A nurse is reinforcing teaching about perineal care to a client who is 2 hours postpartum and has an episiotomy and hemorrhoids. Which of the following statements by the client indicates understanding of the teaching?
"I will remain in the sitz bath for 10 minutes.”.
"I will use the numbing spray prior to cleansing the area.”.
"I will place a heat pack to the area several times a day.”.
"I will apply witch hazel pads after urination.”. .
The Correct Answer is D
Choice A rationale
Remaining in the sitz bath for only 10 minutes might not provide enough relief for a postpartum client with an episiotomy and hemorrhoids. Extended periods in a sitz bath can help reduce pain and promote healing.
Choice B rationale
Using numbing spray before cleansing is helpful for pain management, but it is not as beneficial as other methods for reducing inflammation and promoting healing.
Choice C rationale
Placing a heat pack to the area several times a day can help with pain but might not be as effective as other options in reducing swelling and promoting healing of hemorrhoids and episiotomy sites.
Choice D rationale
Applying witch hazel pads after urination helps reduce swelling, provides soothing relief, and promotes healing for both hemorrhoids and episiotomy sites. Witch hazel has natural astringent properties that are beneficial for postpartum perineal care.
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Correct Answer is A
Explanation
Choice A rationale
Positioning the newborn's car seat at a 45° angle helps to maintain an open airway and reduces the risk of the baby's head falling forward, which can obstruct breathing.
Choice B rationale
Placing the car seat in a forward-facing position is incorrect for a newborn. Newborns and infants should always be placed in a rear-facing car seat to protect their head, neck, and spine in the event of a crash.
Choice C rationale
Placing a rolled blanket behind the newborn's neck is not recommended as it can alter the position of the head and neck, potentially compromising the airway. Proper positioning is crucial to ensure safety and comfort.
Choice D rationale
The retainer clip should be positioned at the level of the newborn's armpits, not the umbilicus. Proper placement of the retainer clip ensures that the harness is secure and reduces the risk of injury in a collision.
Correct Answer is A
Explanation
Choice A rationale
"You will be tested again for GBS at about 36 weeks of gestation.”. This is correct because retesting for GBS at 35-37 weeks of gestation is standard practice to identify colonization status before delivery, which helps in planning intrapartum antibiotic prophylaxis.
Choice B rationale
"If you test positive for GBS, the provider will need to perform a cesarean birth.”. This is incorrect because GBS colonization is not an indication for cesarean delivery. The primary intervention is antibiotic administration during labor to prevent neonatal infection.
Choice C rationale
"You will take an antibiotic during the last 2 weeks of pregnancy to avoid transferring GBS to your baby.”. This is incorrect because antibiotics are given intrapartum (during labor) to prevent GBS transmission, not during the last weeks of pregnancy.
Choice D rationale
"This infection can cause your baby to experience hearing loss at birth.”. This is incorrect because GBS infection primarily causes sepsis, pneumonia, and meningitis in neonates, not hearing loss.