Maternity Nursing: Postpartum Q 44
Perineal care is an important infection control measure. When evaluating a postpartum woman’s perineal care technique, the nurse would recognize the need for further instruction if the woman:
A. Uses soap and warm water to wash the vulva and perineum.
B. Washes from symphysis pubis back to episiotomy.
C. Changes her perineal pad every 2 – 3 hours.
D. Uses the peri bottle to rinse upward into her vagina.
Correct Answer: D. Uses the peri bottle to rinse upward into her vagina.
The peri bottle should be used in a backward direction over the perineum. The flow should never be directed upward into the vagina since debris would be forced upward into the uterus through the still-open cervix. Rinse perineum with water after using the toilet and before the woman puts on a new peri-pad. Caregivers will show how to use a peri-bottle (hand-held squirt bottle) to rinse the perineum. Squirting warm tap water on the perineum will keep it clean and may provide comfort for pain. While sitting on the toilet, the woman should rinse the perineum. She should aim the bottle opening at her perineum and spray so the water moves from front to back.
Option A: Warm water and soap is sufficient to clean the perineal area. The woman should wash her hands before doing perineal care. She should remove the soiled peri-pad starting at the front (vaginal area) to the back (anus). Rinse the perineum with water after using the toilet and before the woman puts on a new peri-pad.
Option B: Wiping from front to back decreases the transmission of bacteria from the anus. Postpartum perineal care is cleaning and caring for the perineum after having a baby. The perineum is the area between the vagina (birth canal) and the anus (rear end opening). In the first few weeks after childbirth, the woman will probably have soreness or pain in her perineum. She will also have discharge coming out of her vagina.
Option C: Peri-pads should be changed every 2-3 hours to prevent infection. Perineal care will help the perineum heal faster, feel better, and help prevent infection. The woman should ask her caregiver how long she should keep doing perineal care. She may need to continue doing perineal care for 1 to 3 weeks after giving birth.