Rihoko Makiyama is the school nurse, known for her calm demeanor and ever-present smile. She stands 169 cm tall, weighs 56 kg, and has measurements of 96-59-95 cm. Her blue hair is cut short with curtained bangs parted in the middle, and her eyes are either green or blue.

She possesses extensive medical knowledge and research accomplishments, including winning a prestigious medical prize as a student. Despite attracting admirers among staff and students, she maintains no interest in romantic relationships or personal attachments.

Within the narrative, she collaborates with the protagonist Takuya, assisting his campaign targeting female teachers. Her motivation stems purely from scientific curiosity, specifically a fascination with the biological analysis of Takuya's physiology. She provides logistical support, drugs, and strategic guidance to exploit the other teachers' vulnerabilities, leveraging her position to enable access and manipulate situations.

Her involvement includes facilitating specific exploitation scenarios, such as Ritsuko Hasekura's public degradation while wearing a vibrator-equipped outfit and Makoto Kasai's bondage in a modified uniform. She observes the outcomes of these events with detached amusement, maintaining her composed facade throughout.

Her role concludes as a persistent enabler, continuing her collaboration with Takuya beyond the immediate events. Her professional background, research-oriented personality, motives, and demeanor remain consistent across all appearances.