The client delivered a 9- pound infant two days ago. An effective means of managing discomfort from an episiotomy is?

Appeared in: DHS 2018 shift 1st

Explanation

Sitz baths are the appropriate intervention for episiotomy discomfort two days (48 hours) after delivery.
After the initial 24-hour period, the therapeutic goal shifts from reducing acute swelling to promoting healing.
The warm water from a sitz bath increases local blood circulation to the perineal tissues.
Enhanced blood flow accelerates tissue repair and provides soothing comfort, making it the standard of care at this stage.

Option A: Medicated suppositories are not indicated for episiotomy pain. They are administered rectally to treat conditions like constipation or hemorrhoids.
Option B: Aspirin is an antiplatelet agent and is generally contraindicated in the immediate postpartum period due to the increased risk of hemorrhage.
Option D: Ice packs are the standard of care for the first 24 hours postpartum, not after 48 hours. Their purpose is to cause vasoconstriction to reduce acute swelling and numb the area.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Management of Postpartum Episiotomy Discomfort as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in educating new mothers about the correct sequence of perineal care (cold therapy first, then warm therapy) to ensure optimal healing, provide comfort, and prevent complications.
Incorrect application (e.g., using heat in the first 24 hours) could increase swelling and pain, while failing to switch to warm therapy could delay the healing process.
What if? If the client was only 12 hours postpartum, the correct answer would be 'Ice packs'. The primary goal in the immediate postpartum period is to reduce acute inflammation and edema through vasoconstriction.

How to Approach the Question

First, identify the core clinical problem: managing discomfort from an episiotomy.
Next, scan the stem for the most critical piece of data, which is the timeframe: 'two days ago' or 48 hours postpartum.
Recall the standard, time-dependent protocol for postpartum perineal care.
Remember the rule: Cold therapy (ice packs) is used for the first 24 hours to reduce swelling. Warm therapy (sitz baths) is used after 24 hours to promote circulation and healing.
Apply the 48-hour timeframe to this rule. This indicates that warm therapy is the appropriate choice.
Select 'Sitz baths' as the correct answer and eliminate 'Ice packs' because the 24-hour window for cold therapy has passed.

Concept Tested & Keywords

Concept Tested: Management of Postpartum Episiotomy Discomfort
Stem keywords: episiotomy, discomfort, two days ago, postpartum
Lead-in keywords: effective means
Clinical cues: The timeframe 'two days ago' (48 hours postpartum) is the critical detail that determines the correct therapeutic modality (heat vs. cold).

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E6 Obstetrics Williams p. 16-32

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 63-77

Practise the full DHS 2018 shift 1st

Attempt every question from this paper in a timed mock, then review the full solution for each one.