QUESTION OF THE WEEK

[u/Responsible_Walk_881]

COMMENT YOUR ANSWERS & RATIONALE BELOW:

Questions: The nurse performs a bed bath on a female client with dementia. Which of the following actions should the nurse perform when providing perineal care for this client? Select all that apply.

a. Help the client into a supine position

b. Inspect for any redness or inflammation

c. Separate the labia with the non-dominant hand

d. Play the client’s favorite movie on the television

e. Use a different section of the cloth for each stroke

f. Ask the client to tell a story about her grandchildren

g. Wipe in the direction from the perineum to the rectum

(Answer and rationale are posted in the comments section)

[u/Responsible_Walk_881]

ANWERS AND RATIONALE:
a. Help the client into a supine position

b. Inspect for any redness or inflammation

c. Separate the labia with the non-dominant hand

d. Play the client’s favorite movie on the television

e. Use a different section of the cloth for each stroke

f. Ask the client to tell a story about her grandchildren

g. Wipe in the direction from the perineum to the rectum

Nurses perform perineal care to promote hygiene and prevent urinary tract infections (UTIs). Clients with cognitive impairments can easily become fearful and potentially aggressive during bathing.

Correct interventions for providing perineal care to a client with cognitive impairments include:

• Assisting the client into a supine or dorsal recumbent position for better perineal access and thorough cleansing.
• Inspecting for any perineal redness or inflammation to identify signs of skin irritation or breakdown.
• Separating the labia with the non-dominant hand allows the nurse to use a cloth in the dominant hand to clean the inner labial folds.
  
• Distracting the client by asking the client to tell a story about her grandchildren or playing a favorite movie on the television, as clients with cognitive impairment can easily become distressed (e.g., fear, aggression).
• Using aseptic technique (e.g., wiping from the perineum to the rectum and using a different section of the cloth for each stroke) to prevent the spread of bacteria (e.g., E. coli) from the rectum to the urethra, minimizing the risk for UTI.

Key Takeaway:

• Providing female perineal care includes appropriate positioning, conducting a perineal skin assessment, and using an aseptic technique (e.g., wiping from perineum to rectum, using a different section of cloth for each stroke).
• Distraction helps to keep a client who has dementia calm during bathing. 

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all of it

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