A nurse is collecting data from a patient who gave birth one week ago.
Which of the following findings should the nurse identify as a manifestation of endometritis?

Choice A rationale:

Three fingerbreadths above the umbilicus is too high for the uterine fundus to be at 12 hours postpartum. Immediately after delivery, the fundus is typically at the level of the umbilicus. It then descends approximately one fingerbreadth per day.

If the fundus is found to be three fingerbreadths above the umbilicus at 12 hours postpartum, it could be a sign of uterine atony, which is a serious condition that can lead to postpartum hemorrhage.

Choice C rationale:

One fingerbreadth above the symphysis pubis is too low for the uterine fundus to be at 12 hours postpartum. This would be more consistent with a woman who is several days postpartum.

Choice D rationale:

One fingerbreadth below the umbilicus is also too low for the uterine fundus to be at 12 hours postpartum. This would be more consistent with a woman who is 1-2 days postpartum.

Choice A rationale:

Urinary retention is not a common sign of impending labor. In fact, it's more likely to occur in the early stages of pregnancy

due to hormonal changes and the pressure of the growing uterus on the bladder. As labor approaches, the baby's head often

descends into the pelvis, which can relieve some of the pressure on the bladder and make urination more frequent, not less

frequent.

Urinary retention can be a sign of other medical concerns, such as a urinary tract infection or problems with bladder function.

It's important to report any difficulty urinating to a healthcare provider for proper evaluation and treatment.

Choice B rationale:

A decrease in vaginal discharge is not typically associated with impending labor. On the contrary, many women notice an

increase in vaginal discharge, often referred to as "bloody show," as labor approaches. This discharge is typically pink or

brownish in color and may contain streaks of blood. It's caused by the release of the mucus plug that seals the cervix during

pregnancy.

A decrease in vaginal discharge could be a sign of other issues, such as a decrease in amniotic fluid or a yeast infection. It's

important to report any changes in vaginal discharge to a healthcare provider for assessment.

Choice D rationale:

A weight gain of 0.5 to 1.5 kilograms (1 to 3 pounds) is not a reliable sign of impending labor. Weight fluctuations are common

in late pregnancy due to factors such as fluid retention and changes in blood volume. Some women may even lose a small

amount of weight in the days leading up to labor.

While significant weight gain (more than 2 kilograms or 4 pounds in a week) could indicate a potential issue like preeclampsia,

a small weight gain or loss is not typically a cause for concern in terms of labor onset.

Choice C rationale:

A surge of energy, often referred to as "nesting instinct," is a common sign that labor may be approaching. This sudden burst of

energy can manifest as a strong urge to clean, organize, and prepare the home for the baby's arrival. It's thought to be caused

by a combination of hormonal changes and the body's natural instincts to prepare for childbirth.

While the exact timing of labor is unpredictable, experiencing a surge of energy, especially in conjunction with other signs like

increased Braxton Hicks contractions, lower back pain, or pelvic pressure, may suggest that labor is likely to start within the

next few days or weeks.