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The nurse is caring for a patient that delivered 6 hours ago. She had a spontaneous vaginal delivery (SVD) with a second degree laceration that was repaired. She pushed for three hours and has swollen perineum and inflamed hemorrhoids. The patient complains of overall perineal discomfort and rates it a 6/10 on the pain scale. Which of the following interventions would the nurse include in the client’s plan of care for pain management? Select all that apply.

A.

Warm compress.

B.

Tucks pads.

C.

Dermaplast spray.

D.

Ibuprofen 600 mg PO.

E.

Encourage the patient to sit in a high Fowler’s position.

Question Solution

Correct Answer : A,B,C,D

Choice A rationale

 

Warm compresses can help to reduce perineal pain and swelling by increasing blood flow to the area, which promotes healing and provides comfort. The warmth can also help to relax the muscles and reduce discomfort.

 

Choice B rationale

 

Tucks pads, which contain witch hazel, are effective in reducing perineal pain and swelling. Witch hazel has anti-inflammatory and astringent properties that help to soothe irritated skin and reduce swelling, providing relief from discomfort.

 

Choice C rationale

 

Dermaplast spray is a topical anesthetic that provides temporary relief from perineal pain. It contains benzocaine, which numbs the area and reduces pain. It also has antiseptic properties that help to prevent infection in the perineal area.

 

Choice D rationale

 

Ibuprofen 600 mg PO is a nonsteroidal anti-inflammatory drug (NSAID) that helps to reduce pain and inflammation. It works by inhibiting the production of prostaglandins, which are chemicals that cause inflammation and pain. Taking ibuprofen can provide significant relief from perineal discomfort.

 

Choice E rationale

 

Encouraging the patient to sit in a high Fowler’s position is not recommended for perineal pain management. This position can increase pressure on the perineum, potentially worsening the pain and discomfort.

 


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Correct Answer is B

Explanation

Choice A rationale

Teaching the parents how to swaddle is important for newborn care, but it is not the priority action immediately after delivery to promote parent-infant bonding. Skin-to-skin contact is more effective in establishing an initial bond.

Choice B rationale

Positioning the infant on the client’s chest for skin-to-skin care is the priority action to promote parent-infant bonding immediately after delivery. Skin-to-skin contact helps regulate the infant’s temperature, heart rate, and breathing, and promotes bonding through physical closeness and sensory interaction.

Choice C rationale

Offering to take the newborn to the nursery so the parents may nap is not the priority action for promoting bonding immediately after delivery. While rest is important, the initial moments after birth are crucial for establishing a bond through direct contact.

Choice D rationale

Assessing the infant under the radiant warmer is important for ensuring the infant’s health, but it is not the priority action for promoting parent-infant bonding immediately after delivery. Skin-to-skin contact should be prioritized unless there are medical concerns that require immediate attention. .

Correct Answer is D

Explanation

Choice A rationale

An increase in lochia is not an indicator of the effectiveness of oxytocin. Lochia is the vaginal discharge after childbirth and its amount can vary.

Choice B rationale

The absence of breast pain is not related to the effectiveness of oxytocin, which is used to prevent postpartum hemorrhage by promoting uterine contractions.

Choice C rationale

An increase in blood pressure is not an expected outcome of oxytocin administration. Oxytocin primarily affects the uterus.

Choice D rationale

A firm fundus to palpation indicates that the uterus is contracting effectively, which is the desired effect of oxytocin administration to prevent postpartum hemorrhage.

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