A nurse is collecting information from a new client who is seeking prenatal care.
Which of the following findings should the nurse identify as a risk factor that increases the risk of pregnancy complications?

Choice A rationale

Lochia rubra, characterized by bright red discharge, typically lasts for the first 3-5 days postpartum. Its presence at 5 weeks postpartum would be abnormal and could indicate a complication such as retained placental fragments or infection, necessitating further medical evaluation due to prolonged uterine bleeding.

Choice B rationale

Lochia serosa, a pinkish-brown discharge, typically follows lochia rubra and can persist for about 2 to 3 weeks postpartum. While some individual variation exists, its presence up to 6 weeks postpartum as the predominant discharge type is less common and might suggest a slower than average uterine involution.

Choice C rationale

Complete cessation of lochia by 5 weeks postpartum is not typical for most individuals. The puerperium, or postpartum period, involves significant uterine involution and discharge. While the volume decreases, some form of lochia, usually alba, is still physiologically expected as the uterus continues to heal and shed decidual tissue.

Choice D rationale

Lochia alba, a yellowish-white discharge, is the final stage of lochia and typically begins around 2 to 6 weeks postpartum, continuing for up to 6 weeks or even longer in some individuals. This discharge consists of leukocytes, decidual cells, mucus, and bacteria, signifying the continued, normal healing and involution of the uterus.

Choice A rationale

This statement is incorrect as caloric needs increase during pregnancy to support fetal growth, placental development, and increased maternal metabolic demands. Inadequate caloric intake can lead to poor fetal outcomes, including low birth weight and impaired development.

Choice B rationale

While caloric needs do increase, an additional 500 calories is generally too high for the average pregnancy. The recommended increase is typically lower, focusing on nutrient-dense foods to ensure sufficient energy for both mother and fetus.

Choice C rationale

Doubling caloric intake is excessive and can lead to excessive maternal weight gain, increasing risks for gestational diabetes, preeclampsia, and delivery complications. The concept of "eating for two" is a common misconception that often leads to overconsumption.

Choice D rationale

During the second and third trimesters, the average pregnant woman requires an additional 300 calories per day above her pre-pregnancy needs. This increase provides adequate energy for rapid fetal growth, development, and maternal physiological changes, such as increased blood volume and uterine expansion.