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 C rationale:

Endometritis is an inflammation of the inner lining of the uterus (endometrium). It is a common complication after childbirth,

affecting up to 1 in 10 women who deliver vaginally. Symptoms of endometritis typically develop within 1-3 days after

childbirth, but they can sometimes take up to a week to appear.

Swelling in the ankles is a common symptom of endometritis. This is because endometritis can cause inflammation and fluid

buildup in the pelvis, which can put pressure on the veins in the legs and cause them to swell.

Choice A rationale:

An increased heart rate can be a symptom of endometritis, but it is not a specific symptom. An increased heart rate can also be

caused by many other factors, such as fever, dehydration, and anxiety.

Choice B rationale:

Decreased appetite can be a symptom of endometritis, but it is not a specific symptom. Decreased appetite can also be caused

by many other factors, such as pain, fatigue, and nausea.

Choice D rationale:

Dry skin is not a typical symptom of endometritis. Dry skin can be caused by many other factors, such as dehydration,

medications, and underlying medical conditions.

Therefore, the most likely manifestation of endometritis in this patient is swelling in the ankles.

The correct answer is Choice D.

Choice A rationale: A fundus that is firm and 4 fingerbreadths above the umbilicus 24 hours postpartum indicates uterine atony or retained placental fragments. This finding is not typical and may require further medical evaluation to prevent postpartum hemorrhage.

Choice B rationale: A soft fundus 2 fingerbreadths below the umbilicus suggests uterine atony, which can lead to postpartum hemorrhage. Uterine atony is a condition where the uterus fails to contract effectively after childbirth.

Choice C rationale: A soft fundus to the right of the umbilicus may indicate a full bladder pushing the uterus to one side. It can interfere with uterine contractions and should be addressed by encouraging the client to empty their bladder.

Choice D rationale: A firm fundus at 1 fingerbreadth below the umbilicus is the expected finding 24 hours postpartum. It indicates that the uterus is contracting well and returning to its pre-pregnancy size, reducing the risk of postpartum hemorrhage.