Which of the following nursing interventions will promote comfort for a client with a labial first degree laceration? Select all that apply.

A) Wash your hands before and after you use the bathroom and change your sanitary pad:
The most important instruction for preventing postpartum infection is proper hand hygiene. The risk of infection in the postpartum period is high, especially because the perineum and cervix are healing after delivery. By washing hands before and after using the bathroom or changing sanitary pads, the mother reduces the risk of introducing harmful bacteria into the vaginal area. Proper hand hygiene helps minimize the risk of urinary tract infections (UTIs), wound infections, and endometritis, which are all common postpartum complications.

B) Do not take tub baths for eight weeks:
While it is true that taking tub baths can potentially introduce bacteria into the vaginal area, particularly if the perineum is healing from a tear or episiotomy, this is a secondary concern. The priority is hand hygiene, which directly prevents infection by limiting bacterial exposure. The recommendation to avoid tub baths is generally valid for the first 6 weeks, but it is less critical than hand washing.

C) Use tampons instead of pads as they are better at inhibiting bacterial growth:
Using tampons is not recommended in the postpartum period because they can increase the risk of toxic shock syndrome and can irritate the vaginal area or interfere with uterine healing. Pads are preferred to absorb lochia (postpartum discharge) and are safer for vaginal healing. Tampons do not inhibit bacterial growth more effectively than pads, and the use of tampons can actually increase the risk of infection, so this option is incorrect.

D) Douche with a mild antiseptic twice a day for two weeks, starting at day three:
Douching is not recommended during the postpartum period. It can disrupt the natural vaginal flora, increase the risk of infections like vaginitis, and delay the healing process. The vagina has its own natural defense mechanisms, and douching with antiseptics is unnecessary and can do more harm than good. Instead, the focus should be on keeping the area clean and dry and practicing proper hand hygiene.

A) The vaccine is a live virus and may cause birth defects in the fetus:
The Rubella vaccine is a live attenuated virus, which means it contains a weakened form of the virus. Although this vaccine is safe for most adults, it can cause serious birth defects if a woman becomes pregnant within a 4-week period after receiving the vaccine. The live virus could potentially affect the developing fetus, causing congenital rubella syndrome (CRS), which can result in severe birth defects like heart defects, deafness, and cataracts. To prevent any risk to a future pregnancy, women are advised to wait at least 4 weeks after
vaccination before trying to conceive.

B) Tests to determine if the client developed immunity are not accurate for a month:
This is not accurate. While some tests for rubella immunity can be done soon after vaccination, the primary reason for delaying pregnancy is the live virus in the vaccine, not a delay in testing. The immune response to the vaccine typically develops within a few weeks, but the risk to a fetus comes from the live virus, not the testing process. The 4-week delay is to ensure that the virus has been cleared from the body before pregnancy is attempted.

C) She may have the virus and feel too sick to tolerate a pregnancy:
While the Rubella vaccine can cause mild side effects like fever, it does not typically cause significant illness that would prevent a woman from tolerating a pregnancy. The primary concern is the safety of the fetus, not the mother's symptoms, as any illness is generally mild and transient. The 4-week delay is to prevent potential harm to a fetus due to the live virus present in the vaccine.

D) Her body is not ready to nurture another pregnancy so quickly:
This rationale is not based on any medical guideline. There is no evidence to suggest that the body needs time to "recover" from the Rubella vaccine before becoming pregnant. The reason for the 4-week delay is to ensure that the live virus has been cleared from the body to avoid any risk to a potential pregnancy. The concern is not about the woman's ability to support another pregnancy, but about the potential for the live vaccine virus to harm a developing fetus.