A nurse is caring for a client who had an abdominal hysterectomy. The nurse observes that the client has a low-grade fever, foul-smelling vaginal discharge and lower abdominal tenderness. Which of the following actions should the nurse take first?

Choice A reason:

This is incorrect because gentle shoulder shrugs and circles are not enough to prevent lymphedema and promote mobility. The client needs to perform more active and progressive exercises that involve the full range of motion of the shoulder joint.

Choice B reason:

This is incorrect because lifting the arm above the head several times a day is too aggressive and may cause swelling and pain. The client should gradually increase the elevation of the arm over several weeks, starting with 90 degrees and then progressing to 120 degrees.

Choice C reason:

This is correct because using the affected arm for normal activities as much as possible helps to restore function and prevent stiffness. The client should avoid heavy lifting, tight clothing, blood pressure measurements, and injections on the affected arm, but otherwise should use it for daily tasks such as combing hair, dressing, and eating.

Choice D reason:

This is incorrect because wearing a compression sleeve on the affected arm is not recommended for routine use after a mastectomy. Compression sleeves are only indicated for clients who have developed lymphedema and need to reduce the swelling. They may also be used for air travel or strenuous exercise, but only with a physician's prescription.

Choice A reason:

Atelectasis is the collapse of alveoli in the lungs, which can impair gas exchange and cause hypoxia. It can occur after surgery due to anesthesia, pain, or immobility. However, atelectasis does not usually cause fever and chills, unless it is complicated by pneumonia.

Choice B reason:

Dehydration is the loss of fluid and electrolytes from the body, which can affect blood pressure, heart rate, and kidney function. It can occur after surgery due to blood loss, vomiting, or inadequate intake. However, dehydration does not usually cause fever and chills, unless it is associated with infection or heat stroke.

Choice C reason:

Inflammation is the body's response to tissue injury or infection, which involves increased blood flow, swelling, pain, and heat. It can occur after surgery as part of the normal healing process. However, inflammation does not usually cause fever and chills, unless it is severe or systemic.

Choice D reason:

Infection is the invasion and multiplication of microorganisms in the body, which can trigger an immune response and cause inflammation, fever, and chills. It can occur after surgery due to contamination of the surgical site, catheters, or intravenous lines. Infection is the most likely cause of fever and chills in a postoperative patient.