The nurse is teaching a postpartum client about caring for her episiotomy. Which of the following statement by the client would indicate a correct understanding of the teaching?
The nurse is teaching a postpartum client about caring for her episiotomy. Which of the following statement by the client would indicate a correct understanding of the teaching?
A. "I can expect to have pain and urgency with urination."
[19%]
B. "I should increase my fluid and fiber intake."
[69%]
C. "I will clean the area with hot, soapy water."
[6%]
D. "I should wipe in a continuous motion using a washcloth."
[6%]
Statistics
Subject/Lesson
Subject
Maternal & Newborn Health
Lesson
Postpartum
Client Need
Test Plan
Health Promotion and Maintenance
Related Topic
Ante/Intra/Postpartum and Newborn Care
Item Type
Item Type
Analysis
Explanation
Choice B is correct. The client should be instructed to increase their fluid and fiber intake to prevent constipation because constipation may cause a client to experience significant pain at the episiotomy site during defecation. If the client is still experiencing constipation as they recover from an episiotomy, the primary healthcare provider (PHCP) may prescribe a stool softener.
Choices A, C, and D are incorrect. Pain and urgency with urination are concerning symptoms of cystitis. The client should report this to the PHCP. Stinging with urination may occur but should not be painful or have an increased urgency. The client should be instructed to clean the area with a peri bottle and pat it dry. For the first 12 hours following an episiotomy, the nurse should advise the client to apply a cold compress for the first 12 hours, followed by a warm compress afterward. The client should not use a continuous motion when wiping, nor should they use a washcloth which may cause trauma to the area. Patting dry with toilet paper or using a sitz bath or peri bottle could be helpful.
Additional Info
✓ An episiotomy is an incision into the perineum right before birth
✓ Indications for an episiotomy include resolution of shoulder dystocia, breech delivery, macrosomic fetus, and birth assisted with a vacuum or forceps.
✓ Infection is the main risk following an episiotomy.
✓ Fever should be reported along with foul-smelling drainage.
✓ Cold applications are applied for at least the first 12 hours, followed by warm perineal applications after 12 hours.
✓ The client should increase their fluids and fiber to prevent constipation which may aggravate their pain.
✓ It is also recommended that the client pat dries with toilet paper and irrigate the peri area with warm water.
