Question

The new mother who had a vaginal delivery yesterday has a white blood cell count of 30,000 cells/dL. The nurse should:

1) notify charge nurse of a possible infection.
2) prepare to put the patient in isolation.
3) have the infant removed from the room and returned to the nursery.
4) assess the patient further.

Answer 1

The appropriate action for a new mother with a high white blood cell count post-delivery is to further assess the patient for signs of infection and then proceed based on the findings.

Step-by-step explanation:

A white blood cell count of 30,000 cells/dL for a new mother who had a vaginal delivery yesterday is notably elevated, considering that the average range for a healthy individual is 3.5 to 11 x 10⁹ cells/L. While elevated white blood cell counts can be normal during labor and postpartum due to stress and physical exertion, such a high level may suggest a possible postpartum infection. Therefore, the most appropriate action is to assess the patient further, which includes evaluating her temperature, heart rate, uterine tenderness, and the characteristics of lochia, which is the postpartum vaginal discharge composed of uterine lining cells, leukocytes, and other debris. Typically, lochia progresses from red to pinkish to a creamy or watery discharge over several weeks after delivery. If the nurse uncovers signs and symptoms of infection, they should then notify the charge nurse, and if warranted, further steps such as isolation and having the infant removed from the room may be taken as per hospital protocols and the severity of the situation.