A nurse is collecting data from a patient who gave birth one week ago.
Which of the following findings should the nurse identify as a manifestation of endometritis?

Choice A rationale:

Stopping breastfeeding until the antibiotics are done is not a recommended practice. Most antibiotics are safe to use while

breastfeeding. Moreover, stopping breastfeeding can lead to engorgement.

Choice B rationale:

Applying cold compresses 20 minutes before each feeding is not a recommended practice. Cold compresses are usually

recommended after breastfeeding to help reduce swelling. Warm compresses or taking a warm shower before breastfeeding

can help increase milk flow and promote the letdown reflex.

Choice C rationale:

Feeding the baby every 2 hours is a good practice to prevent breast engorgement. Frequent feeding helps to empty the breasts,

which can prevent them from becoming overly full and engorged.

Choice D rationale:

Not wearing a bra during the daytime is not a recommended practice. Wearing a well-fitted bra can provide support and help

reduce discomfort associated with breast engorgement.

Rationale for Choice A:

Having the client pant during the next few contractions is not appropriate at this time. While panting can be a helpful

breathing technique during earlier stages of labor, it is not recommended when the client feels the urge to push.

Panting can actually delay the progress of labor by preventing the client from bearing down effectively.

It is important to allow the client to push when she feels the urge, as this will help to facilitate the descent of the fetal head and

progress labor.

Rationale for Choice B:

Helping the client to the bathroom to empty her bladder is not the priority action at this time. While a full bladder can

sometimes interfere with labor progress, it is more important to assess the perineum for signs of crowning before taking the

client to the bathroom.

If the fetal head is crowning, it is crucial to avoid any unnecessary delays in delivery.

Rationale for Choice C:

Assisting the client into a comfortable position is important for labor progress, but it is not the priority action at this time.

Assessment of the perineum for signs of crowning takes precedence, as it will guide the nurse's subsequent actions.

Once crowning is confirmed, the nurse can then help the client into a position that facilitates pushing, such as squatting, semi-

sitting, or side-lying.

Rationale for Choice D:

Assessing the perineum for signs of crowning is the most appropriate action for the nurse to take in this situation.

Crowning is the term used to describe the appearance of the fetal head at the vaginal opening.

It is a definitive sign that the client is in the second stage of labor and that delivery is imminent.

By assessing for crowning, the nurse can confirm the progress of labor and prepare for the delivery of the baby.