A nurse is caring for a client who is 4 days postpartum following a. cesarean birth.

Exhibits

For each potential assessment finding, click to specify if the assessment finding is consistent with mastitis or endometritis.

Each finding may support this more than 1 disease process.

Choice A rationale:

Having the client exhale deeper than she inhales is a breathing technique that can help manage pain but does not specifically address the request for pain management techniques during natural childbirth. Option A does not provide comprehensive information about pain management strategies during labor.

Choice B rationale:

Providing information about the use of hydrotherapy during labor is a valid suggestion. Hydrotherapy, such as taking a warm bath or using a shower during labor, can help alleviate pain and promote relaxation. It is a non-pharmacological pain management option that the client can consider.

Choice C rationale:

Encouraging the client to have the family exit the room when the pain is unbearable may offer emotional support, but it does not provide a direct pain management technique. Additionally, the presence of loved ones can be a source of comfort for the client during labor.

Choice D rationale:

Informing the client that using pharmacological pain management will not impact the delivery is a true statement. Pharmacological pain relief methods, such as epidural anesthesia, do not affect the progress of labor or the outcome of delivery. However, this option does not provide an alternative pain management technique for the client who desires natural childbirth.

Choice A rationale:
Contractures are a risk for this client due to the lack of movement and constant positioning on one side. Contractures occur when the muscles, tendons, or ligaments shorten and tighten, limiting range of motion and flexibility. This can be a result of prolonged immobility or lack of use of the muscles.
Choice B rationale:
Calcium resorption is not a risk for this client. Calcium resorption refers to the process where bone tissue is broken down and calcium is released into the bloodstream. This process is not directly related to immobility or multiple sclerosis.
Choice C rationale:
Hypocalcemia, or low calcium levels in the blood, is also not a direct risk for this client. While immobility can lead to bone loss over time, it does not directly cause hypocalcemia.
Choice D rationale:
Diarrhea is not a risk for this client based on the information provided. Diarrhea can be a symptom of many conditions but there is no indication in the scenario that this client is at risk.
Choice E rationale:
Urinary stasis is a risk for this client due to their immobility. When a person is immobile, urine can pool in the bladder, creating an environment where bacteria can grow, potentially leading to urinary tract infections.

Choice F rationale:
Hypertension, or high blood pressure, is not a direct risk for this client based on the information provided. While chronic diseases like multiple sclerosis can indirectly contribute to hypertension through stress or medication side effects, it’s not directly caused by immobility or multiple sclerosis.

Choice G rationale:

Pressure injury is a significant risk for this client due to their constant positioning on one side and refusal to change positions. Pressure injuries occur when there is prolonged pressure on one area of the body, restricting blood flow and leading to tissue damage and necrosis.

Choice H rationale:

Atelectasis, or collapse of part of the lung, is also a risk for this client due to their immobility. When a person is immobile, they may take shallow breaths which do not fully inflate the lungs, leading to areas of collapse.