A nurse reviews the provider prescriptions and reassesses the client.

Exhibits

The nurse is continuing to care for the client. Which of the following actions should the nurse take? Select all that apply.

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.

A. Vaccinate susceptible children and adults against smallpox: Vaccination is a public health intervention but is typically conducted under the direction of public health authorities and is not a routine nursing disaster preparation activity.

B. Assess types, levels, and scopes of disasters: While understanding disaster types is important, assessment of scope and level is generally part of emergency management planning at an organizational or governmental level, rather than a direct nursing responsibility.

C. Make quarantine preparations for those exposed to anthrax: Quarantine planning is a public health measure implemented by authorities during an actual event. Nurses may assist in care during quarantine, but preparing quarantines is not a primary preparation activity.

D. Participate in community drills and mock events: Engaging in drills and simulations allows nurses to practice roles, improve response times, and enhance preparedness for real disaster situations. Participation in these exercises is a key nursing activity in disaster planning.