A nurse is assessing the amount, color, odor, consistency, and presence of clots or tissue in the lochia of a postpartum client.

Which of the following findings should the nurse report as abnormal?

The correct answer is choice D.“You should avoid straining during bowel movements.” This is because straining can cause pain and bleeding in the perineal area, especially if the client has an episiotomy or hemorrhoids.Straining can also worsen the damage to the pelvic floor muscles or the anal sphincter muscles that might have occurred during delivery.

Choice A is wrong because taking a laxative can cause diarrhea, dehydration, and electrolyte imbalance.Laxatives should only be used if prescribed by a health care provider.

Choice B is wrong because increasing fluid intake alone is not enough to prevent or treat constipation.Fluid intake should be combined with adequate fiber intake and physical activity.

Choice C is wrong because increasing fiber intake alone is not enough to prevent or treat constipation.Fiber intake should be combined with adequate fluid intake and physical activity.

Normal ranges for fluid intake are about 2 to 3 liters per day for a lactating woman and about 1.5 to 2 liters per day for a non-lactating woman.Normal ranges for fiber intake are about 25 to 35 grams per day for adults.Normal ranges for physical activity are about 150 minutes of moderate-intensity exercise per week for healthy adults.

The correct answer is choice D. Large clots on day 3 postpartum.This is because large clots indicate excessive bleeding and may be a sign of postpartum hemorrhage, which is a rare but potentially fatal condition that requires immediate medical attention.

Choice A is wrong because lochia rubra, which is dark or bright red blood, is normal for the first three to four days after birth.

Choice B is wrong because lochia serosa, which is pinkish brown discharge that’s less bloody looking, is normal for four to 12 days after birth.

Choice C is wrong because lochia alba, which is yellowish white discharge with little to no blood, is normal from about 12 days to six weeks after birth.

Normal ranges for lochia are:

• Lochia rubra: lasts for three to four days, flows like a heavy period, small clots are normal.

• Lochia serosa: lasts for four to 12 days, flow is moderate, less clotting or no clots.

• Lochia alba: lasts from about 12 days to six weeks, light flow or spotting, no clots.