A nurse is assessing a client who is 6 hr postpartum and has endometritis. Which of the following findings should the nurse expect?
A.
Temperature 37.4°C (99.3°F).
B.
Uterine tenderness.
C.
WBC Count 9,000/mm.
D.
Scant lochia.
The Correct Answer and Explanation is:
The correct answer is B. Uterine tenderness.
Explanation:
Endometritis is an infection of the endometrial lining of the uterus that can occur after childbirth, particularly in the postpartum period. The condition is commonly associated with a variety of clinical findings that nurses need to monitor for effective management and intervention.
- Temperature 37.4°C (99.3°F):
- A temperature of 37.4°C (99.3°F) is generally considered within the normal range for a postpartum client. Postpartum women can experience mild fever in the first 24 hours post-delivery due to the body’s response to labor and delivery, but a sustained or higher fever might indicate infection. Endometritis typically presents with a fever higher than 38°C (100.4°F), so a temperature of 37.4°C would not be a primary indicator of endometritis.
- Uterine tenderness:
- Uterine tenderness is a significant finding in cases of endometritis. This condition often causes discomfort or pain in the uterine area, which can be assessed through palpation. The infection can lead to inflammation and increased sensitivity in the uterus, making uterine tenderness a key indicator of endometritis. This finding should be carefully assessed by the nurse, as it helps in diagnosing the condition and guiding further management.
- WBC Count 9,000/mm³:
- A white blood cell (WBC) count of 9,000/mm³ is within the normal range for a postpartum client. After delivery, a mild elevation in WBC count can be expected as part of the body’s response to the stress of childbirth. However, endometritis is typically associated with a higher WBC count, often greater than 15,000/mm³, indicating an infection. Therefore, a WBC count of 9,000/mm³ would not be indicative of endometritis in isolation.
- Scant lochia:
- Lochia refers to the vaginal discharge after childbirth, which includes blood, mucus, and uterine tissue. Scant lochia is often a normal finding and does not specifically point to endometritis. Endometritis is more commonly associated with abnormal lochia, such as a foul odor, increased amount, or a change in color.
In summary, uterine tenderness is a key finding in endometritis as it reflects the infection and inflammation of the uterine lining, which is critical for diagnosing and managing this condition effectively.