A nurse is evaluating a postpartum woman’s knowledge about pain management after birth.

The nurse asks the woman what she would do if she has uterine cramping while breastfeeding her baby.

Which response by the woman indicates a need for further teaching?

The correct answer is D) Decreased white blood cell count.Postpartum endometritis is an infection of the lining of the uterus that causes fever, abdominal pain, uterine tenderness and sometimes discharge.It is usually caused by bacteria from the lower genital or gastrointestinal tract.White blood cell count is a marker of inflammation and infection, so a decreased white blood cell count indicates that the treatment is effective and the infection is resolving.

A) Decreased vaginal bleeding is not a sign of effective treatment for postpartum endometritis.

Vaginal bleeding after delivery is normal and gradually decreases over time.It is not related to the infection of the uterus.

B) Increased abdominal pain is a sign of worsening infection, not effective treatment.Abdominal pain is one of the symptoms of postpartum endometritis and should improve with antibiotic therapy.

C) Increased temperature is also a sign of worsening infection, not effective treatment.Fever is another symptom of postpartum endometritis and should decrease with antibiotic therapy.

The correct answer is choice A) Nausea and vomiting.This is because nausea and vomiting are common adverse effects of many antibiotics, especially clindamycin and gentamicin, which are often used to treat postpartum endometritis.Nausea and vomiting can also indicate a more serious complication of antibiotic therapy, such as Clostridioides difficile infection.

Choice B) Increased appetite is wrong because antibiotics do not typically affect appetite, and postpartum endometritis may cause loss of appetite due to fever, pain, and inflammation.

Choice C) Increased urine output is wrong because antibiotics do not usually increase urine output, and postpartum endometritis may cause dehydration due to fever and vomiting.

Choice D) Decreased heart rate is wrong because antibiotics do not generally lower heart rate, and postpartum endometritis may cause tachycardia due to fever, infection, and sepsis.