The patient is recovering from a delivery that included a midline episiotomy. Her perineum is swollen and sore. Ten minutes after an ice pack is applied, the patient asks for another. The best response from the nurse is:
1. "I'll get you one right away."
2. "You only need to use one ice pack."
3. "You need to leave it off for at least 20 minutes and then reapply."
4. "I'll bring you an extra so that you can change it when you are ready."
3
Rationale 1: Providing an additional ice pack before 20 minutes have passed would increase the perineal edema.
Rationale 2: More than one ice pack must be used in order to apply ice for 20 minutes on followed by 20 minutes off.
Rationale 3: Optimal effects from the use of an ice pack occur when it is applied for 20–30 minutes and then removed for at least 20 minutes before being reapplied.
Rationale 4: An ice pack that is provided now for use in 20 minutes would melt before being used.
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