A nurse on a postpartum unit is caring for a client.

For each finding, click to specify if the finding is consistent with uterine atony or infection. Each finding may support more than 1 disease process or none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row.

A. Increase intake of milk products: Many clients with irritable bowel syndrome (IBS) have lactose intolerance or worsened gastrointestinal symptoms with dairy consumption. Increasing milk products could exacerbate bloating, cramping, and diarrhea.

B. Increase intake of foods high in gluten: Gluten can trigger symptoms in some clients, especially those with IBS or non-celiac gluten sensitivity. Increasing gluten intake is not recommended and may worsen abdominal discomfort and bloating.

C. Sweeten foods with fructose corn syrup: Fructose and high-fructose corn syrup can worsen IBS symptoms, causing gas, bloating, and diarrhea. Clients should avoid foods high in fructose to minimize gastrointestinal discomfort.

D. Consume foods high in bran fiber: Soluble fiber, such as that found in bran, can help regulate bowel movements and reduce constipation in IBS. Increasing intake of fiber-rich foods is a safe and effective dietary strategy to manage symptoms.

A. WBC count: The client’s WBC count decreased from 33,000/mm³ to 10,000/mm³, returning to the expected postpartum reference range. This decline indicates resolution of the infectious or inflammatory process, consistent with effective antibiotic therapy for postpartum infection such as endometritis.

B. Heart rate: The heart rate decreased from tachycardic values (104–110/min) to 78/min, which is within normal limits. Resolution of tachycardia suggests improvement in systemic stress, infection, and overall hemodynamic stability.

C. Fundal height: The fundus progressed from being above the umbilicus to 4 cm below the umbilicus, demonstrating appropriate uterine involution. This finding reflects improved uterine tone and reduced risk of postpartum hemorrhage or ongoing uterine infection.

D. Temperature: The client’s temperature normalized from febrile readings (38.2–38.6°C) to 37.1°C. Resolution of fever is a key indicator of infection control and clinical improvement following antimicrobial treatment.

E. Hgb: Hemoglobin decreased from 11.1 g/dL to 10 g/dL, which does not indicate improvement. This trend suggests ongoing physiologic postpartum blood loss or dilution and does not reflect recovery.

F. Lochia: Lochia changed from dark brown with foul odor to a small amount of brownish-red lochia without odor. This improvement indicates resolution of uterine infection and normalization of postpartum uterine discharge.