After teaching a client with perineal excoriation caused by diarrhea from acute gastroenteritis, a nurse assesses the client's understanding. Which statement by the client indicates a need for additional teaching?
a. "I'll rinse my rectal area with warm water after each stool and apply zinc oxide ointment."
b. "I will clean my rectal area thoroughly with toilet paper after each stool and then apply aloe vera gel."
c. "I must take a sitz bath three times a day and then pat my rectal area gently but thoroughly to make sure I am dry."
d. "I shall clean my rectal area with a soft cotton washcloth and then apply vitamin A and D ointment."
ANS: B
Toilet paper can irritate the sensitive perineal skin, so warm water rinses or soft cotton washcloths should be used instead. Although aloe vera may facilitate healing of superficial abrasions, it is not an effective skin barrier for diarrhea. Skin barriers such as zinc oxide and vitamin A and D ointment help protect the rectal area from the excoriating effects of liquid stools. Patting the skin is recommended instead of rubbing the skin dry.
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