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A nurse called to report a low grade temperature in a 20-year-old woman who delivered a healthy baby 12 hours earlier. She had a normal vaginal delivery, and the placenta was delivered spontaneously. She had shaking chills during and ten minutes following the delivery. She continues to have bloody vaginal discharge. Her temperature is 38.0C (100.4F), blood pressure is 120/80 mmHg, pulse is 76/min and respirations are 14/min. Pelvic examination shows bloody discharge along with small blood clots on the introitus and vaginal walls. Her uterus is soft and non-tender. Laboratory studies show a WBC of 11,000/mm3 with 78% neutrophils. Which of the following is the most appropriate next step in management?

A ). Reassurance
B ). Endometrial curettage
C ). Start empiric antibiotics
D ). Obtain urinalysis
E ). Culture of discharge


C - Started b4 culture of discharge.


Hi, Brain,
You did well along except this onewink
The answer is a.

I chose c, too. Based on she is having a fever and uterus is soft (lack of contraction leads to bleeding and infection??)

The answer says since she is not having foul smelling discharge, it is not infection. So a.


Thank you TSR. How can we explain she has fever and soft uterus? Is it indicated for early infection?


good one

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