Question

A nurse is caring for a client who is 3 days postpartum.

Medical History
Gravida 1, Para 1. 38 weeks of gestation. Forceps-assisted birth following failed vacuum-assisted attempt.3rd degree laceration with a repair. Amniotic membranes ruptured for 18 hr prior to delivery. Pregnancy complicated by gestational diabetes and anemia.

Vital Signs:
Temperature 38.3° C (101° F)Heart rate 104/min. Respiratory rate 20/min. Blood pressure 108/70 mm Hg

Nurses' Notes:
Client states "I feel terrible today. I have this feeling of pain and pressure in my pelvis." The Client reports general malaise and chills. Uterus firm at the umbilicus and tender to palpation. Moderate amount of dark foul-smelling lochia noted. Generalized perineal edema observed. Frequently voiding large amounts of urine. Client reports an abdominal pain level of 5 on a scale of 0 to 10.

Diagnostic Results:
Hemoglobin 10 mg/dL (12 to 16 mg/dL, pregnant > 11 g/dL) Hematocrit 37% (37 to 47%, pregnant > 33%) WBC count 37,000/mm3 (5,000 to 10,000 mm3​)

A nurse is caring for a client who is 3 days postpartum. Based on the information provided, what is the most concerning finding that requires immediate attention?

A) Uterus firm at the umbilicus.

B) Dark foul-smelling lochia.

C) Generalized perineal edema.

D) Frequently voiding large amounts of urine.

Answer 1

The dark foul-smelling lochia is the most concerning finding that requires immediate attention postpartum.

Step-by-step explanation:

Based on the information provided, the most concerning finding that requires immediate attention is the dark foul-smelling lochia. Dark foul-smelling lochia may indicate an infection such as endometritis, which is inflammation of the uterine lining. This can be a serious condition that requires prompt medical intervention to prevent further complications.