Obtain consent, ensure privacy, and have a chaperone present per agency policy before beginning the examination.
Inspect the perineal and genital skin systematically, including the skin folds and the sacrococcygeal and buttock areas, under good light.
Distinguish incontinence-associated dermatitis — diffuse erythema and denudation in a moisture pattern, often with satellite lesions — from a pressure injury localized over a bony prominence with a defined depth.
Assess any wound for location, size, depth, tissue type, and exudate, and stage per the Wounds module.
Inspect the meatus and the catheter or device securement site for erythema, breakdown, and trauma.
Assess specifically for the signs of a necrotizing infection — disproportionate pain, discoloration, crepitus, and systemic toxicity — and escalate immediately if present.
Evaluate moisture sources and the barrier and containment plan and their effectiveness.
For signs of a necrotizing infection, escalate rather than continuing the exam.
