A nurse is caring for a client who is 4 days postpartum following a. cesarean birth.
Nurses’ Notes.
Today.
0800:. Client reports not feeling well with headache, body aches, and.
chills.
Left breast red and tender with swollen, tender lymph.
nodes in the left axilla.
Incision edges well-approximated.
without erythema or drainage.
Small amount of lochia rubra.
noted.
0830:. Provider notified of findings.
Prescriptions received.
Laboratory Results.
3 days ago:. Hgb 12.0 g/dL (14 to 18 g/dL). Hct 40% (42% to 529%). WBC Count 20,500/mm³ (6,200 to 17,000/mm). Today.
0900:. Hgb 12.2 g/dL (14 to 18 g/dL). Hct 41% (429% to 5296). WBC count 34,500/mm² (6,200 to 17,000/mm). Vital Signs.
Today.
0800:. BP 116/81 mm Hg. Heart rate 104/min.
Temperature 38.8° C (101.9° F). Respiratory rate 19/min.
For each potential assessment finding, click to specify if the assessment.
finding is consistent with mastitis or endometritis.
Each finding may support this.
more than 1 disease process.
A.
Chills.
B.
Temperature.
C.
Painful, tender breast.
D.
Foul-smelling lochia.
The correct answer and Explanation is :
In the scenario provided, the nurse is assessing a postpartum client with several symptoms that could indicate either mastitis or endometritis. Let’s evaluate each potential assessment finding:
A. Chills.
Consistent with: Both mastitis and endometritis.
Explanation: Chills are a common symptom of infection and can occur in either condition. In mastitis, the infection can lead to systemic symptoms, including chills. Similarly, endometritis, an infection of the uterine lining, often presents with systemic symptoms as well.
B. Temperature.
Consistent with: Both mastitis and endometritis.
Explanation: The client’s elevated temperature (38.8° C or 101.9° F) indicates fever, which is a common sign of infection. In mastitis, fever occurs as the body responds to infection in the breast tissue. Endometritis also typically presents with fever due to the infection of the uterine lining.
C. Painful, tender breast.
Consistent with: Mastitis.
Explanation: Pain and tenderness in the breast are hallmark signs of mastitis. This condition usually presents with localized breast pain, swelling, and redness. While endometritis can cause pelvic pain, it does not typically cause breast tenderness.
D. Foul-smelling lochia.
Consistent with: Endometritis.
Explanation: Foul-smelling lochia is a key indicator of endometritis, suggesting a possible infection within the uterus. This symptom is less common in mastitis, which primarily affects breast tissue.
In summary, while chills and fever can be present in both conditions, painful, tender breast is specific to mastitis, and foul-smelling lochia is indicative of endometritis. This assessment helps in identifying the likely infection and guiding appropriate treatment for the postpartum client.