MEDizzy - On the first postpartum day, the primiparous client reports

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Postpartal Care

On the first postpartum day, the primiparous client reports perineal pain of 5 on a scale of 1 to 10 that was unrelieved by ibuprofen 800 mg given 2 hours ago. The nurse should further assess the client for:

ExplanationIf the client continues to complain of perineal pain after an analgesic medication has been given, the nurse should inspect the client’s perineum for a hematoma, because this is the usual cause of such discomfort. Ibuprofen is a nonsteroidal antiinflammatory medication used to relieve mild pain. Pain from a perineal hematoma can be moderate to severe, possibly requiring a stronger analgesic, such as acetaminophen with codeine (Tylenol with Codeine). Ice applied to the perineum during the first 24 hours postpartum may decrease the severity of hematoma formation. The application of warm heat, such as a sitz bath three times daily for 20 minutes, also can help to relieve the discomfort when implemented after the first 24 hours. Typically hematomas resolve themselves within 6 weeks. A puerperal infection would be indicated if the client’s temperature were 100.4° F (41° C) or higher. Also, lochia most likely would be foul-smelling. A continuous trickle of lochia rubra would suggest a possible vaginal laceration. No evidence is presented to suggest a history of drug abuse.