A nurse is reviewing the medical record of a client who had abdominal surgery 2 days ago. The nurse should identify that which of the following findings indicates the client is at risk for delayed wound healing?

Rationale:
A. Fundal height: The fundus has descended to 4 cm below the umbilicus and remains firm, indicating effective involution of the uterus and improvement from the previously boggy, tender fundus.

B. Heart rate: The client’s heart rate has decreased from 110/min on postpartum day 3 to 88/min on day 5, reflecting stabilization and decreased physiologic stress.

C. Hgb: Hemoglobin decreased slightly from 11.1 g/dL to 10 g/dL. While this is a minor drop, it does not indicate improvement and may reflect ongoing blood loss or hemodilution postpartum.

D. Temperature: The client’s temperature has normalized to 37.2° C (99° F) from febrile readings of 38.6° C (101.5° F), indicating resolution of the infection or inflammatory process.

E. WBC count: The WBC count decreased from 33,000/mm³ to 10,000/mm³, demonstrating resolution of the previous leukocytosis associated with infection or postpartum inflammation.

F. Lochia: Lochia has decreased in amount, is brownish-red without odor, indicating normal postpartum progression and resolution of the previously foul-smelling discharge, signifying improvement.

Rationale:
A. Gently push the syringe plunger to administer medication: Medications given via NG tube should be administered slowly and gently using a syringe to avoid tube damage, aspiration, or sudden changes in gastric pressure. This technique ensures safe and effective delivery of the medication.

B. Dissolve the medications together: Mixing multiple medications can cause chemical interactions or precipitation, which can block the NG tube or reduce medication efficacy. Each medication should be dissolved and administered separately.

C. Flush the NG tube with 5 mL of cold tap water after administration: Flushing is necessary to maintain tube patency, but 5 mL is insufficient for continuous feedings. Typically, 15–30 mL of warm or room-temperature water is used to prevent tube occlusion.

D. Add medication directly to the enteral feeding: Adding medication to the feeding can alter the composition, affect absorption, and create a risk for tube blockage. Medications should be given separately with flushing before and after administration.