The practical nurse is caring for a preschooler with spina bifida who was admitted with a febrile urinary tract infection.
Which action should the practical nurse prioritize to minimize complications of vesicoureteral reflux?

Choice A rationale

Applying a cold pack to the perineum after a vaginal delivery effectively reduces localized edema and inflammation. Cold therapy causes vasoconstriction, which decreases blood flow to the area, thereby minimizing fluid extravasation into the interstitial spaces and reducing swelling of the episiotomy site.

Choice B rationale

While cold packs do provide a degree of comfort by numbing nerve endings and reducing pain signals, their primary physiological benefit in the postpartum period is the reduction of swelling and inflammation, which indirectly contributes to comfort. Comfort is a secondary effect.

Choice C rationale

The statement is incorrect. Cold therapy is a recognized and effective intervention postpartum. While it may help reduce bruising by limiting subcutaneous bleeding, its most significant and immediate benefit relates to the reduction of swelling and pain.

Choice D rationale

While cold can induce vasoconstriction and thus potentially reduce bleeding, it is not the primary or most effective method for controlling significant postpartum hemorrhage. Fundal massage and uterotonics are the primary interventions for controlling postpartum bleeding.

Choice A rationale

Changes in food selections and preparation can be a minor stressor for hospitalized toddlers, as familiar routines are disrupted. However, while dietary changes might cause some fussiness, they typically do not elicit the profound emotional distress and regression seen with more significant stressors like separation from primary caregivers.

Choice B rationale

Fear of the unknown and painful procedures is certainly a stressor for toddlers. The lack of understanding about medical interventions and the potential for discomfort can cause anxiety. However, for a toddler, the underlying fear of being abandoned by their primary attachment figures often outweighs the fear of the procedures themselves.

Choice C rationale

Unfamiliar people and strange equipment can contribute to a toddler's stress during hospitalization, as they are outside of their usual environment and routine. This can lead to feelings of insecurity and apprehension. However, the emotional impact of these elements is generally less profound than the distress caused by the absence of parents.

Choice D rationale

Separation from parents and home is the most significant stressor for hospitalized toddlers. At this developmental stage, toddlers are deeply reliant on their primary caregivers for security and comfort. Separation can trigger profound feelings of abandonment, anxiety, and lead to regression in developmental milestones.