A nurse is interviewing the partner of a client who was admitted in the manic phase of bipolar disorder. The partner states, "I don't know what to do. Everything has been happening so quickly." Which of the following responses by the nurse is therapeutic?

• Client reports feeling unwell: This is clinically significant when combined with fever, foul-smelling lochia, and elevated WBCs; it could indicate systemic infection such as endometritis.
• Fundus boggy but firms with massage: Indicates uterine atony, a risk factor for postpartum hemorrhage. Even if it responds to massage, repeated bogginess suggests the need for uterotonic medications and close monitoring.
• Foul-smelling, dark brown lochia: These findings are highly suggestive of uterine infection (endometritis), especially when paired with uterine tenderness, fever, and elevated WBCs.
• WBC count 33,000/mm³: Severely elevated — well above normal postpartum leukocytosis (typically up to 20,000/mm³). A level of 33,000 strongly suggests an ongoing infectious process.
• Temperature 38.2°C (100.8°F): Slightly elevated, and while low-grade fever is common postpartum, when associated with uterine tenderness and abnormal lochia, it raises concern for infection and should be monitored and managed appropriately.
• Lung sounds diminished in the bases: Could be due to post-surgical hypoventilation, immobility, or atelectasis. Should prompt encouragement of deep breathing, incentive spirometry, and ambulation.
• No bowel movement since birth, hypoactive bowel sounds: This is a common post-cesarean finding due to anesthesia and immobility, but it still indicates delayed return of GI function and should be monitored for signs of ileus.

A. Irrigate the wound using a 10-mL syringe. A 10-mL syringe does not provide adequate pressure for effective irrigation. Typically, a 30- to 60-mL syringe with an 18-gauge catheter is used to deliver appropriate pressure (between 4–15 psi) to clean wounds effectively.
B. Irrigate the wound with a low-pressure flow of solution. This is correct. A low-pressure irrigation system helps gently remove debris and bacteria without damaging healthy tissue. It also minimizes the risk of forcing contaminants deeper into the wound bed.
C. Cleanse the insertion site of the drain using a circular motion toward the center. The site should be cleansed from the center outward, not toward the center, to prevent dragging contaminants into the insertion site and reduce infection risk.
D. Cleanse the wound starting at the bottom and moving upward. Wound cleaning should occur from the least contaminated (top) to the most contaminated (bottom) area to avoid transferring microorganisms from dirtier areas to cleaner areas, thereby minimizing the risk of infection.