A nurse is providing prenatal teaching about iron to a client who follows a vegetarian diet. The nurse should recommend that the client consume which of the following foods to enhance the absorption of nonheme iron?

Rationale:

A. Remove the thermometer from the client’s room for use on another client: Equipment used for clients with C. difficile should be dedicated or properly disinfected before reuse. Removing and using the same thermometer on other clients without disinfection increases the risk of cross-contamination.

B. Wash hands with an alcohol-based cleaner: Alcohol-based hand sanitizers are ineffective against C. difficile spores. Handwashing with soap and water is required to physically remove the spores from the hands.

C. Change gloves after contact with infectious material: Gloves must be changed between tasks and after contact with infectious material to prevent spread. This is standard contact precaution practice for C. difficile infections.

D. Wear a gown when providing care: A gown should be worn during any direct care or activities likely to involve contact with the client or contaminated surfaces, as C. difficile is transmitted via the fecal-oral route and can persist on surfaces.

E. Wear an N95 respirator when providing care: An N95 respirator is not required for C. difficile, which is transmitted through contact, not airborne routes. Standard and contact precautions, not airborne, are appropriate.

Rationale for Correct Choices:

• Intravenous antibiotic: The client shows multiple signs of endometritis: uterine tenderness, foul-smelling lochia, fever, tachycardia, and elevated WBC count. IV antibiotics are the first-line treatment for postpartum uterine infections, particularly after cesarean delivery with risk factors like prolonged rupture of membranes.
• Increase in daily fluid intake: Clients with infection and fever require increased hydration to support perfusion, manage elevated metabolic demands, and help clear the infection. Fever and poor bowel motility may also contribute to mild dehydration, making fluid support essential.

Rationale for Incorrect Choices:

• Intrauterine tamponade balloon: This is used to control postpartum hemorrhage due to uterine atony or trauma. Although the fundus was boggy, it firmed with massage, and there is no indication of active or excessive bleeding, making tamponade unnecessary.
• Kleihauer-Betke test: This test detects fetal blood in the maternal circulation and is used after trauma or suspected fetal-maternal hemorrhage, especially in Rh-negative mothers. It is not relevant to this postpartum infection scenario.
• Tocolytic medication: Tocolytics are used during pregnancy to suppress preterm labor by relaxing the uterus. In the postpartum period, they are not indicated and would be contraindicated in the presence of infection, as they can reduce uterine tone and worsen involution.