In which clinical situation would the nurse most likely anticipate a fetal bradycardia?

• White blood cell count: Expected—mild leukocytosis is normal postpartum due to physiological stress.
• Blood clot size: Expected—small clots, like a pea-sized clot, are common and not concerning unless excessive bleeding occurs.
• Uterine findings: Expected—firm and midline uterus indicating effective involution.
• Lochia findings: Expected—progressing normally without signs of infection (no foul odor).
• Calf findings: Expected—a single varicose vein without tenderness or swelling is not concerning.
• Blood pressure: Expected—within normal postpartum range.

The nurse should first address the client’s calf findings followed by their stress about discharge.

Rationale for correct answers

Calf findings must be addressed first due to the risk of deep vein thrombosis (DVT), which is a known complication of cesarean delivery and postpartum immobility. The presence of unilateral calf edema (3 cm greater than the right) and tenderness, combined with an elevated D-dimer, strongly suggests a thrombotic process requiring urgent evaluation. If DVT is confirmed, anticoagulation therapy should be initiated promptly to prevent progression to pulmonary embolism.

Stress about discharge should be the second priority, as emotional concerns can affect adherence to postpartum care instructions. Addressing anxiety about recovery, follow-up visits, and newborn care can improve the client’s overall well-being and readiness for discharge.

Rationale for incorrect Response 1 options

• Breast engorgement: Although uncomfortable, this is a transient issue that can be managed with cold compresses and supportive bras. It does not pose an immediate health risk.
• Constipation: Postpartum bowel irregularities are expected after cesarean delivery; stool softeners and hydration can alleviate symptoms without urgency.
• Surgical incision pain: Rated only 2/10, indicating mild pain that does not require immediate intervention beyond routine analgesia.