The nurse is planning comfort measures to implement for a client after a vaginal birth. Which measures should the nurse plan to implement? (Select all that apply.)
a. Sitz baths four times a day
b. Use of only warm water with the sitz baths
c. Topical anesthetic spray after perineal care
d. Ice pack to the perineum for the first 24 hours
e. Sitting while relaxing the perineal and buttock areas
ANS: A, C, D
Sitz baths provide continuous circulation of water, cleansing and comforting the traumatized perineum. Ice causes vasoconstriction and is most effective if applied soon after the birth to prevent edema and to numb the area. Anesthetic sprays decrease surface discomfort and allow more comfortable ambulation. Cool water in the sitz bath reduces pain caused by edema and may be most effective within the first 24 hours. The mother should be advised to squeeze her buttocks together, not relax them, before sitting, and to lower her weight slowly onto her buttocks.
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