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Difficulty: EasyAnte/Intra/Postpartum and Newborn Care

A practical nurse (PN) is reinforcing discharge teaching for a client who is 36 hours postpartum following an uncomplicated vaginal birth. The PN instructs the client to seek immediate medical attention if which change in vaginal bleeding (lochia) occurs at home?

  1. Saturating a perineal pad completely in less than 1 hour.Answer
  2. B
    Transitioning of the discharge to a pinkish-brown color.
  3. C
    Experiencing a temporary increase in bleeding while breastfeeding.
  4. D
    Noticing a fleshy, menstrual-like odor to the vaginal discharge.

Answer

Saturating a perineal pad completely in less than 1 hour.
Saturating a perineal pad in less than 1 hour is a classic danger sign of postpartum hemorrhage. The practical nurse must ensure the client understands that this requires immediate medical evaluation to prevent severe hypovolemic shock.

Step-by-Step Solution

1
Analyze the time frame.
The client is 36 hours postpartum and preparing for discharge.
Understanding the timeline helps distinguish between normal physiological changes and danger signs of late postpartum complications.
2
Evaluate each option against normal postpartum findings.
Pinkish-brown discharge, increased flow during breastfeeding, and a fleshy odor are all expected normal findings. Saturating a pad in under an hour is abnormal.
Identifying expected versus unexpected lochial characteristics is essential for safe discharge education.
3
Determine the priority action.
Instruct the client that excessive bleeding (saturating a pad in less than 1 hour) requires immediate emergency medical attention.
This is a classic sign of postpartum hemorrhage, which can rapidly lead to hypovolemic shock.

Key Concept

Postpartum Hemorrhage Identification
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Topics

Ante/Intra/Postpartum and Newborn Care

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