A practical nurse is providing morning hygiene for an adult uncircumcised male client who has an indwelling urinary catheter. In what order should the nurse perform the following steps of perineal care? Arrange the actions in the correct sequence.
- 1Don clean gloves and place a waterproof pad beneath the client's buttocks.
- 2Gently retract the client's foreskin to fully expose the urethral meatus.
- 3Cleanse the meatus and glans using a circular motion, moving from the center outward.
- 4Wipe down the catheter tubing for approximately 4 inches, moving away from the meatus.
- 5Wash, rinse, and dry the shaft of the penis and the scrotal sac.
- 6Return the foreskin to its natural anatomical position over the glans penis.
Answer
The correct sequence begins with preparation and exposure, followed by cleansing from the cleanest area (meatus) to dirtier areas (catheter tubing, then scrotum), and concludes with replacing the foreskin to prevent injury.
Performing perineal care with an indwelling catheter relies on strict adherence to the principles of medical asepsis. The nurse must clean from the least contaminated area (the urethral meatus) to the most contaminated areas (the surrounding skin). Proper sequence requires initial preparation, exposure of the meatus, cleansing of the meatus, cleansing down the catheter (wiping away from the body), and then washing the surrounding tissue. Finally, replacing the foreskin is an absolute safety requirement to prevent paraphimosis.
Step-by-Step Solution
Key Concept
Perineal Care and Aseptic Technique