NCLEX Review Guide: Postpartum Infections

Definition and Types

• Postpartum infection is defined as a temperature of 38°C (100.4°F) or higher on any two of the first 10 days postpartum, excluding the first 24 hours.
• Common types include endometritis, wound infections, urinary tract infections, and mastitis.
• Risk factors include prolonged labor, prolonged rupture of membranes, multiple vaginal examinations, and cesarean delivery.

Assessment and Clinical Manifestations

• Fever, chills, malaise, and abdominal pain are primary symptoms of endometritis.
• Foul-smelling lochia is a classic sign that requires immediate attention and antibiotic therapy.
• Uterine tenderness on palpation and subinvolution (delayed uterine return to pre-pregnancy size) may occur.

Types and Management

• Episiotomy infections present with increased pain, edema, erythema, and purulent drainage at the incision site.
• Cesarean incision infections show similar signs plus possible wound dehiscence or separation.
• Treatment includes antibiotics, wound care, and possible surgical intervention for severe cases.

1. Assess wound daily for signs of infection (redness, warmth, swelling, drainage)
2. Maintain strict aseptic technique during wound care
3. Teach proper perineal hygiene (front to back cleansing)
4. Monitor for systemic signs of infection

Assessment and Nursing Care

• Unilateral breast pain, redness, and warmth typically occurring 2-4 weeks postpartum in breastfeeding mothers.
• Flu-like symptoms including fever, chills, and body aches accompany breast symptoms.
• Continue breastfeeding to prevent milk stasis and promote healing - this is often counterintuitive to patients.

Risk Factors and Prevention

• Catheterization during labor, bladder trauma, and urinary retention increase UTI risk postpartum.
• Encourage frequent voiding every 2-3 hours and complete bladder emptying to prevent stasis.
• Symptoms include dysuria, frequency, urgency, and possible flank pain if pyelonephritis develops.

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