A nurse is caring for a client who is 4 days postpartum and has a vaginal birth with an episiotomy.

The client reports that her perineal area is sore and asks the nurse what she can do to relieve the discomfort.

Which of the following responses should the nurse make?

The correct answer is choice B. Sexual intercourse may be uncomfortable due to vaginal dryness.According to Mayo Clinic, hormonal changes after pregnancy might leave the vagina dry and tender, especially if the client is breast-feeding.

This can cause pain and discomfort during sex.

The client can use lubricant or try alternative forms of intimacy to ease the discomfort.

Choice A is wrong because sexual intercourse can be resumed after 4 weeks postpartum only if the client feels comfortable and has no complications.The general recommendation is to wait until 6 weeks postpartum or until the provider clears the client for sex.

Choice C is wrong because sexual intercourse should not be avoided until lochia alba stops.

Lochia alba is the last stage of postpartum bleeding that lasts from 10 to 14 days after delivery.The client can resume sex before lochia alba stops if they feel ready and use contraception to prevent pregnancy.

Choice D is wrong because sexual intercourse may not cause uterine bleeding or infection if the client follows proper hygiene and uses protection.The risk of complications is highest during the first two weeks after delivery, but it decreases after that.

The correct answer is choice C.“Take a warm sitz bath.” A sitz bath is a shallow bath that covers the perineum and can help relieve pain and swelling after a vaginal birth with an episiotomy.A sitz bath can also promote healing and prevent infection by keeping the area clean.

Choice A is wrong because applying heat to the perineum can increase inflammation and delay healing.Choice B is wrong because using an ice pack on the perineum is only recommended for the first 24 hours after delivery to reduce swelling.After that, ice can cause tissue damage and slow down blood flow to the area.Choice D is wrong because using a heating pad on the abdomen has no effect on the perineal pain and can also cause burns or overheating.

Normal ranges for postpartum perineal pain vary depending on the type and degree of injury, but generally it should improve within a few weeks.If the pain persists or worsens, or if there are signs of infection such as fever, foul-smelling discharge, or redness, it is important to seek medical attention.