The practical nurse (PN) is reviewing education for the parents of an infant with developmental dysplasia of the hip about dynamic splinting.
Which information should the PN reinforce about the purpose of this treatment?

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

Observing for any changes in nail bed color is crucial for assessing capillary refill and circulation distal to the cast. Pallor, cyanosis, or prolonged capillary refill (normal <2 seconds) can indicate impaired blood flow or nerve compression, signs of compartment syndrome, requiring immediate medical attention to prevent permanent tissue damage.

Choice B rationale

Allowing the child to return to school after only one day's rest is generally not advisable immediately after cast application. The initial 24-48 hours are critical for observing for swelling, neurovascular compromise, and managing pain. Rest and elevation are typically recommended to minimize edema formation.

Choice C rationale

Wrapping the cast in a plastic bag when the child takes a shower is important to prevent the cast from getting wet. A wet cast can soften, lose its supportive integrity, and promote skin maceration and infection underneath. Moisture can also lead to skin irritation and breakdown.

Choice D rationale

Giving the child a dose of acetaminophen as prescribed for pain is important for pain management, but it is not the most important home care information. While essential for comfort, it does not address the critical neurovascular assessment needed to prevent severe complications like compartment syndrome.