twice a day and try to recover the patient in early healing .

3 3 min Definition- . Lecture cum Flash cards what is

 Perineal care is an anteseptic irrigation of the vulva and perineum discussion perineal
after voiding or defecation in specified period following delivery or care ?
an operation of birth canal ,perineum ,urinary meats or anus .
 Cleansing the area between the anus and vulva in female,or the anus
and scrotum in male ,promotes comfort and prevents odur kin
excoriation ,and infection usually fiven along with a complete bed
bath ,but may have to do more often (e.g. incontinent of urine or
feces)
 Perineal care is the term applied to the external irrigations or
cleansing of the vulva and perineum region as a means of prevent
infection ,promote healing of the stitched perineum and making the
 patient comfortable
 Cleansing procedure prescribed for the genital and anal areas as part
of the daily bath of after various obstetrical and gynaecological
procedures.
4 2 min PURPOSE- Lecture cum Power point What are the
Enumerate the 1. To clean the skin and mucous membrane of the vulva and perineum discussion presentation purposes of
purposes of 2. To climate the bacterial growth by applications of antiseptic solution perineal care
perineal care 3. To increase the healing of perineal tissues ?
4. To relieve itching pain,,discomfort of the perineal area
5. To prevent the infection into the genital area
6. To minimize pain, tenderness and edema due to operational trauma
after episiotomy
7. To observe the colour ,nature and characterstics of lochia

5 3 min Listout the Indications of perineal care - Lecture cum Power point What are rhe
indications of 1. Postpartum patients especially with stitches in the discussion presentation indications of
perineal care perineum perineal
2. Persons with surgery of the gastrointestinal tract care ?
3. Patients with lesion’s ulcer or surgery of the perinea
area or rectum .
4. Patients having excessive vaginal discharge
5. Patients with incontinence of urine and stool
6. Patients should not be perform the perineal care by
herself .
6 3 min Describe the General instructions – Lecture cum PPT What is the
general  maintain strict aseptic technique during the procedure discussion time for
instructions  provide privacy to the mother episiotomy?
about the  observe the colour ,nature and characterstics of lochia.
procedure  don’t touch inner area of the sterile tray
 use the swab for each stock upward to downward
 if the gloves is soil before procedure change it
 to observe the patient for discomfort during procedure
 discard all the swabs and pad in the paper bag or dustbin
 used mild antiseptic solution or plain warm water for perineal care

7 2 min Discuss the Preliminary assessment – Lecture cum PPT What are the
general discussion nursing
 instructions  identify he patient diagnosis
about the  check the doctor' during 1st
procedure Preperations of the mother – stage of
 Provide privacy ,adequate lightning labour?
 Explain the procedure to the patient
 Empty the bladder if needed .
 Encourage the mother to bear down .
8. 5 min List out the Articles Lecture cum PPT What are the
articles needed A sterile tray containing- discussion needed
for episiotomy  Episiotomy scissor articles for
 Sponge holding forceps episiotomy ?
 Bowl with antiseptic solution
 Sims speculum
 Needle holder
 Toothed thumb forceps
 Straight scissor
 Gauze pad
 Suture material
 Syringe with inj . xylocaine 2%
 Kidney tray
9. 8 min Explain the Procedure of episiotomy – Lecture cum PPT What is the
procedure of  Prefer the site of infiltrations ,insert and direct needle beneath the discussion procedure for
the episiotomy skin at the angle of approximately 45degree for about 4-5 cm in the episiotomy?
and after care same line for a medio lateeral episiotomy .
 Withdraw the pistin of the syringe to ensure needle has not entered
the blood vessels
 In filtrate the perineum continuously as the needle is slowly
withdrawn
 Place two finger in the vagina between the presenting part and the
vaginal wall pointing downward
 Give a episiotomy (a single delibrate cut ) during the peak of uterine
contraction when there is good uterine contraction
 Give perineal support with right hand and urethral support with left
and expert pressure over the occiput
 Apply pressure with gauze pad in the episiotomy between
contractions with a sterile gauze pad ifthere is delay in delivery.
 After delivery of baby ,clean the perineum with antiseptic solution
and drape with central hole towel .
  Inspect for any laceration ,paraurethral tear ,cervical laceration .
 Infilterate with inj .xylocaine 2% in perineum .
 Place the needle in the catgut in the tip of the needle holder and the
needle holder correctly .
 Suturing is done by vaginal epithelium ,muscle and skin layer by
continous suturing .
 After suturing perineum and perineum and rectum is examined for
any abnormalities .
After care –
 Place the sterile pad in genital area
 Position the mother in the position with cross legs
 Clean and replace all the articles and instruments
 Record the time and types of episiotomy
 Check for any bleeding or hematoma.

10. 3 min Summary

in this class we have discussed about definition of
episiotomy,purposes,indications,principles,timings,articles needed ,types
and procedure with after care .

11. 4 min. Conclusion

the students are able to learn about episiotomy ,types and procedure in
detail and they will implement in their practical activities in all clinical
settings .
12 1 min

Bibliography-

 Manual of nursing have discussed and practice ,second

edition ,published by wolters kulwer pvt .ltd , new
delhi ,page no 847 to 853.
 D.C.DUTTA text book of obestrical nursing 7th edition
page no . 647-649