A postpartum client sustained a fourth-degree perineal laceration during vaginal delivery. The nurse is developing a care plan focused on promoting healing and preventing complications. Which combination of interventions best addresses the unique challenges of this type of injury?

A. Fourth-degree lacerations extend through the rectal mucosa, making infection and wound dehiscence major concerns. Stool softeners prevent straining, while perineal hygiene and peri-bottle use reduce bacterial contamination. Monitoring for urinary retention ensures early detection of pelvic floor dysfunction or trauma-related swelling. B. While ambulation aids circulation, restricting fluids can cause dehydration and constipation. Avoiding Kegel exercises delays pelvic floor strengthening, which supports healing. Cold compresses are beneficial initially but should not replace hygiene and bowel care. C. Limiting pain control can impair mobility and self-care. Dietary fiber restriction worsens constipation and straining, which increase pain and risk of wound disruption. Sitz baths are beneficial but not sufficient alone for complete care. D. Strong laxatives can cause diarrhea and trauma to sutures, while inadequate cleansing heightens infection risk. Early follow-up is crucial for wound assessment, making delayed appointments unsafe.