A nurse is assessing a client for postpartum infection. Which of the following findings should indicate to the nurse that the client requires further evaluation for endometritis?

Pelvic pain

Hematuria

A localized area of breast tenderness

A moderate amount of dark red lochia with a foul odor

Answer and Explanation

The Correct Answer is A

Choice a) reason: Pelvic pain is a common symptom of endometritis. The pain is typically located in the lower abdomen and may be associated with uterine tenderness upon physical examination. This symptom, especially when combined with other signs such as fever and foul-smelling lochia, strongly suggests the need for further evaluation for endometritis.

Choice b) reason: Hematuria, or blood in the urine, is not a typical symptom of endometritis. While it could be a sign of other postpartum complications, such as urinary tract infections or bladder injury during childbirth, it does not directly indicate endometritis.

Choice c) reason: A localized area of breast tenderness is more indicative of a breast infection, such as mastitis, especially if associated with breastfeeding. It is not a symptom of endometritis, which affects the uterus and not the breasts.

Choice d) reason: While foul-smelling lochia can be a sign of endometritis, the key is the presence of a foul odor. A moderate amount of dark red lochia alone, without a foul odor, is a normal finding in the immediate postpartum period. It's the transition from rubra (red) to serosa (pink/brown) to alba (yellow/white) that is expected as the uterus heals.

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Correct Answer is C

Explanation

Choice a reason:
A male condom is a barrier method of contraception that is typically easy to use and accessible. It has the added benefit of providing protection against sexually transmitted infections (STIs). However, its effectiveness can be compromised by improper use or breakage. With typical use, male condoms are about 85% effective.

Choice b reason:
A diaphragm with spermicide is another barrier method that can be used to prevent pregnancy. The diaphragm covers the cervix and the spermicide kills or immobilizes sperm. The effectiveness of a diaphragm with spermicide is generally lower than some other methods, with typical use effectiveness around 88%.

Choice c reason:
An intrauterine device (IUD) is a small device inserted into the uterus by a healthcare provider. IUDs come in two types: hormonal and copper. Both types are highly effective, with over 99% effectiveness. They are long-acting, reversible, and do not require daily attention, which contributes to their reliability.

Choice d reason:
An oral contraceptive, also known as the birth control pill, is a popular method of contraception that requires the user to take a pill at the same time every day. The effectiveness of the pill can be high, but because it relies on user adherence, its typical use effectiveness is around 91%.

A. Provide a sitz bath to a client who has a fourth-degree laceration and is 2 days postpartum. B. Monitor vital signs during admission of a client who has gestational hypertension. C. Change the perineal pad of a client who just transferred from labor and delivery. D. Observe an area of redness on the breast of a client who is 1 day postpartum.

Correct Answer is C

Explanation

Choice A reason:
Providing a sitz bath to a client with a fourth-degree laceration is a task that requires clinical judgment and skill to assess the healing process and manage potential complications. This task should not be delegated to an AP as it falls outside their scope of practice.

Choice B reason:
Monitoring vital signs during the admission of a client with gestational hypertension involves assessment and interpretation of data to detect potential complications. This is a nursing responsibility and should not be delegated to an AP, as it requires clinical judgment and knowledge of gestational hypertension.

Choice C reason:
Changing the perineal pad of a client who just transferred from labor and delivery is a task that can be delegated to an AP. This task does not require the AP to make assessments or clinical judgments, which makes it appropriate for delegation. The nurse should ensure that the AP has been trained and is competent in performing this task.

Choice D reason:
Observing an area of redness on the breast of a client who is 1 day postpartum involves assessment skills to determine if the redness is indicative of an infection or other complication. This task should not be delegated to an AP, as it requires clinical judgment and knowledge of postpartum complications.

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A nurse is assessing a client for postpartum infection. Which of the following findings should indicate to the nurse that the client requires further evaluation for endometritis?

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