Final answer:
When assessing for signs of an impending hemorrhage due to cervical lacerations, monitoring for continuous trickling of blood is crucial. The firmness of the uterus and the observation of lochia are additional considerations. It is vital to examine the placenta for completeness and to understand the normal postpartum process of uterine involution.
Step-by-step explanation:
When assessing a postpartum client for signs of an impending hemorrhage secondary to lacerations of the cervix, in addition to monitoring for a firm uterus, it is also important to observe for a continuous trickling of blood. This could indicate that despite a well-contracted uterus, there are lacerations elsewhere in the birth canal that are bleeding. Monitoring vital signs is crucial; however, a decrease in pulse rate or an increase in blood pressure are not typically associated with hemorrhage (pulse rate would likely increase and blood pressure might drop in case of significant bleeding). Persistent muscular twitching is not a direct indicator of hemorrhage. It is also important for healthcare professionals to examine the placenta and any expelled tissues to ensure they are intact and that no fragments remain that could cause a hemorrhage.
Postpartum uterine contractions, known as involution, help to limit blood loss and facilitate the process of the uterus returning to its pre-pregnancy size. Breastfeeding supports this process by promoting uterine contractions. Additionally, the observation of lochia, a postpartum vaginal discharge, can provide insight into the uterine healing process and should transition from lochia rubra to lochia serosa and finally to lochia alba over the weeks following childbirth.