Question

The nurse ambulates a postpartum client to the bathroom for the first time after the client gave birth 3 hours ago. The client reports feeling a sudden gush of bleeding from the vagina while ambulating. Which is most likely the cause of the bleeding?

a) Uterine atony
b) Cervical laceration
c) Vaginal hematoma
d) Normal postpartum lochia

Answer 1

The sudden gush of bleeding from the vagina while ambulating is likely due to lochia, which is the normal postpartum vaginal discharge, as the client's position change likely caused the repositioning of clots and pooling of lochia.Thus, the correct answer is option D.

Step-by-step explanation:

The sudden gush of bleeding from the vagina that the postpartum client experienced upon ambulation is most likely due to the repositioning of clots and pooling of lochia that occurs when the mother changes position. Lochia is the postpartum vaginal discharge made up of uterine lining cells, erythrocytes, leukocytes, and other debris. It is normal to see a gush of this discharge, especially after being in a reclined position for a while, such as after giving birth.

This scenario is not typically indicative of uterine atony, which would cause a more constant and heavy flow of blood due to the uterus not contracting effectively. A cervical laceration or vaginal hematoma might also cause bleeding, but these are typically associated with trauma during delivery and would likely have been identified earlier by the obstetric care team or present with more continuous bleeding or pain.

The normal process of lochia involves lochia rubra, which is thick, dark, and typically continues for 2-3 days after childbirth. It is followed by lochia serosa, a thinner, pinkish discharge lasting until about the tenth postpartum day, and then by lochia alba, a scant, creamy, or watery discharge continuing for another 1-2 weeks.