A nurse is assessing a client who is 1 hr postpartum. Which of the following findings should the nurse report to the provider?

A. Heart rate 90/min:

A heart rate of 90 beats per minute is within the normal range for a postpartum client. While tachycardia (an elevated heart rate) can be a sign of hemorrhage, a heart rate of 90/min alone is not necessarily indicative of hemorrhage.

B. Blood pressure 88/40 mm Hg:

A blood pressure of 88/40 mm Hg is low and may indicate hypotension, which can be a sign of hemorrhage. Hypotension, especially when accompanied by other signs such as tachycardia, pallor, or altered mental status, can indicate significant blood loss.

C. Urinary output 40 mL/hr:

A urinary output of 40 mL/hr is low and may indicate decreased perfusion, which can be a sign of hemorrhage. Postpartum hemorrhage can lead to decreased blood volume, resulting in decreased organ perfusion and urine output.

D. Moderate rubra lochia:

Lochia rubra, which is red-tinged vaginal discharge occurring in the first few days after childbirth, is normal postpartum. However, the presence of moderate rubra lochia alone is not a definitive sign of hemorrhage. It's essential to assess the amount, color, and consistency of lochia along with other clinical signs and symptoms.

. Lochia rubra with small clots:

Lochia rubra is the normal vaginal discharge occurring after childbirth, consisting of blood, mucus, and uterine tissue. It is expected for lochia to be present in the immediate postpartum period, and small clots are also considered normal as long as they are not excessive in size. Therefore, this finding is within the expected range for a client who is 1 hour postpartum and does not require immediate reporting to the provider.

B. Minimal perineal edema:

Perineal edema, or swelling in the perineal area, can be common after childbirth, particularly following vaginal delivery or if there was perineal trauma during labor. Some degree of perineal edema is generally expected in the immediate postpartum period and may resolve with time and appropriate care. As long as the edema is minimal and not causing significant discomfort or obstructing the assessment, it is not typically a cause for immediate concern or reporting to the provider.

C. Boggy fundus:

A boggy fundus refers to a uterus that feels soft and mushy instead of firm and well-contracted. It suggests uterine atony, which is a significant concern in the postpartum period as it can lead to excessive bleeding and postpartum hemorrhage. Therefore, a boggy fundus should be reported promptly to the provider so that interventions can be initiated to address the uterine atony and prevent complications.

D. Temperature 37.7°C (99.9°F):

A temperature of 37.7°C (99.9°F) is slightly elevated but may still fall within the normal range for the immediate postpartum period. While fever can indicate infection, a single temperature reading alone may not be sufficient to confirm an infection. It is important for the nurse to continue monitoring the client's temperature and assess for other signs and symptoms of infection before reporting to the provider. Therefore, this finding does not necessarily warrant immediate reporting unless accompanied by other concerning symptoms suggestive of infection.