A nurse is caring for a male client who has a spinal cord injury.
Which of the following techniques should the nurse use when providing perineal care?
A.
Wash the penis from the scrotum to the tip using a spiral motion.
B.
Use water with no soap to prevent skin irritation.
C.
Don sterile gloves to prevent infection.
D.
Discard the washcloth after cleansing the urethral meatus.
The Correct Answer and Explanation is:
The correct answer is A. Wash the penis from the scrotum to the tip using a spiral motion.
Explanation:
Perineal Care and Spinal Cord Injury:
Perineal care is a crucial aspect of nursing care for clients with spinal cord injuries, as these clients are at increased risk for skin breakdown, urinary tract infections, and other complications due to immobility and loss of sensation. Proper technique is essential to maintain hygiene and prevent infections.
Option A: Wash the penis from the scrotum to the tip using a spiral motion.
This is the recommended technique. Washing from the scrotum to the tip of the penis using a spiral motion helps in cleaning the area thoroughly. The spiral motion is effective in removing secretions and debris from the skin. This method also ensures that the urethral meatus, which can harbor bacteria, is cleaned properly without spreading contaminants. Moving from the scrotum to the tip also aligns with the natural flow of urine and minimizes the risk of pushing bacteria toward the urethra.
Option B: Use water with no soap to prevent skin irritation.
While it is true that soap can sometimes cause skin irritation, especially in sensitive areas, the use of a mild, non-irritating soap is often recommended. The use of water alone may not be sufficient to remove all secretions or bacteria. Therefore, it is typically best to use a mild soap that is appropriate for the client’s skin type and condition, followed by thorough rinsing.
Option C: Don sterile gloves to prevent infection.
For perineal care, clean gloves are usually sufficient, not sterile gloves. Sterile gloves are typically reserved for more invasive procedures where sterility is crucial. Clean gloves are adequate for routine perineal care, as the primary goal is to maintain hygiene and prevent cross-contamination.
Option D: Discard the washcloth after cleansing the urethral meatus.
There is no need to discard the washcloth after cleansing the urethral meatus unless it is visibly soiled or contaminated. Reusing the washcloth for other parts of perineal care is generally acceptable if it is properly rinsed and if clean areas are used for different parts of the body. Discarding the washcloth after each use would be wasteful and unnecessary if proper hygiene practices are followed.
In summary, the correct technique for perineal care involves using a spiral motion from the scrotum to the tip of the penis, ensuring effective cleaning and minimizing the risk of infection and skin irritation.