A nurse is caring for four 1-day postpartum clients. Which assessment requires follow-up?

A nurse is caring for four 1-day postpartum clients. Which assessment requires follow-up?

• A. Lochia red and foul-smelling odor
• B. Mild afterpains
• C. Pulse rate of 60 beats per minute
• D. Colostrum discharge from both breasts

Answer: (A)

In the immediate postpartum period, watch for signs of uterine infection versus normal involution. Red lochia with a foul odor is not expected and points to a possible endometritis; this requires prompt follow-up and assessment because infection can worsen quickly and may need antibiotics and uterine evaluation. Mild afterpains are a common, normal part of postpartum uterine involution and can be managed with comfort measures. A pulse of 60 beats per minute can be normal after delivery due to increased vagal tone and ongoing stabilization, so this alone isn’t alarming. Colostrum discharge from the breasts is expected as lactation begins. The presence of foul-smelling lochia is the finding that most clearly indicates a need for immediate follow-up.

In the immediate postpartum period, watch for signs of uterine infection versus normal involution. Red lochia with a foul odor is not expected and points to a possible endometritis; this requires prompt follow-up and assessment because infection can worsen quickly and may need antibiotics and uterine evaluation. Mild afterpains are a common, normal part of postpartum uterine involution and can be managed with comfort measures. A pulse of 60 beats per minute can be normal after delivery due to increased vagal tone and ongoing stabilization, so this alone isn’t alarming. Colostrum discharge from the breasts is expected as lactation begins. The presence of foul-smelling lochia is the finding that most clearly indicates a need for immediate follow-up.