A nurse is teaching a postpartum client about lochia and when to report abnormal findings.

Which of the following statements by the client indicates an understanding of the teaching?

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.

The correct answer is choice C. Palpate the fundus for firmness.This is because an unpleasant odor of lochia (postpartum vaginal discharge) can indicate an infection or retained placental fragments in the uterus.Palpating the fundus can help assess the uterine involution and detect any abnormalities.

Choice A is wrong because documenting the finding is not enough to address the potential problem.The nurse should also notify the provider and take further actions as ordered.

Choice B is wrong because encouraging the woman to empty her bladder regularly is not related to the odor of lochia.It is a general measure to prevent urinary tract infections and promote uterine contraction.

Choice D is wrong because administering oxytocics as prescribed is not a nursing action for lochia with an unpleasant odor.Oxytocics are drugs that stimulate uterine contractions and are used to prevent or treat postpartum hemorrhage.

They do not affect the infection or retention of placental fragments.

Normal ranges for lochia are:

• Lochia rubra: dark or bright red blood, lasts for 3 to 4 days, flows like a heavy period, small clots are normal.

• Lochia serosa: pinkish brown discharge, lasts for 4 to 12 days, thinner and more watery than lochia rubra, moderate flow, less or no clots.

• Lochia alba: yellowish white discharge, lasts from 12 days to 6 weeks, light flow or spotting, no clots.

Lochia should have a stale, musty or metallic odor like menstrual blood.It should not smell fishy or foul, which can indicate an infection.