Which perineal care practice would indicate the need for further instruction?

• 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 peribottle to rinse upward into her vagina

Answer: (D)

The main idea is cleansing direction to prevent introducing bacteria to healing tissue. After childbirth, perineal care should move water from the front toward the back, away from the vagina, using the peribottle to rinse in that direction. Rinsing upward into the vagina can push bacteria from the anal area into the vaginal canal or urinary tract and can disrupt healing, increasing infection risk. So, using the peribottle to rinse upward into the vagina would indicate a need for further instruction. Proper technique also includes gentle cleaning with warm water (and mild soap if desired), washing front to back, and changing the perineal pad as needed based on lochia, then patting dry.