Approximately 8 hours ago, a woman gave birth after 2.5 hours of pushing. She required an episiotomy and an assisted birth (forceps). The perinatal nurse assesses a slight bulge in the perineum and the presence of ecchymosis to the right of the episiotomy
The area feels "full" and is approximately 4 cm in diameter. The patient describes this area as "tender." What intervention does the nurse anticipate for this situation?
A.
Application of ice
B.
Exploratory surgery
C.
Incision and drainage
D.
Sitz bath every 12 hours
ANS: A
This patient has a perineal hematoma. If the hematoma is less than 3 to 5 cm in diameter, the physician usually orders palliative treatments, such as ice to the area for the first 12 hours along with pain medication. After 12 hours, sitz baths are prescribed to replace the application of ice. However, a hematoma larger than 5 cm may require incision and drainage with the possible placement of a drain.
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