The postpartum period, also known as the puerperium, is a transformative phase that commences immediately after childbirth and typically spans six to eight weeks. This period marks the beginning of the mother’s journey back to her pre-pregnancy physiological state while simultaneously navigating the profound psychological and emotional adjustments of new parenthood. Recovery during this time is highly individualized, influenced by the mode of delivery, any complications experienced during childbirth, and pre-existing health conditions. Nurses specializing in postpartum care play a crucial role in supporting mothers through this period by identifying potential health challenges and implementing tailored care strategies.
The Nursing Process in Postpartum Care
Nurses specializing in labor and delivery, postpartum care, neonatal intensive care (NICU), and obstetrics are expertly trained to provide holistic care for mothers and parents throughout all stages of pregnancy and beyond. During the postpartum period, these nurses are instrumental in delivering essential education, emotional support, and practical guidance. Their expertise aids patients in recovering from childbirth, fostering a strong bond with their newborns, and proactively managing their physical, emotional, and psychological well-being. By employing the nursing process, which includes assessment, diagnosis, planning, implementation, and evaluation, nurses ensure comprehensive and patient-centered care during this critical time.
Postpartum Nursing Care Plans: Addressing Key Diagnoses
Once a nurse has thoroughly assessed a postpartum patient, the identification of specific nursing diagnoses becomes paramount. These diagnoses serve as the foundation for developing individualized nursing care plans. Nursing care plans are dynamic tools that prioritize nursing interventions and assessments, guiding both short-term and long-term care goals. The following sections detail common nursing diagnoses encountered in postpartum care, providing examples of comprehensive care plans for each.
Acute Pain Management in Postpartum
Postpartum pain is a prevalent experience for new mothers, manifesting in various areas including the urogenital region, breasts, and back. Perineal pain is particularly common following vaginal deliveries due to potential bruising, swelling, or episiotomies. For mothers who have undergone Cesarean births (C-sections), pain is typically concentrated at the incision site and may be exacerbated by movement, coughing, or breastfeeding. Effective pain management is crucial for postpartum recovery and overall well-being.
Nursing Diagnosis: Acute Pain
Related Factors:
- Tissue trauma from childbirth
- Cesarean delivery surgical incision
- Episiotomy or perineal laceration repair
- Perineal hematoma formation
- Mastitis (breast infection)
- Breast engorgement
- Impaired skin integrity
- Surgical procedure complications
As evidenced by:
- Patient report of pain intensity and location
- Expressive pain behaviors (e.g., grimacing, moaning)
- Guarding behavior of the painful area
- Protective body positioning to minimize pain
- Distraction behaviors
- Diaphoresis (sweating)
- Hot and swollen breasts
Expected Outcomes:
- The patient will verbally report a reduction in pain intensity to a manageable level within a specified timeframe.
- The patient will demonstrate effective use of non-pharmacological and pharmacological comfort measures to alleviate pain.
Nursing Assessments:
1. Comprehensive Pain Assessment:
Rationale: A thorough pain assessment is fundamental for effective pain management. It helps pinpoint the exact location of pain, understand the nature of the discomfort (e.g., sharp, dull, throbbing), assess the severity using a pain scale (e.g., 0-10), and identify factors that exacerbate or relieve the pain. This detailed assessment guides the selection of appropriate pain relief interventions.
2. Uterine Contraction and Abdominal Assessment:
Rationale: Afterpains, or uterine contractions, are a normal physiological process in the postpartum period as the uterus contracts back to its pre-pregnancy size. While expected, these contractions can be a significant source of discomfort. Assessing the intensity and frequency of afterpains, as well as palpating the abdomen to evaluate uterine tone, is essential. A boggy or atonic uterus (uterine atony) is a critical finding that can indicate postpartum hemorrhage, a life-threatening complication requiring immediate intervention.
3. Perineal Assessment for Lacerations and Hematomas:
Rationale: Perineal trauma, including spontaneous lacerations or episiotomies, is common during vaginal delivery. Careful assessment of the perineal area is necessary to identify the extent of lacerations, assess the repair, and detect signs of hematoma formation. Even in the absence of visible tears, perineal pain can arise from tissue trauma and underlying hematoma development. Early identification allows for prompt management to prevent complications and promote healing.
4. Breast Assessment for Pain and Engorgement:
Rationale: Breast pain is a frequent complaint in postpartum patients, often due to breast engorgement as milk production increases, or inadequate milk drainage during breastfeeding. Assessing the breasts for signs of engorgement (firmness, warmth, tenderness) and symptoms of mastitis (localized pain, redness, fever) is crucial. Untreated mastitis can lead to infection and abscess formation, necessitating timely intervention.
Nursing Interventions:
1. Pharmacological Pain Management:
Rationale: Administering pain medications as prescribed provides systemic pain relief. Non-opioid analgesics like ibuprofen or acetaminophen are often effective for mild to moderate postpartum pain. In cases of more severe pain, opioid analgesics may be necessary, particularly in the immediate postpartum period or following a C-section. Antibiotics may be indicated if an infection, such as mastitis, is present.
2. Non-Pharmacological Pain Relief Techniques:
Rationale: Encouraging relaxation techniques empowers patients to actively manage their pain. Deep breathing exercises, massage, meditation, and guided imagery can help reduce pain perception, promote relaxation, and shift focus away from discomfort. These techniques are valuable adjuncts to pharmacological interventions and can be used independently for mild pain.
3. Early Ambulation Promotion:
Rationale: Early ambulation, as tolerated, offers multiple benefits in postpartum recovery. It enhances blood circulation, which is vital for tissue healing and reducing the risk of thromboembolism. Movement also aids in relieving constipation and gas pain, common postpartum discomforts. Furthermore, ambulation can promote a sense of well-being and contribute to overall pain reduction.
4. Hot and Cold Therapy Education:
Rationale: Educating patients on the appropriate use of hot and cold therapies provides them with accessible and effective pain management tools. Cold compresses are particularly beneficial for reducing perineal pain and swelling in the immediate postpartum period. Warm compresses or sitz baths promote vasodilation, increasing blood flow to the perineal area, which can soothe tissues and promote healing. Heating pads can be effectively used for back pain relief.
5. Breastfeeding Support and Guidance:
Rationale: Encouraging breastfeeding, when not contraindicated, is crucial for managing breast discomfort related to engorgement. Frequent and effective breastfeeding helps prevent milk stasis and engorgement, which can contribute to breast pain. For patients who are not breastfeeding, instruction on proper breast pump use is essential to ensure complete breast emptying and prevent complications like mastitis and breast abscess formation.
6. Dietary Modifications to Prevent Constipation:
Rationale: Perineal pain can make defecation uncomfortable, leading to constipation if patients avoid bowel movements. Encouraging the consumption of high-fiber foods, along with adequate fluid intake, promotes bowel regularity and softens stools. In some cases, stool softeners or mild laxatives may be recommended to prevent straining during defecation, which can exacerbate perineal pain.
Imbalanced Nutrition: Less Than Body Requirements in Postpartum
Adequate nutrition is paramount during the postpartum period to facilitate the mother’s physical recovery, replenish energy reserves, support hormonal balance, and ensure sufficient breast milk production for breastfeeding mothers. Nutritional deficiencies can impede recovery and impact both maternal and infant health.
Nursing Diagnosis: Imbalanced Nutrition: Less Than Body Requirements
Related Factors:
- Altered taste perception
- Postpartum depression affecting appetite
- Food aversions or cravings
- Lack of interest in food
- Sleep deprivation and fatigue
- Inadequate knowledge of postpartum nutritional needs
- Limited access to or preparation of nutritious food
- Insufficient caloric and nutrient intake to meet metabolic demands
As evidenced by:
- Weight loss or failure to gain weight appropriately
- Body weight below the ideal range for age and gender
- Pale mucous membranes indicating potential anemia
- Lethargy and fatigue
- Excessive hair loss
- Poor wound healing or delayed recovery
- Inadequate breast milk production
- Constipation or other gastrointestinal disturbances
- Hypoglycemia (low blood sugar)
- Patient report of food intake less than recommended daily allowance
- Abdominal pain or discomfort
Expected Outcomes:
- The patient will demonstrate adequate nutritional intake to meet her body’s needs for postpartum recovery, as evidenced by stable weight, improved energy levels, and timely wound healing.
- For breastfeeding mothers, the patient will demonstrate adequate breast milk production sufficient to meet the infant’s nutritional needs.
Nursing Assessments:
1. Laboratory Data Review:
Rationale: Laboratory tests provide objective data on the patient’s nutritional status. Serum albumin and pre-albumin levels are indicators of protein status and can be decreased in malnutrition. Hemoglobin and hematocrit levels can detect anemia, a common postpartum condition. Micronutrient deficiencies, such as iron, vitamin B12, and folate, can also be identified through blood tests.
2. Dietary Intake Assessment:
Rationale: A detailed assessment of the patient’s daily food intake helps identify potential nutritional gaps and patterns of unhealthy eating. This includes reviewing the types and quantities of food consumed, meal frequency, and fluid intake. For breastfeeding mothers, assessing caloric intake and intake of key nutrients like protein, calcium, and fluids is particularly important, as their nutritional needs are elevated to support milk production. Understanding dietary habits, preferences, and cultural influences on food choices is also essential for providing culturally sensitive nutritional counseling.
3. Psychosocial and Emotional Factors Impacting Nutrition:
Rationale: The postpartum period is a time of significant emotional and lifestyle adjustment. Postpartum depression, anxiety, and sleep deprivation can profoundly impact appetite and dietary habits. Assessing for symptoms of postpartum mood disorders and evaluating the patient’s emotional well-being is crucial. Factors like social support, stress levels, and coping mechanisms can also influence nutritional intake. Lack of sleep and fatigue can further contribute to poor dietary choices and reduced appetite.
Nursing Interventions:
1. Personalized Nutritional Counseling:
Rationale: Discussing the patient’s current eating habits, food intolerances, dietary preferences, and cultural food practices allows for the development of individualized nutritional recommendations. Postpartum patients require adequate protein for tissue repair and wound healing, especially after a C-section or perineal lacerations. For vegetarian or vegan patients, ensuring adequate intake of protein, iron, vitamin B12, and calcium requires specific dietary planning.
2. Vitamin and Mineral Supplementation:
Rationale: Recommending or continuing prenatal or postnatal vitamins and mineral supplements helps address common postpartum nutrient deficiencies. Iron supplementation is often needed to prevent or treat postpartum anemia. Iodine is crucial for thyroid function and breast milk production. Omega-3 fatty acids are beneficial for both maternal and infant health. Calcium and vitamin D are important for bone health, particularly for breastfeeding mothers.
3. Rest and Sleep Hygiene Promotion:
Rationale: Adequate rest and sleep are essential for postpartum recovery and optimal nutrient utilization. Sleep deprivation increases metabolic rate and stress hormone levels, potentially impairing nutrient absorption and utilization. Encouraging rest periods and promoting good sleep hygiene practices helps reduce metabolic demands and ensures that nutrients are effectively used for healing, energy production, and milk synthesis.
4. Hydration Education and Encouragement:
Rationale: Adequate fluid intake is vital for overall health and particularly important in the postpartum period. Dehydration can exacerbate fatigue, constipation, and reduce breast milk production. Encouraging patients to drink plenty of water throughout the day, especially breastfeeding mothers who have increased fluid needs, is essential.
5. Referral to Registered Dietitian:
Rationale: Referral to a registered dietitian provides patients with specialized expertise in nutrition. A dietitian can conduct a comprehensive nutritional assessment, develop personalized meal plans tailored to individual needs and preferences, and provide ongoing support and education to promote healthy eating habits during the postpartum period and beyond. This is particularly beneficial for patients with complex nutritional needs, dietary restrictions, or those struggling to meet their nutritional goals independently.
Ineffective Breastfeeding Management
Successful breastfeeding offers numerous benefits for both mother and infant. However, various challenges can arise, leading to ineffective breastfeeding patterns and potential frustration for new mothers. Issues such as infant latch difficulties, pain during breastfeeding, or perceived insufficient milk supply can contribute to this diagnosis.
Nursing Diagnosis: Ineffective Breastfeeding
Related Factors:
- Infant prematurity or low birth weight
- Infant oral anomalies (e.g., cleft palate, tongue-tie)
- Weak or uncoordinated infant sucking reflex
- Maternal anxiety, stress, or lack of confidence
- Maternal knowledge deficit regarding breastfeeding techniques
- Interruptions in breastfeeding routine or schedule
- History of previous ineffective breastfeeding attempts
As evidenced by:
- Patient verbalizes or demonstrates difficulty with breastfeeding
- Patient reports nipple pain or soreness during or after breastfeeding
- Observed or reported poor infant latch or ineffective sucking
- Insufficient breast milk emptying after feedings or perceived inadequate milk supply
- Infant exhibits signs of inadequate intake, such as poor weight gain, insufficient wet diapers, or persistent hunger cues
- Observed failure of infant to latch onto the breast
Expected Outcomes:
- The mother will verbalize understanding of at least two effective breastfeeding techniques to improve latch and milk transfer.
- The infant will demonstrate effective breastfeeding, as evidenced by appropriate weight gain, adequate wet diapers, and satisfied feeding cues.
Nursing Assessments:
1. Breastfeeding Knowledge Assessment:
Rationale: Assessing the mother’s existing knowledge about breastfeeding practices, including proper latch techniques, feeding cues, milk supply, and common breastfeeding challenges, is essential. Identifying any cultural beliefs, myths, or misunderstandings surrounding breastfeeding allows for targeted education and addressing misinformation.
2. Physical Breast and Infant Assessment:
Rationale: A physical assessment of the mother’s breasts includes evaluating for signs of engorgement, mastitis (infection), nipple inversion or flatness, and any anatomical factors that may impede breastfeeding. Assessing the infant’s oral anatomy, including palate, tongue, and suck reflex, is crucial to identify potential barriers to effective latch and sucking. Observing a breastfeeding session allows for direct evaluation of latch, suckling pattern, milk transfer, and infant cues.
3. Support System Evaluation:
Rationale: A supportive partner, family members, and healthcare team are vital for breastfeeding success. Assessing the level of support available to the mother, including emotional encouragement, practical assistance with household tasks, and positive reinforcement of breastfeeding efforts, is important. Lack of support can significantly impact a mother’s confidence and persistence with breastfeeding.
Nursing Interventions:
1. Individualized Breastfeeding Support:
Rationale: Breastfeeding is a learned skill for both mother and infant, often requiring time, patience, and practice. Providing one-on-one support, encouragement, and hands-on assistance during breastfeeding sessions is crucial, especially in the early postpartum period. Allowing ample time (30 minutes or more initially) for each session, offering emotional reassurance, and addressing concerns can significantly enhance the breastfeeding experience.
2. Infant Feeding Cue Education:
Rationale: Educating mothers to recognize and respond to early infant feeding cues promotes timely and effective feeding. Early cues, such as rooting, lip-smacking, sucking on fingers or hands, and increased alertness, indicate the infant’s readiness to feed. Feeding the infant when these cues are present, rather than waiting for crying (a late hunger cue), leads to a more relaxed and successful breastfeeding experience for both mother and baby.
3. Breastfeeding Complication Prevention and Management:
Rationale: Addressing common breastfeeding challenges proactively is essential. For nipple pain, assess latch technique and provide guidance on proper positioning. Lanolin cream can be applied to nipples for soothing and healing. Avoid harsh soaps that can dry nipples. Wearing cotton bras and breast pads allows for breathability and prevents moisture buildup. For breast engorgement, encourage frequent breastfeeding or pumping to remove milk. Warm compresses or massage before feeding can facilitate milk let-down, while cool compresses after feeding can reduce swelling and discomfort.
4. Lactation Consultant Referral:
Rationale: Lactation consultants are specialized healthcare professionals with in-depth knowledge and expertise in breastfeeding management. Referring patients to a lactation consultant provides access to advanced support, including personalized instruction on various breastfeeding positions, strategies to increase milk supply, guidance on using breast pumps effectively, and troubleshooting complex breastfeeding issues. Lactation consultants can significantly improve breastfeeding outcomes and maternal confidence.
Risk for Impaired Parenting
The transition to parenthood is a significant life event that can be both joyous and challenging. Certain factors can increase the risk of impaired parenting, which is defined as the inability to create or maintain a nurturing environment that promotes the healthy growth and attachment between parent and child. Recognizing risk factors and implementing preventative measures are crucial for supporting new families.
Nursing Diagnosis: Risk for Impaired Parenting
Related Factors:
- Premature birth or infant health complications
- Multiple births (twins, triplets, etc.)
- Unplanned or unwanted pregnancy
- Infant physical or developmental handicap
- Prolonged parent-infant separation
- Parental immaturity or lack of parenting skills
- Low parental educational level
- Low socioeconomic status and financial strain
- Young maternal age or adolescent parenthood
- Closely spaced pregnancies and maternal depletion
- Difficult or traumatic birthing experience
- Parental sleep deprivation and fatigue
- History of maternal depression, anxiety, or other mental health conditions
- Substance abuse or dependence in either parent
- History of familial or intimate partner violence
- Lack of family or spousal support network
As evidenced by:
A risk diagnosis is not evidenced by existing signs and symptoms because the problem has not yet occurred. Nursing interventions for a risk diagnosis are primarily focused on prevention.
Expected Outcomes:
- The parent will verbally identify individual risk factors that increase the potential for impaired parenting.
- The parent will identify and verbalize available resources and personal strengths that can help overcome parenting barriers.
- The parent will actively participate in educational classes or support groups designed to promote effective parenting skills.
Nursing Assessments:
1. Family Support and Dynamics Assessment:
Rationale: Assessing the family structure, support network, and dynamics is fundamental. Determine the level of involvement of the infant’s father or partner in parenting responsibilities. Evaluate the availability of extended family support, such as grandparents or other relatives. Assess the presence of other children in the household and the overall family functioning. Understanding the family context provides valuable insights into potential stressors and support systems available to the new parents.
2. Parent-Infant Attachment Observation:
Rationale: Observing the interactions and attachment behaviors between parents and their infant provides crucial information. Assess the parent’s overall attitude and affect when interacting with the infant (e.g., warmth, responsiveness, engagement). Monitor parent-infant interactions during feeding, diaper changes, and comforting. Note any signs of reluctance, indifference, negativity, or avoidance in parenting behaviors. These observations can indicate potential difficulties in parent-infant bonding.
3. Parental Capabilities and Challenges Assessment:
Rationale: Evaluating the parent’s capabilities, skills, and potential challenges is essential for identifying areas where support is needed. Consider the parent’s age, maturity level, educational background, and any pre-existing physical or mental health conditions. Assess their knowledge of infant care, child development, and parenting skills. For young parents or those with unplanned pregnancies, assess their preparedness and resources for parenthood. Identify any intellectual, emotional, or physical limitations that may impact their parenting capacity.
Nursing Interventions:
1. Positive Interaction Modeling and Bonding Time Promotion:
Rationale: Nurses should model positive and nurturing interactions with the infant and parents to demonstrate appropriate parenting behaviors. Creating opportunities for parent-infant bonding is crucial. Keep the infant in a bassinet at the bedside to facilitate close proximity. Educate parents on essential infant care skills, such as feeding techniques, proper holding and swaddling, bathing, and comforting strategies. Encourage skin-to-skin contact to promote bonding and regulate infant temperature and heart rate.
2. Parental Self-Care and Stress Management Education:
Rationale: Parental stress is a significant contributor to postpartum depression and impaired parenting. Emphasize the importance of parental self-care and stress management. Encourage parents to identify healthy coping mechanisms and positive outlets for stress relief. Advise them to prioritize rest, nutrition, and engage in activities they enjoy outside of parenting responsibilities. Remind them that taking breaks from parenting is not selfish but essential for their well-being and ability to provide optimal care.
3. Postpartum Depression Screening and Referral:
Rationale: Postpartum depression is a serious condition affecting a significant percentage of new mothers. Routine depression screening during postpartum care is crucial for early detection. Symptoms of postpartum depression can include persistent sadness, loss of interest in activities, changes in appetite or sleep, fatigue, feelings of guilt or worthlessness, and difficulty bonding with the infant. Promptly refer mothers who screen positive for depression to mental health professionals for further evaluation and treatment. Postpartum depression requires intervention for both maternal and infant well-being.
4. Community Resource and Support Network Referral:
Rationale: Young, single, or unprepared parents often benefit from community resources and support programs. Provide information and referrals to parenting classes, which offer education on child development, positive discipline, and effective parenting techniques. Connect parents with government assistance programs, such as WIC (Women, Infants, and Children) and food stamps, to address financial needs. Referrals to support groups for new parents can provide peer support, reduce isolation, and offer valuable advice and encouragement. Connecting families with community resources enhances the safety and health of both the infant and parents.
Risk for Infection in Postpartum
Childbirth, while a natural process, carries an inherent risk of infection for the mother. Trauma to tissues during delivery, invasive procedures, and surgical interventions like Cesarean sections can create portals of entry for pathogens. Understanding risk factors and implementing preventative measures are essential to minimize postpartum infections.
Nursing Diagnosis: Risk for Infection
Related Factors:
- Trauma to the abdominal wall (Cesarean section incision)
- Trauma to the uterus, perineum, and urinary tract during delivery
- Episiotomy or perineal lacerations
- Advanced maternal age
- Elevated Body Mass Index (BMI)
- Pre-existing chronic conditions (e.g., diabetes mellitus, hypertension, immunosuppression)
- Presence of sexually transmitted infections (STIs)
- Preterm or post-term labor
- Prolonged rupture of amniotic membranes (PROM)
- Frequent or excessive internal examinations during labor
- Endometritis (uterine infection)
As evidenced by:
A risk diagnosis is not evidenced by existing signs and symptoms because the problem has not yet occurred. Nursing interventions for a risk diagnosis are primarily focused on prevention.
Expected Outcomes:
- The patient will remain free from infection throughout the postpartum period.
- The patient will demonstrate appropriate surgical site healing (following C-section or episiotomy) without signs of infection, such as redness, warmth, swelling, or purulent drainage.
Nursing Assessments:
1. Infection Risk Factor Identification:
Rationale: Identifying individual risk factors helps tailor preventative strategies. Conditions such as gestational diabetes, intrapartum infections, prolonged rupture of membranes (PROM), preeclampsia/eclampsia, and prolonged labor increase the susceptibility to postpartum infections. Documenting these risk factors allows for heightened vigilance and targeted interventions.
2. Infection Signs and Symptoms Monitoring:
Rationale: Early detection of infection is crucial for prompt treatment and preventing serious complications. Monitor for systemic signs of infection, such as fever, chills, and elevated heart rate. Assess for localized signs of infection, such as uterine tenderness, abdominal pain, foul-smelling lochia (vaginal discharge), and changes in lochia color or amount. For surgical incisions (C-section, episiotomy), monitor for localized infection signs: redness, warmth, swelling, pain, and purulent drainage.
3. Laboratory Data Monitoring:
Rationale: Laboratory tests can provide objective evidence of infection and guide treatment. Monitor white blood cell count (WBC), which is typically elevated in infection. Elevated neutrophils and lactic acid levels can also indicate infection. Blood cultures may be obtained to identify specific pathogens before initiating antibiotic therapy, particularly in cases of suspected sepsis or severe infection.
Nursing Interventions:
1. Antibiotic Administration:
Rationale: Administering antibiotics as prescribed is crucial for treating postpartum infections. Broad-spectrum antibiotics are often initiated empirically (before pathogen identification) to cover a range of potential bacteria. In severe infections or sepsis, intravenous (IV) antibiotics are necessary for rapid and effective treatment. Once cultures identify the specific pathogen, antibiotic therapy may be narrowed to target the causative organism. For less severe infections, oral antibiotics may be appropriate for outpatient management.
2. Infection Risk Reduction Strategies Pre-Delivery:
Rationale: Proactive measures to reduce infection risk are essential throughout the peripartum period. Emphasize meticulous hand hygiene for healthcare providers and patients. Avoid routine perineal shaving prior to vaginal delivery, as it can create micro-abrasions that increase infection risk. Preoperative showering with antiseptic soap before Cesarean sections reduces skin bacterial load. Maintain strict glycemic control in patients with diabetes to minimize infection susceptibility.
3. Patient Education on Infection Recognition and Prevention:
Rationale: Educating patients about the signs and symptoms of postpartum infection empowers them to seek timely medical attention. Instruct patients to monitor for fever, persistent or worsening pain, changes in lochia (foul odor, increased bleeding), and signs of wound infection (redness, swelling, drainage). Provide clear instructions on when to seek prompt medical care.
4. Wound Care Education and Demonstration:
Rationale: Proper wound care is essential for preventing infection and promoting healing of episiotomy and C-section incisions. For episiotomy care, advise patients to avoid straining during bowel movements (stool softeners may be needed). Encourage the use of ice packs in the immediate postpartum period to reduce swelling and pain. Sitz baths with warm water can be initiated 24 hours after birth to promote healing and comfort. Instruct patients to change postpartum pads frequently (every 2-4 hours) and to always wipe from front to back after using the restroom to prevent fecal contamination. Demonstrate perineal cleansing using a peri-bottle with warm water and patting dry with a clean towel. For C-section incision care, instruct patients to keep the dressing clean and dry until instructed to remove it. Advise washing the incision gently with soap and water as directed, avoiding scrubbing.
