The nurse instructs a postpartum patient in the use of a sitz bath. Which action by the patient indicates that the teaching was effective?

The patient uses the sitz bath three times a day.

The patient alternates between warm and cool sitz baths.

The patient remains in the sitz bath for up to 60 minutes.

The patient alternates tightening and relaxing her perineal muscles during her sitz bath.

Answer and Explanation

The Correct Answer is A

The correct answer is choice A. The patient uses the sitz bath three times a day. This indicates that the patient understands the benefits of sitz baths for postpartum recovery, such as pain relief, increased blood flow, relaxation, cleansing, and itch relief. Sitz baths can be done with warm or cool water, depending on the preference of the patient. However, they should not be done for more than 20 minutes at a time, as this can cause the stitches in the perineal area to fall apart.

Therefore, choice C is wrong. Choice B is also wrong, as there is no evidence that alternating between warm and cool sitz baths has any additional benefits or effects.

Choice D is wrong, as tightening and relaxing the perineal muscles during a sitz bath is not recommended. This can cause more pain and irritation to the area, and interfere with the healing process. The normal ranges for sitz baths are two to four times a day for up to 20 minutes each.

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Correct Answer is D

Explanation

The correct answer is choice D. If the client feels like she has butterflies in her stomach, it means her baby is moving.

This is a normal and expected change during pregnancy, especially in the second and third trimesters.The baby’s movements can be felt as flutters, kicks, or rolls.

Choice A is wrong because spotting of blood on the underwear is not a normal change during pregnancy.

It can indicate a problem such as placenta previa, placental abruption, or miscarriage.Any bleeding during pregnancy should be reported to the health care provider.

Choice B is wrong because clear fluid leaking from the vagina is not a normal change during pregnancy.

It can indicate that the membranes have ruptured and amniotic fluid is escaping.

This can lead to infection and preterm labor if not treated promptly.Any fluid leakage during pregnancy should be reported to the health care provider.

Choice C is wrong because dark patches on the face are not a sign of high blood pressure during pregnancy.

They are called melasma or chloasma and are caused by increased pigmentation due to hormonal changes.They usually fade after delivery and are not harmful.High blood pressure during pregnancy can cause symptoms such as headache, blurred vision, swelling, and protein in the urine.

A. Observe the patient for vaginal discharge of bright red blood. B. Assess the patient’s vaginal tone. C. Massage the patient’s perineum. D. Apply petrolatum to the patient’s perineum.

Correct Answer is D

Explanation

The correct answer is choice D. Apply petrolatum to the patient’s perineum.This is because petrolatum can help soothe and protect the perineal area, which may be swollen, bruised, or have stitches after a vaginal delivery.Applying petrolatum can also prevent the pad from sticking to the wound and causing more pain.

Choice A is wrong because observing the patient for vaginal discharge of bright red blood is not a specific action for perineal care.Bright red blood may indicate postpartum hemorrhage, which requires immediate medical attention.

Choice B is wrong because assessing the patient’s vaginal tone is not a priority action for perineal care.Vaginal tone may be reduced after childbirth due to stretching of the pelvic floor muscles, but this can improve with time and exercises.

Choice C is wrong because massaging the patient’s perineum is not recommended for perineal care.Massaging the perineum may cause more trauma and discomfort to the area, especially if there are stitches or hemorrhoids.Massaging the fundus (the top of the uterus) may be done to help it contract and prevent bleeding, but this is different from massaging the perineum.

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The nurse instructs a postpartum patient in the use of a sitz bath. Which action by the patient indicates that the teaching was effective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is D

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