Question

The nurse is monitoring a postpartum client in the fourth stage of labor. Which finding, if noted by the nurse, would indicate a complication related to a laceration of the birth canal?

1. Presence of dark red lochia
2. Palpation of the uterus as a firm contracted ball
3. The saturation of more than one peripad per hour
4. Palpation of the fundus at the level of the umbilicus

Answer 1

The saturation of more than one peripad per hour is a finding that suggests a birth canal laceration, which indicates an excessive bleeding complication in a postpartum client during the fourth stage of labor.

Step-by-step explanation:

The nurse monitoring a postpartum client in the fourth stage of labor may find several signs that are indicative of normal postpartum changes or potential complications. A finding that would suggest a complication, such as a laceration of the birth canal, is the saturation of more than one peripad per hour. This could indicate excessive bleeding and might be associated with a birth canal laceration rather than normal lochia discharge. After the delivery of the placenta, the mother experiences a vaginal discharge called lochia. Lochia rubra, which is thick and dark red, typically continues for 2-3 days, followed by lochia serosa and lochia alba over the next few weeks. The contraction of the uterus after delivery helps limit blood loss and initiate the process of involution, returning the uterus and abdominal organs to their pre-pregnancy state. It's important that aspects such as the presence of dark red lochia, the firmness of the uterus, and the position of the fundus are monitored. However, excessive bleeding would be more indicative of a complication like a birth canal laceration than the expected lochia or a normally contracting uterus.