A nurse on a postpartum unit is reinforcing discharge teaching for a client who had an episiotomy. Which of the following statements by the client indicates an understanding of the teaching?

“I will use a sitz bath at least once a day."

“I will check the amount of bleeding with every other pad change”

“I will wash my perineum with mild soap and warm water every other day?”

“I will change my pad at least three times a day”

Answer and Explanation

The Correct Answer is D

A. "I will use a sitz bath at least once a day.": Sitz baths should be used more frequently, typically several times a day, to promote perineal healing, relieve discomfort, and reduce swelling after an episiotomy. Limiting it to once daily may not provide adequate relief or hygiene support.

B. "I will check the amount of bleeding with every other pad change": The amount of lochia (postpartum bleeding) should be checked with every pad change, not every other. Monitoring bleeding closely helps detect signs of hemorrhage or infection early, ensuring prompt intervention if abnormalities are found.

C. "I will wash my perineum with mild soap and warm water every other day.": Perineal hygiene should be performed daily, and often multiple times a day, especially after urination or bowel movements. Washing every other day is insufficient and could increase the risk of infection at the episiotomy site.

D. "I will change my pad at least three times a day": Changing the perineal pad at least three times daily, or more often as needed, maintains cleanliness, helps prevent infection, and allows for regular monitoring of lochia and healing. This statement demonstrates good understanding of postpartum perineal care.

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Correct Answer is A

Explanation

A. Hold the catheter with the dominant hand during insertion: The dominant hand should be used to insert the catheter because it provides better control and precision during the sterile procedure. The nondominant hand is used to expose and maintain the position of the urethra but is considered contaminated once touching the client.

B. Advance catheter 7.5 cm (3 in) after urine begins to flow: The catheter should be advanced approximately 2.5 to 5 cm (1 to 2 inches) further after urine appears, not 7.5 cm. Advancing too far could cause discomfort or trauma to the bladder.

C. Hang collection bag below the level of the bladder: While this is an important step in managing the catheter after insertion to prevent backflow and infection, it does not specifically pertain to the insertion process itself.

D. Lubricate the catheter 12.5 cm (5 in) prior to insertion: Typically, for female catheterization, about 2.5 to 5 cm (1 to 2 inches) of the catheter is lubricated, not 12.5 cm. Excessive lubrication is unnecessary and may cause difficulty during insertion.

A. Explain the rounding schedule to the client B. Tell the client about the visiting hours C. Review meal options with the client. D. Place the call light within reach of the client.

Correct Answer is D

Explanation

A. Explain the rounding schedule to the client: While explaining the rounding schedule helps reassure the client that frequent checks will occur, it does not immediately address safety needs. Immediate actions to reduce fall risk are prioritized before providing routine information.

B. Tell the client about the visiting hours: Informing the client about visiting hours is part of general orientation but is not critical to preventing falls. Safety interventions must be implemented first to minimize risk of injury as soon as possible upon admission.

C. Review meal options with the client: Discussing meal options is part of admission and planning for nutrition, but it is not an urgent action to ensure the client's immediate safety, particularly when there is a known risk for falls.

D. Place the call light within reach of the client: Ensuring the call light is within reach allows the client to easily request assistance before attempting to move independently. This simple action is a high-priority intervention to prevent falls and promote immediate client safety.

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A nurse on a postpartum unit is reinforcing discharge teaching for a client who had an episiotomy. Which of the following statements by the client indicates an understanding of the teaching?

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