Endometritis

Endometritis

Endometritis

        Endometritis is the inflammation and infection of the inner lining of the uterus. This is the most common site of infection in the postpartum period. Endometritis occurs in 1-3% of people who have vaginal births and in 10-20% of people who have cesarean births. This infection usually begins at the site of the endometrium that the placenta is attached to and spreads to the entire endometrium. The onset of this infection occurs about 2-4 days following childbirth. Signs and symptoms of endometritis include prolonged fever >100.4 degrees fahrenheit, either heavy, foul smelling lochia, or scant, odorless lochia, depending on the bacteria present, uterine or abdominal tenderness, chills, poor appetite, malaise, increased pulse rate, edema, dysuria, cramping pain, and increased white blood cell count. Because urinary tract infection can also occur anytime during or after pregnancy, differentiating the various signs and symptoms is important. The nurses role in caring for a patient with endometritis includes, administering the ordered antibiotics and treating the symptoms. We would treat the symptoms for this infection by encouraging our patient to rest, administering antipyretics, increasing fluid intake, encourage high protein and foods high in vitamin c, promote uterine drainage by ambulation and Fowler’s position, and encourage effective perineal care. It may be difficult for the mother to focus on rest and self care with a newborn baby at home so it’s important for the nurse to keep that in mind. Tests and procedures that a women with this infections may have include, a vaginal and bimanual examination, a culture of lochia, a urinalysis to rule out urinary tract infection, and a complete blood count to check white blood cell count. It’s important to educate the patient and their families about the diagnosis and prognosis of the infection and the treatment plan and measures to promote good hygiene and follow-up care. Although many infections are easily cured with antibiotics, the psychosocial stress of the postpartum complication can affect the patient and their family. Prolonged treatment of hospital stays may create financial burdens, negatively impact family relationships, and interfere with attachment with the new infant. The infant will also be affected if the mother has to stay in the hospital and cannot breastfeed the infant. As nurses, it’s important for us to refer our patients to the social worker, chaplin, financial counselor, lactation consultant, or a community health nurse to ensure holistic care. The nurse has the responsibility to help the patient and her family identify when these referrals are beneficial and advocate to ensure these needs are being met (Hisley & Ward, 2016). A nursing diagnosis that would fit this postpartum complication would be, Interrupted Family Processes related to a temporary shift in the health status of the mother. The first intervention I would use for this diagnosis would be to acknowledge the range of emotions and feelings that the mother may be experiencing being away from her new baby and being unable to help her family. My rationale for this intervention is that the nurse needs to be empathetic to the mother and provide her with whatever resources she needs during this time and ensure the mothers knows we are there to listen if she wants to talk. The second intervention I would use, is to assist the family in setting realistic goals. My rationale for this intervention is that it will help the family gain control over the situation. The nurse can help educate other family members on how to care for the baby so the mother can rest and heal. The nurse can also give reassurance that they are available if the family has any questions or concerns (Ackley & Ladwig, 2017).