A nurse is assessing a client who is postpartum and has developed endometritis.
Which of the following findings should the nurse expect?

Choice A rationale

Cranberry juice has a low pH, creating an acidic environment in the gastrointestinal tract which can help to neutralize bacteria and reduce malodorous compounds like indole and skatole, thereby decreasing odor. This action is beneficial, so avoiding it is not the correct advice for odor control.

Choice B rationale

Breath mints or commercial deodorizers contain ingredients like peppermint or chlorophyll that chemically neutralize odor-causing volatile sulfur compounds produced during digestion. Placing a breath mint inside the ostomy pouch releases these agents, effectively masking and reducing the unpleasant smell from gas and stool.

Choice C rationale

Eggs are a rich source of sulfur-containing amino acids, such as cysteine and methionine. When these are digested by intestinal bacteria, they produce hydrogen sulfide gas, which is the primary contributor to a strong, unpleasant odor and increased flatus. Consuming eggs would exacerbate the problem.

Choice D rationale

Sugar-free gum often contains sugar alcohols like sorbitol or xylitol. These are poorly absorbed in the small intestine and are fermented by colonic bacteria, leading to the production of gas. This can increase flatus and may contribute to bloating and discomfort for the client.

Choice E rationale

Removing the old dressing is the first step in a dressing change procedure. It must be done to visualize the site and assess for signs of infection or other complications. Proper removal also prevents contamination of the new dressing materials and allows for thorough cleansing of the area before a new dressing is applied, which is a critical step in maintaining aseptic technique.

Choice C rationale

Masking is a crucial step in maintaining a sterile field and preventing cross-contamination. Donning a mask protects the client from respiratory microorganisms of the nurse and protects the nurse from potential splashes or aerosolized particles from the client's catheter site. This step is performed after removing the old dressing but before creating the sterile field to minimize contamination risk.

Choice B rationale

Creating a sterile field is an essential step in preventing microbial contamination of the catheter site. A sterile field provides a clean, controlled environment for sterile supplies and equipment. The nurse must establish this field after donning a mask and before touching any sterile items to ensure that the materials used for the dressing change remain free of pathogens.

Choice D rationale

Cleansing the site with an antiseptic solution like povidone-iodine is a critical step to reduce the bacterial load and prevent infection. This action is performed after the sterile field is established but before applying the new dressing. The antiseptic solution disrupts microbial cell membranes and inactivates enzymes, thus reducing the risk of a catheter-associated bloodstream infection.

Choice A rationale

Applying precut gauze pads is the final step in the sequence. These pads provide a protective barrier over the cleansed site, absorb any drainage, and prevent environmental microorganisms from entering the site. This action is taken after the site has been thoroughly cleaned and dried, ensuring that the new dressing remains sterile and effective. *.