A nurse is caring for a client who is at 20 weeks of gestation and has trichomoniasis.
Which of the following findings should the nurse expect?

Rationale:

A. Administering methylergonovine is not appropriate for a fourth-degree perineal laceration.

Methylergonovine is typically used to prevent or treat postpartum hemorrhage by promoting uterine contractions.

B. Applying povidone-iodine to the client's perineum is not indicated for the management of a perineal laceration. Povidone-iodine is an antiseptic solution used for wound cleansing, but it may be too harsh for the perineal area.

C. Providing the client with a cool sitz bath is appropriate for managing discomfort and promoting healing after a fourth-degree perineal laceration. A sitz bath helps to soothe the perineal area and reduces inflammation.

D. Applying a moist, warm compress to the perineum is not recommended for a fourth-degree perineal laceration, as it may increase the risk of infection and discomfort.

Rationale:

A. When teaching parents about the Plastibell circumcision technique, it's important to explain that a yellow exudate (sometimes referred to as granulation tissue) will typically form at the surgical site within 24 hours after the procedure. This is a normal part of the healing process and should not be a cause for concern.

B. The end of the penis will likely get red, then develop a yellow discharge, and finally scab over, “like a skinned knee.” This is the normal healing process and will progress over the 7-14 days that the Plastibell Ring stays on. The correct size Plastibell Ring is secured with a string and the excess skin trimmed. The skin that overlaps the ring will turn dark “like the umbilical cord” before the ring falls off at 7-14 days.

C. The Plastibell is typically left in place for several days, not removed 4 hours after the procedure.

D. Ensuring the newborn's diaper is snug may help keep the Plastibell in place, but it is not the most crucial aspect of care related to the circumcision technique.