The practical nurse (PN) is assisting the registered nurse (RN) in caring for a client with placenta previa who is at 31-weeks gestation.
Which method should the PN use to most accurately estimate blood loss?

Choice A rationale

Administering ibuprofen, an NSAID, can alleviate pain by inhibiting prostaglandin synthesis, reducing inflammation. However, increased pain and pressure postpartum, especially with a laceration, could indicate complications like a hematoma. Normal pain is expected, but increasing pain warrants further assessment, as it could mask a worsening condition and delay necessary intervention.

Choice B rationale

Increased pain and pressure postpartum after a vaginal delivery, especially with a second-degree perineal laceration, could signal a perineal hematoma. This condition involves blood accumulation in the tissue, causing significant pain and pressure. Notifying the healthcare provider is crucial for immediate assessment, diagnosis, and potential intervention to prevent further complications.

Choice C rationale

Applying an ice pack to the perineum is a common intervention for pain and swelling after a vaginal delivery and laceration repair. Cold therapy induces vasoconstriction, which reduces blood flow to the area, thereby minimizing edema and inflammation. This can provide localized pain relief, but for increasing pain, it might only offer symptomatic relief without addressing the underlying cause.

Choice D rationale

Routine perineal care, including cleansing and hygiene, is essential for preventing infection and promoting healing after a vaginal delivery and laceration. It helps remove lochia and bacteria, maintaining a clean environment. While crucial for recovery, routine care does not directly address or alleviate increasing pain and pressure that could indicate a complication like a hematoma.

Choice A rationale

Emptying the bladder prior to amniocentesis reduces the risk of bladder puncture during the procedure. A full bladder could also displace the uterus, making needle insertion more challenging and increasing the potential for complications. This anatomical consideration ensures a safer and more accurate procedure for both mother and fetus.

Choice B rationale

Refraining from sexual intercourse for 48 hours prior to the procedure is not a standard or necessary instruction for an amniocentesis. While pelvic rest might be advised in certain high-risk pregnancies or after procedures that could compromise cervical integrity, it is not a general prerequisite for this diagnostic test.

Choice C rationale

Showering with an antibacterial soap the night before the procedure is a general hygienic practice but is not specifically required for an amniocentesis. While aseptic technique is paramount during the procedure itself, a special antibacterial shower beforehand is not a standard protocol to prevent infection in this context.

Choice D rationale

Taking an enema the morning of the procedure is not indicated for an amniocentesis. Enemas are typically used to clear the bowel for gastrointestinal procedures or to relieve constipation. There is no physiological or procedural benefit to bowel evacuation prior to an amniocentesis.