A charge nurse is preparing to lead negotiations among nursing staff due to a conflict about overtime requirements. Which of the following strategies should the charge nurse use to promote effective negotiation?

A. Weight gain 2.3 kg (5 lb): Mild weight gain can occur with oral contraceptive use and is generally not dangerous. This finding does not require immediate reporting.

B. Frequent nausea: Nausea is a common side effect, especially during the first few months of therapy. While bothersome, it is usually not an urgent concern unless severe or persistent.

C. Breast tenderness: Breast tenderness is a common, mild side effect of oral contraceptives and does not typically indicate a serious problem requiring immediate intervention.

D. Persistent headache: A new, persistent, or severe headache can indicate vascular complications, such as hypertension or increased risk of thromboembolism, which are serious adverse effects of oral contraceptives. This finding requires immediate reporting.

Rationale for Correct Choices:

• Intravenous antibiotic: The client is exhibiting signs of postpartum endometritis, including fever, tachycardia, a boggy and tender uterus, and foul-smelling lochia. IV antibiotics are the standard treatment to rapidly address bacterial infection and prevent systemic complications.
• Increase in daily fluid intake: Adequate hydration supports the client’s recovery by improving perfusion to the uterus, aiding in the clearance of infection, and preventing dehydration, especially if the client is febrile or breastfeeding.

Rationale for Incorrect Choices:

• Intrauterine tamponade balloon: This intervention is used primarily for severe postpartum hemorrhage, which is not evident in this client. Vital signs and lochia amount do not indicate ongoing hemorrhage.
• Kleihauer-Betke test: This test identifies fetal-maternal hemorrhage, which is not relevant to postpartum infection management. The client’s presentation suggests infection rather than blood loss.
• Tocolytic medication: Tocolytics are used to suppress preterm labor, which is not a concern for a postpartum client. The client’s symptoms are consistent with infection rather than uterine contractions needing suppression.