A nurse is preparing a discharge plan for a postpartum woman who had a vaginal delivery with a second-degree perineal tear.
The nurse includes instructions on how to care for the perineum at home.
Which statement by the woman indicates that she understands the instructions?
I will change my perineal pad every time I use the bathroom.
I will wipe my perineum from back to front after urinating or defecating
I will apply ice packs on my perineum for the first week after birth
I will avoid sitting or standing for long periods of time
The Correct Answer is A
The correct answer is choice A. The woman should change her perineal pad every time she uses the bathroom to prevent infection and promote healing of the perineal area.
Some possible explanations for the other choices are:
• Choice B is wrong because the woman should wipe her perineum from front to back after urinating or defecating to avoid introducing bacteria from the anus to the vagina or urethra.
• Choice C is wrong because the woman should apply ice packs on her perineum for the first 24 hours after birth, not for the first week.
Ice packs help reduce swelling and pain in the per
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Naxlex Comprehensive Predictor Exams
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Correct Answer is D
Explanation
The correct answer is choice D. I would stop feeding my baby until the pain goes away.This response indicates a need for further teaching because stopping breastfeeding can worsen the uterine cramping and also affect the milk supply and the baby’s nutrition.Uterine cramping or “afterpains” are normal after delivery and are caused by the uterus contracting and shrinking back to its normal size.Breastfeeding can trigger these contractions because it stimulates the release of oxytocin, a hormone that helps the uterus contract.
Choice A is wrong because ibuprofen is a safe and effective pain reliever for postpartum women and can be taken before feeding the baby.Choice B is wrong because massaging the abdomen gently during feeding can help ease the afterpains by stimulating blood flow and relaxing the muscles.Choice C is wrong because relaxation and breathing techniques can also help reduce the pain by lowering stress and tension levels.These are some of the self-help treatments that can be used along with medications to manage postpartum pain.
Correct Answer is D
Explanation
The correct answer is choice D. Massage her fundus.
This is because a boggy and displaced fundus indicates uterine atony, which is the failure of the uterus to contract sufficiently after delivery.
This can lead to excessive bleeding and postpartum hemorrhage.Massaging the fundus can help stimulate uterine contractions and reduce blood loss.
Choice A is wrong because administering oxytocin is not the first action the nurse should take.Oxytocin is a medication that can also help the uterus contract, but it should be given after massaging the fundus and assessing the bleeding.
Choice B is wrong because assisting with ambulation is not appropriate for a client with a boggy and displaced fundus.Ambulation can increase bleeding and cause orthostatic hypotension due to blood loss.
Choice C is wrong because encouraging frequent voiding is not the first action the nurse should take.
A full bladder can displace the uterus and prevent effective contractions, so voiding can help the uterus return to its normal position.However, this should be done after massaging the fundus and assessing the bleeding.
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