A postpartum client who delivered four hours ago and has a mediolateral episiotomy and large hemorrhoids is rating her pain at 7 on a scale of 1–10. She has a history of anaphylactic reaction to acetaminophen (Tylenol)

Question

Which nursing action would be best? 1. Offer the client 800 mg ibuprofen (Advil) orally with food.
2. Provide 2 oxycodone with acetaminophen (Percocet) by mouth.
3. Encourage use of benzocaine topical anesthetic spray (Dermoplast).
4. Run very warm water into the tub and assist her into the bath.

Answer 1

1. Offer the client 800 mg ibuprofen (Advil) orally with food.

Rationale:
Offering ibuprofen (Advil) is the best option because the client is experiencing moderately severe pain with inflammation. Ibuprofen is a nonsteroidal antiinflammatory drug that both reduces inflammation and provides pain relief. Oxycodone with acetaminophen (Percocet) is contraindicated because of the client's allergic reaction to acetaminophen. Topical anesthetic sprays such as Dermoplast can be a helpful adjunct in pain relief but are not sufficient when a client has moderately severe pain. Ice packs instead of a warm bath would be better at this stage, because they will cause vasoconstriction to reduce edema and pain relief.