A nurse is planning care for a client who is to begin using a hearing aid. Which of the following instructions should the nurse include in the plan?

A. Back pain: Back pain is not a hallmark finding of postpartum endometritis. While some discomfort may occur due to uterine involution or positioning during labor, infection of the endometrial lining typically presents with uterine tenderness rather than isolated back pain. It is more commonly associated with musculoskeletal strain or renal conditions.

B. Bradycardia: Endometritis is an infectious process, and the body’s response typically includes tachycardia rather than bradycardia due to fever and systemic inflammation. Bradycardia would be inconsistent with the expected physiological response to infection and may suggest an alternative or unrelated condition.

C. Agitation: Although severe infection or sepsis can lead to altered mental status, agitation is not a primary or early sign of postpartum endometritis. More common early findings include fever, uterine tenderness, foul-smelling lochia, and systemic signs of infection rather than behavioral or cognitive disturbances.

D. Chills: Chills are a classic systemic manifestation of infection and are commonly associated with postpartum endometritis. The infection of the uterine lining triggers an inflammatory response, leading to fever and chills as the body attempts to fight the invading pathogens. These findings often occur alongside uterine tenderness and foul-smelling lochia.

A. Airborne: Airborne precautions are used for pathogens that remain infectious over long distances when suspended in the air, such as Mycobacterium tuberculosis or measles virus. MRSA is not transmitted via airborne particles, so airborne precautions are not indicated.

B. Contact: Contact precautions are appropriate for infections transmitted by direct or indirect contact with the client or contaminated surfaces. MRSA, particularly in wound infections, can spread through touching the wound, dressings, or contaminated objects. Implementing contact precautions—including wearing gloves and gowns and practicing strict hand hygiene—reduces the risk of transmission to other clients and healthcare personnel.

C. Droplet: Droplet precautions are used for infections spread by large respiratory droplets, such as influenza or pertussis. MRSA wound infections are not transmitted via respiratory droplets, making droplet precautions unnecessary.

D. Protective environment: Protective environment precautions are designed to protect immunocompromised clients, such as those undergoing hematopoietic stem cell transplantation, from exposure to environmental pathogens. This is not relevant for a client with MRSA infection, whose care focuses on preventing transmission to others rather than shielding the client