A nurse is evaluating a client on the maternity unit who delivered a term newborn 10 hours ago via an uncomplicated vaginal birth. Which of the following findings should the nurse identify as expected and normal during this time? (Select all that apply.)
- A firm uterus palpated at the level of the umbilicusAnswer
- Moderate amount of dark red vaginal dischargeAnswer
- CResting heart rate of 118 beats per minute
- DComplete saturation of one perineal pad in 20 minutes
- Reports of mild, intermittent uterine cramping while breastfeedingAnswer
Answer
The expected and normal findings are a firm uterus at the umbilicus, a moderate amount of dark red vaginal discharge, and mild uterine cramping during breastfeeding.
In the initial 24 hours following childbirth, the body undergoes expected physiological adaptations. The uterus should remain firm and central, near the umbilicus, to compress blood vessels and prevent bleeding. Lochia rubra (dark red discharge) in moderate amounts is expected. Additionally, the release of oxytocin during breastfeeding causes the uterus to contract, leading to normal but sometimes painful afterpains.
Step-by-Step Solution
Key Concept
Normal postpartum physiological adaptations versus danger signs of hemorrhage.