Final answer:
A nurse should expect normal postpartum changes such as lochia rubra and a decreasing uterine fundus level. A fundus 2 cm above the umbilicus is not expected at 32 hours postpartum, temperature of 39°C indicates a possible infection, and urine output of 3,000ml/24hr is within normal range.
Step-by-step explanation:
A nurse collecting data from a client who is 32 hours postpartum should expect several physiologic changes as the body begins to recover from childbirth. Lochia rubra, the vaginal discharge made up of uterine lining cells, erythrocytes, leukocytes, and debris, is usually present during the initial 2-3 days postpartum. This discharge would not saturate a perineal pad every 15 minutes, which could indicate excessive blood loss requiring medical attention. The fundus, or top of the uterus, should be returning to its non-pregnant size and location. It is typically found around the level of the umbilicus (navel) immediately after birth and descends 1-2 cm each day. Therefore, a fundus 2 cm above the umbilicus would be an expected finding soon after birth but not at 32 hours postpartum. A temperature of 39°C (102.2°F) is indicative of a potential infection and is not a normal finding postpartum. The urine output of 3,000 ml in 24 hours may be on the higher end but is considered a normal postpartum finding as the body eliminates excess fluid accumulated during pregnancy.
Complete Question
A nurse is collecting data from a client who is 32ℎr postpartum. Which of the following findings should the nurse expect?
1.Saturation of one perineal pad every 15min
2.Fundus 2cm above the umbilicus
3.Temperature of 39°C (102.2°F)
4.Urine output of 3,000ml in 24ℎr