A nurse is providing care for a client who is scheduled for electroconvulsive therapy. Which of the following conditions should the nurse identify as an increased risk for complications?

Rationale:
A. Instruct the client’s partner to assume care of the colostomy for the client: Having the partner take over care may reinforce the client’s avoidance and hinder acceptance of the stoma. The goal is to promote gradual involvement and self-care.

B. Encourage the client and partner to avoid expressing negative feelings about the colostomy: Suppressing emotions can delay psychological adjustment. The nurse should instead encourage open discussion of feelings.

C. Transfer the client to a rehabilitation facility for instruction about self-management of the colostomy: Transferring the client is unnecessary at this stage and may add emotional stress. Education and emotional support can be effectively provided in the current care setting.

D. Suggest the client join a support group for people who have colostomies: Support groups provide opportunities to share experiences with others who have undergone similar surgeries. Peer support can reduce isolation, promote acceptance, and help the client adapt to lifestyle changes more confidently.

Rationale:
A. Obtain a culture specimen of the lochia from the client's perineal pad using a sterile swab: The client exhibits signs of postpartum infection, including foul-smelling lochia, fever, and elevated WBC count. Collecting a culture helps identify the causative organism and guide antibiotic therapy.

B. Instruct the client to wash her hands before and after changing her perineal pad: Hand hygiene reduces the risk of introducing additional pathogens to the uterine or perineal area, supporting infection control and client safety.

C. Initiate contact precautions: Contact precautions are typically used for highly contagious or multidrug-resistant infections. Standard precautions, including hand hygiene, are sufficient for most postpartum infections like endometritis.

D. Encourage the client to maintain a semi-Fowler's position to enhance uterine drainage: Semi-Fowler’s positioning promotes drainage of lochia, reduces uterine stasis, and helps prevent further infection or discomfort.

E. Monitor the height and tone of the client's fundus: Regular assessment of fundal height and tone is essential postpartum to detect uterine atony, retained tissue, or infection. Monitoring ensures early intervention if complications develop.

F. Request a prescription for terbutaline from the provider: Terbutaline is a tocolytic used to suppress preterm labor. There is no indication for its use in this postpartum client with uterine infection.

G. Inform the client she will need to formula feed her newborn until she has received antibiotics for 24 hr: Most antibiotics, including clindamycin, are compatible with breastfeeding. The client does not need to discontinue breastfeeding unless specifically contraindicated.