The nurse is caring for a postpartum client who is experiencing severe pain and a sensation of pressure in her perineum.
Her uterus is firm, and she has a moderate flow of lochia.
Upon inspection, the nurse discovers that a perineal hematoma is starting to form. What should the nurse assess first?

Choice A rationale

While the healing of the placental site is a part of the postpartum recovery process, it does not directly correlate with the return of menstruation.

Choice B rationale

Ovulation does need to resume for menstruation to return, but the timing of ovulation resuming postpartum can vary greatly among individuals and does not provide a specific timeframe.

Choice C rationale

For a postpartum client who is formula-feeding her new baby, menstruation typically resumes six to eight weeks after birth.

Choice D rationale

While it is possible for menstruation to resume four weeks after birth, this is less common. The typical timeframe for the return of menstruation for a postpartum client who is formula- feeding is six to eight weeks.

Choice A rationale

A client who is 3 weeks postpartum and feeling tired all the time is a common scenario. Adjusting to a new baby can be challenging and it’s normal for new mothers to feel overwhelmed and fatigued. The nurse’s response should be empathetic and supportive,

encouraging the client to share more about her situation. This could help the nurse understand the client’s support system and provide appropriate advice or resources.

Choice B rationale

While it’s important to ensure that the client isn’t overexerting herself with chores, suggesting that she shouldn’t be doing any at all might not be practical or feasible. The presence and involvement of family members can vary greatly, and while their help can be beneficial, it’s not the only factor in managing postpartum fatigue.

Choice C rationale

It’s indeed common for new mothers to feel worn out for the first few months. However, simply advising the client to rest when the baby is sleeping might not address the root cause of her fatigue. It’s also important to consider other factors such as nutrition, emotional well- being, and available support.

Choice D rationale

Telling the client that it’s normal to feel fatigued for the first few weeks might minimize her feelings. Each person’s postpartum experience is unique, and it’s crucial to validate her feelings and provide individualized care.