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 B
Explanation
Choice A rationale
1/2 cup (4 oz) orange juice provides about 55 micrograms of folate. While it is a good source of vitamin C and other nutrients, it does not contain as much folate compared to leafy greens.
Choice B rationale
1 cup cooked spinach contains approximately 263 micrograms of folate, making it one of the richest sources of this essential vitamin. Folate is crucial for DNA synthesis and cell division, especially during pregnancy.
Choice C rationale
1 large egg contains about 24 micrograms of folate. Although eggs offer several nutrients like protein and vitamins, their folate content is relatively low compared to green vegetables.
Choice D rationale
1 cup pasta has around 102 micrograms of folate, assuming it is enriched pasta. While it contributes to daily folate intake, it does not compare to the high levels found in spinach.
Correct Answer is A
Explanation
Choice A rationale
Fundus located to the right of the umbilicus requires intervention. This can indicate a full bladder, which can inhibit uterine contraction and increase the risk of postpartum hemorrhage.
Choice B rationale
A temperature of 37.8° C (100° F) is a common finding postpartum and usually does not require intervention unless it is accompanied by other signs of infection.
Choice C rationale
Deep tendon reflexes 2+ is a normal finding and does not require intervention. It indicates normal neuromuscular function.
Choice D rationale
A moderate amount of lochia rubra is expected postpartum and does not require intervention unless it is excessive or associated with other abnormal symptoms.