A nurse is teaching a newly licensed nurse about workplace bullying. Which of the following should the nurse include in the discussion as an example of workplace bullying?

Rationale:

A. Obtain filterless IV tubing: Blood transfusions require specialized IV tubing with an in-line filter to remove clots and debris. Using filterless tubing would increase the risk of transfusing particulate matter into the client’s bloodstream.

B. Place the blood in a warmer for 1 hr: Blood should only be warmed if specifically prescribed and done using an approved device immediately before administration. Prolonged warming increases the risk of bacterial growth and hemolysis.

C. Use a 24-gauge IV catheter: Packed RBCs should be administered through a larger-bore catheter (typically 18–20 gauge) to allow adequate flow and prevent hemolysis. A 24-gauge catheter is too small for efficient transfusion.

D. Prime IV tubing with 0.9% sodium chloride: Normal saline is the only compatible solution for priming and administering blood products. It prevents clotting and hemolysis while ensuring that the blood flows freely without interacting with other IV solutions.

Rationale for Correct Choices:

• Intravenous antibiotic: The client is exhibiting signs of postpartum endometritis, including fever, tachycardia, a boggy and tender uterus, and foul-smelling lochia. IV antibiotics are the standard treatment to rapidly address bacterial infection and prevent systemic complications.
• Increase in daily fluid intake: Adequate hydration supports the client’s recovery by improving perfusion to the uterus, aiding in the clearance of infection, and preventing dehydration, especially if the client is febrile or breastfeeding.

Rationale for Incorrect Choices:

• Intrauterine tamponade balloon: This intervention is used primarily for severe postpartum hemorrhage, which is not evident in this client. Vital signs and lochia amount do not indicate ongoing hemorrhage.
• Kleihauer-Betke test: This test identifies fetal-maternal hemorrhage, which is not relevant to postpartum infection management. The client’s presentation suggests infection rather than blood loss.
• Tocolytic medication: Tocolytics are used to suppress preterm labor, which is not a concern for a postpartum client. The client’s symptoms are consistent with infection rather than uterine contractions needing suppression.