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The nurse is providing education to a client that is 3 hours postpartum after a vaginal delivery with a second-degree laceration. Which of the following actions should the nurse include in the perineal care teaching? (Select all that apply.)

A.

Wash your hands before and after perineal care or voiding.

B.

Leave your current pad on until it is fully saturated.

C.

Wipe the perineum thoroughly with a back-and-forth motion.

D.

Use a perineal squeeze bottle to cleanse the perineum.

E.

Apply ice or cold packs to the perineum.

Question Solution

Correct Answer : A,D,E

Choice A rationale

 

Washing hands before and after perineal care or voiding is essential to prevent infection. Proper hand hygiene reduces the risk of introducing bacteria to the perineal area, which is particularly vulnerable to infection postpartum.

 

Choice B rationale

 

Leaving the current pad on until it is fully saturated is not recommended. Changing pads frequently helps to maintain cleanliness and reduce the risk of infection. A saturated pad can harbor bacteria and increase the risk of infection.

 

Choice C rationale

 

Wiping the perineum thoroughly with a back-and-forth motion is not recommended. Instead, the perineum should be wiped from front to back to prevent the spread of bacteria from the rectal area to the perineal area, reducing the risk of infection.

 

Choice D rationale

 

Using a perineal squeeze bottle to cleanse the perineum is recommended. It helps to gently clean the area without causing irritation or discomfort. The warm water can also provide soothing relief to the perineal area.

 

Choice E rationale

 

Applying ice or cold packs to the perineum can help to reduce swelling and provide pain relief. The cold temperature constricts blood vessels, reducing inflammation and numbing the area to alleviate discomfort.

 


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Correct Answer is C

Explanation

Choice A rationale

Lack of appetite is not typically associated with the taking-in phase of maternal postpartum adjustment. During this phase, the mother is more focused on her own needs, such as rest and recovery from childbirth.

Choice B rationale

Eagerness to learn newborn care skills is more characteristic of the taking-hold phase, which follows the taking-in phase. In the taking-in phase, the mother is more passive and dependent, focusing on her own needs.

Choice C rationale

Discussion of the birth experience is a common behavior during the taking-in phase. The mother often wants to talk about her labor and delivery experience as a way to process and integrate the event.

Choice D rationale

Reconnection with her partner is not a primary focus during the taking-in phase. The mother is more focused on her own recovery and the immediate needs of her newborn.

Correct Answer is D

Explanation

Choice A rationale

Changing the dressing on a cesarean incision for a patient who is 1 day post-op requires sterile technique and assessment skills, which are beyond the scope of practice for assistive personnel (AP). This task should be performed by a licensed nurse.

Choice B rationale

Documenting the lochia amount on the perineal pad of a client who just transferred from labor and delivery involves assessment and documentation, which are nursing responsibilities. This task should not be delegated to AP.

Choice C rationale

Assessing an area of redness on the breast of a client who is 4 days postpartum requires clinical judgment and assessment skills, which are within the scope of practice for a licensed nurse. This task should not be delegated to AP.

Choice D rationale

Providing a sitz bath to a client who has a third-degree laceration and is 2 days postpartum is an appropriate task for AP. It is a comfort measure that does not require clinical judgment or assessment skills, making it suitable for delegation to AP.

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