A nurse is planning care for a client who is 12 hr postpartum and has a third-degree perineal laceration. Which of the following interventions should the nurse include in the plan?

Place a witch hazel pad on the client's perineal pad after each voiding

Apply hydrogel pads to the perineum every 4 hr

Prepare the client for a pudenal nerve block

Encourage the client to apply a warm pack to the perineum for discomfort

Answer and Explanation

The Correct Answer is B

A. Place a witch hazel pad on the client's perineal pad after each voiding: Witch hazel pads can provide relief from perineal discomfort, but they are typically used in the immediate postpartum period for general comfort rather than specifically for third-degree perineal lacerations.

B. Apply hydrogel pads to the perineum every 4 hr: Hydrogel pads can help soothe and cool the perineal area, providing relief from pain and discomfort. This intervention is appropriate for third-degree perineal lacerations.

C. Prepare the client for a pudendal nerve block: Pudendal nerve blocks are typically used for pain relief during the second stage of labor and delivery. They are not a standard intervention for managing third-degree perineal lacerations postpartum.

D. Encourage the client to apply a warm pack to the perineum for discomfort: While warm packs can provide comfort, they are generally not recommended for third-degree perineal lacerations. Cold packs or hydrogel pads are often more appropriate for reducing swelling and providing relief in this situation.

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Correct Answer is A

Explanation

A. Previous cervical cerclage

Cervical cerclage is a surgical procedure in which a stitch is placed in the cervix to reinforce it and reduce the risk of preterm birth. The fact that the client has had a previous cervical cerclage suggests a history of cervical insufficiency or a shortened cervix, which increases the risk of preterm delivery in subsequent pregnancies.

B. Previous delivery at 37 weeks gestation: A delivery at 37 weeks gestation is considered term. While it is on the earlier side of term, it does not inherently indicate an increased risk for preterm delivery.

C. Previous delivery of a newborn weighing 2.5 kg (5.5 lb): While low birth weight can be associated with preterm birth, the weight alone does not necessarily indicate a history of preterm delivery. Birth weight can be influenced by various factors.

D. Previous reactive non-stress test: A reactive non-stress test is a reassuring result, indicating that the fetus is responsive and generally doing well. It does not suggest a history or risk of preterm delivery.

A. The client cleans the perineum with a squeeze bottle after urinating B. The client as changing the perineal pad once daily C. The client as using witch hazel pads on the perineum D. The client's perineal suture line is well-approximated

Correct Answer is B

Explanation

A. The client cleans the perineum with a squeeze bottle after urinating: This action is appropriate for postpartum perineal care. Using a squeeze bottle to cleanse the perineum with warm water after urination helps maintain cleanliness without causing trauma to the area.

B. The client is changing the perineal pad once daily: Changing the perineal pad once daily is not optimal for wound healing. Postpartum perineal wounds require frequent changing of pads to maintain cleanliness, prevent infection, and promote healing.

C. The client is using witch hazel pads on the perineum: Using witch hazel pads is a common practice for postpartum perineal care. Witch hazel has a soothing effect and can help reduce inflammation and discomfort without negatively affecting wound healing.

D. The client's perineal suture line is well-approximated: A well-approximated perineal suture line is a positive finding, indicating that the edges of the wound are properly aligned and closed, which supports the healing process.

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A nurse is planning care for a client who is 12 hr postpartum and has a third-degree perineal laceration. Which of the following interventions should the nurse include in the plan?

Nursing Test Bank

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