Care of perineum and sexual organs

Before you begin sanitary measures, shut off the patient's bed by a screen. All manipulations with the bedpanbag and the bedpan should be performed in gloves (Pic. 81).

Picture 81.

Give a urinal bag to a patient

The procedure:

1. Lay an oilcloth under the pelvic region.

2. Rinse the bedpan bag with warm water and leave a little bit of water in it.

3. Gently moving your hand under the patient's sacrum, slowly lift the pelvis, the patient's legs should be bent at the knees.

4. Bring a narrow part of the bedpan bag below the sacrum to align the holes of the bedpan with the perineum so that the perineum is over the opening of the urinal.

5. Cover the patient with a blanket.

6. After defecation, perform intimate wash.

7. Remove the bedpan and the oilcloth.

8. Pour the contents of the urinal, it shall be disinfected.

The procedure for giving a urinal bag is similar, but it is placed between the patient's legs and leads to the urethra (penis must be through in the lumen of short tube of urinal bag). For men with incontinence of urine is better to use external catheter and urinary collection bag (Pic. 82)

The equipment: urinal bag, urine container, connecting tube, gloves, wipes, antiseptic solution, oilcloth, cloth.

Manipulations:

1. Ask the patient to lift his pelvis and lay oilcloth and diaper beneath his buttocks.

2. Ask the patient to bend his knees and push them slightly.

3. Wash the patient's genitals.

4. Open the package of urinal bag (its form and type are similar as condom).

5. Grab the penis with your left hand; take the urinal bag for the tough part with your right.

6. Put on a urinal bag on the bellend.

7. Roll out the urine bag and fasten it to the base of the penis.

8. Insert the connector pipe in the bedpan, attach the urinal bag for urine drainage bag.

9. Fix it onto the bed or on the patient's hip.

Picture 82.

Application technique of urinal bag

Modern urinal bags are arranged so that they are invisible to others. They have flat shape, odor-resistant, not rustle and not visible under usual clothing. If necessary, you can attach removable urinal bag on the patient's belt or put it in a large pocket on the inside of the pyjamas (jacket).

Algorithm of intimate washing of patient

The equipment:

Sterile tray, forceps, sterile cotton swabs, oilcloth, vessel, clean diapers, jug (with warm (30-35° c) with a soft solution), squirt filled with warm water or antiseptic (1: 5000 furacillin solutions or a weak solution of potassium permanganate), gloves, apron, oilcloth bag for recycling.

Wash male genitals (pic. 83 а, б)

Picture 83.

Intimate washing of a patient

The procedure:

1. Place the patient on his back, ask him to bend his knees slightly and spread them in the hips.

2. Lay the oilcloth and put a bedpan bag on it, putting it under the patient's buttocks.

3. Wear apron, gloves.

4. Stand up to the right of the patient to take pitcher with soapy water in his left hand, and forceps with a cotton ball in the right.

5. Gently pull the foreskin and expose the bellend.

6. Lush out the perineum and genitals thoroughly by using cotton swabs, soaked in a mug with a soap solution, changing them as soon as they become dirty.

7. Cleansing of patient's skin should be carried out in the following direction: from your vagina to your anus so do not bring the infection from the side of the anus area in the following sequence: bellend, the skin of the penis, perineum, anus area, scrotum.

8. With running water (or disinfectant solution) from Esmarch cup by rinsing in the same sequence.

9. Wipe genital and perineal skin dry with cotton swabs in the same direction as you did rinse.

10. To remove the bedpan bag and oilcloth.

11. Place the patient in a comfortable position.

12. Bedpan and the oilcloth soak it in a solution with disinfectants, cotton swabs in a bag for disposal.

13. Removing the apron and gloves, put them in disinfectant solution.

14. Wash your hands.

Intimate female wash in bed (Pic. 83 в, г, д)

The procedure:

1. Place the patient on her back, ask to slightly bend your knees and spread in the hips.

2. Lay oilcloth and put the bedpan bag on it, previously having enclosed under the patient's buttocks.

3. Wear apron and gloves.

4. Stand up to the right of the patient to take pitcher with soapy water in your left hand, and sponge forceps with a cotton ball in your right.

5. Flush out the perineum and genitals thoroughly by using cotton swabs, soaked in a mug with a soap solution, changing them as they become dirty.

6. Cleansing should be carried out in the following direction: from the external genitalia to the anus, so as not to bring the infection to the anal area in the following sequence:small labia, labia lips, scope of the mons pubis, perineum, and anus area.

7. Splash (or disinfectant solution) water from Esmarch cup by rinsing it in the same sequence.

8. Dry the skin of genital and perineal with the dry cotton swabs in the same direction, as rinsing.

9. To remove the bedpan and oilcloth.

10. Give the patient a comfortable position.

11. The bedpan and the oilcloth soak in a disinfectant solution, throw cotton swabs in a bag for disposal.

12. Removing the apron and gloves, soaked in a disinfectant solution.

13. Wash your hands.

Modern technology offers to use wet wipes, impregnated with anti-bacterial and/or disinfectants. Wipes replace the full treatment: cleanse, moisturize and deodorize the skin, also eliminates the need in water for washing and rinsing.

Proper care of patients can not only speed up the process of its recovery, but also help to avoid possible complications arising in severe illness. Conversely, poor organization of this care which is not followed all doctor's prescriptions and patient's regimen is broken, can slow down recovery process and even worsen his condition.

Properly caring of patients nurse must have not only experience and expertise, but also possessed a certain moral-psychological qualities, because the mood of the patient and his desire to get well play an important role in the recovery process. However, to maintain a good mood and optimism during illness is even more difficult than in ordinary life, so one of the important duties of the nurse is to create a relaxed and friendly atmosphere around the patient in all possible ways. In creation a comfort atmosphere around the patient must participate all his surrounding: Furniture, lighting, bedding, hygiene (cloth, ship, nappies and diapers). In addition, the nurse must monitor a comfortable environment for a patient. Hygienic conditions in which he lives are important for his recovery, the routine of the day that works best in case of disease is also the responsibility of the nurse. Typically, they include the patient's compliance with the recommended feeding diets and nutritional characteristics prescribed by the physician.

Section VI

Дата добавления: 2015-10-29