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 1–10. 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.
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.
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