An uncircumcised adult client requires assistance with personal hygiene while on strict bed rest. In what sequence should the practical nurse execute the steps for male perineal care? Arrange the actions from first to last.
- 1Position the client supine and use a bath blanket to drape the body, exposing only the genitalia.
- 2Gently retract the prepuce to fully expose the glans penis.
- 3Cleanse the glans using a circular motion, starting from the urethral meatus and moving outward.
- 4Rinse and dry the glans thoroughly, then immediately pull the prepuce back over the glans.
- 5Wash the shaft of the penis and the scrotum using downward strokes toward the thighs.
Answer
The correct sequence is to first position and drape the client, retract the prepuce, cleanse the glans from the meatus outward, dry the glans and immediately replace the prepuce, and finally wash the shaft and scrotum.
The principles of medical asepsis require cleaning from the least contaminated area to the most contaminated. For an uncircumcised male, the sequence begins with proper positioning and draping to respect dignity. Next, the prepuce (foreskin) is retracted to expose the meatus. The glans is washed from the meatus outward to prevent introducing microorganisms into the urethra. Crucially, the prepuce must be immediately returned to its natural position after drying the glans to prevent paraphimosis (swelling and compromised circulation). Finally, the shaft and scrotum, which are considered more contaminated, are washed.
Step-by-Step Solution
Key Concept
Basic Hygiene and Infection Control: Male Perineal Care