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 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.

The correct answer is choice D. Both A and B.A boggy uterus is a uterus that is enlarged, soft, and tender due to the failure of the uterus to contract sufficiently after delivery.This condition is called uterine atony and it is the most common cause of postpartum hemorrhage.Postpartum hemorrhage is excessive bleeding after childbirth that can lead to shock and death if not treated promptly.

The nursing actions indicated for a boggy uterus are:

• Perform immediate fundal massage: This helps to stimulate uterine contractions and reduce bleeding.

• Ambulate to the bathroom or use bedpan to empty bladder: This helps to reduce bladder distension and allow the uterus to contract and descend into the pelvis.

Choice A is partially correct but not sufficient by itself.

Choice B is also partially correct but not sufficient by itself.Choice C is incorrect because administering oxytocin alone may not be effective in restoring uterine tone if there are other factors contributing to uterine atony, such as overdistension, prolonged labor, or infection.Oxytocin is a hormone that stimulates uterine contractions.