A nurse is reviewing the prescribed orders for a client who is two days postpartum and has a fourth degree perineal laceration. Which of these orders should the nurse question?

A. Acetaminophen is an appropriate analgesic for postpartum pain relief. B. Encouraging oral fluids is essential for hydration, bowel function, and healing. C. A sitz bath is beneficial for perineal healing, reducing pain and inflammation. D. Correct. Enemas are contraindicated in clients with fourth-degree perineal lacerations because they may cause trauma, pain, and further damage to the perineal area. Stool softeners are preferred to prevent straining.