Asked by Shannon Klein on May 17, 2024
Verified
A nurse is caring for a postpartum client who experienced perineal lacerations during labor. What interventions should the nurse make related to this perineal trauma? (Select all that apply.)
A) Monitor the client's temperature every 4 hours
B) Encourage the client to take a sitz bath
C) Inspect the perineum for signs of hematoma
D) Perform a speculum and bimanual examination of the vagina
E) Apply ice to the perineum
Perineal Lacerations
Tears in the perineum, the area between the vagina and anus, occurring often during childbirth.
Sitz Bath
A therapeutic bath in which only the hips and buttocks are soaked in warm or cold water, often used to relieve pain or inflammation in the genital or anal areas.
Hematoma
A localized collection of blood outside of blood vessels, usually in liquid form within the tissue.
- Comprehend the methods and interventions utilized in the prevention and management of perineal trauma throughout childbirth.
Verified Answer
LS
Lau Sin Yee JessieMay 21, 2024
Final Answer :
A, B, C, E
Explanation :
Monitoring the client's temperature can help identify infection. Encouraging sitz baths can aid in healing and comfort. Inspecting the perineum for signs of hematoma is important for detecting complications. Applying ice can reduce swelling and discomfort. Performing a speculum and bimanual examination is typically not a nursing intervention and may not be appropriate for all postpartum clients, especially immediately following childbirth due to the risk of causing further trauma or infection.
Learning Objectives
- Comprehend the methods and interventions utilized in the prevention and management of perineal trauma throughout childbirth.