Editing Maternal and Newborn Nursing – LPN Practice Questions (section)

==Question 9==
An LPN is providing perineal care to a client 6 hours after a vaginal birth with a second-degree laceration repair. Which action is appropriate?
# Apply a warm compress to the perineum to promote circulation.
# Apply an ice pack to the perineum for the first 24 hours.
# Instruct the client to wipe from back to front after voiding.
# Insert a rectal suppository if the client reports constipation.

'''Answer:''' 2 (B). Apply an ice pack to the perineum for the first 24 hours.

''Rationale:'' Cold produces vasoconstriction that limits edema and hematoma formation and numbs the area, so ice is used for roughly the first 24 hours. '''Heat, including sitz baths, is used after that period''' to promote circulation and healing, so option 1 is applied too early. Option 3 is backward: the client is taught to cleanse and wipe '''front to back''' to avoid moving rectal flora toward the urethra and the healing suture line, and a peri-bottle of warm water is used rather than rubbing. Option 4 is incorrect because no suppository has been ordered and constipation on the first postpartum day is reported and managed with fluids, fiber, ambulation, and stool softeners; rectal suppositories and enemas are '''contraindicated''' with a third- or fourth-degree laceration.