On the second day postpartum, the patient experiences ...

[mpobi80]

On the second day postpartum, the patient experiences engorgement. To relieve her discomfort, the nurse should encourage the patient to:
 
  1. Remove her bra.
  2. Apply heat to her breasts.
  3. Apply ice packs to her breasts.
  4. Limit breastfeeding to twice daily.

Question 2

The postpartum patient delivered 4 hours ago. She has a mediolateral episiotomy and large hemorrhoids. She is rating her pain at 7 on a scale of 110. She has a history of anaphylactic reaction to Tylenol (acetaminophen).
 
  1. Offer the patient 800 mg Advil (ibuprofen) orally with food.
  2. Provide two Percocet (oxycodone with acetaminophen) by mouth.
  3. Encourage use of Dermoplast topical anesthetic spray.
  4. Run very warm water into the tub and assist her into the bath.

[paavo]

Answer to Question 1

Correct Answer: 3
Rationale 1: Removing her bra will only serve to increase breast milk production.
Rationale 2: Applying heat will promote breast milk production.
Rationale 3: Applying ice packs to the breasts relieves discomfort through the numbing effect of ice.
Rationale 4: Limiting breastfeeding to b.i.d. actually would decrease the flow of breast milk eventually, and would not serve to decrease the discomfort of mother or infant.

Answer to Question 2

Correct Answer: 1
Rationale 1: This is the best option, because the patient is experiencing moderately severe pain with inflammation. Ibuprofen is a nonsteroidal anti-inflammatory drug that both reduces inflammation and provides pain relief.
Rationale 2: This medication is contraindicated because of the patient's allergic reaction to acetaminophen.
Rationale 3: Topical anesthetic sprays can be a helpful adjunct in pain relief, but are not sufficient when a patient has moderately severe pain.
Rationale 4: Ice packs would be better at this stage, because they will cause vasoconstriction to reduce edema and pain relief.

[mpobi80]

Excellent

[bdobbins]

Thanks for the timely response, appreciate it