A nurse is collecting data from a client who is postpartum. Which of the following findings should alert the nurse to the possibility of a postpartum complication?

Expressions of excitement are typical during the dependent, taking-in phase, which lasts for the first 24 to 48 hr after delivery. The client may relive and review her labor and delivery experience, and may need reassurance and validation from others.

Choice B reason:

Lack of appetite is not an expected finding during the dependent, taking-in phase, as the client may have increased hunger and thirst after delivery. The nurse should encourage adequate nutrition and hydration to promote healing and lactation.

Choice C reason:

Eagerness to learn newborn care skills is more characteristic of the dependent-independent, taking-hold phase, which begins around the third day postpartum. During this phase, the client becomes more confident and interested in caring for herself and her newborn.

ChoiceD reason:

Focus on the family unit and its members is more characteristic of the interdependent, letting-go phase, which occurs after the first week postpartum. During this phase, the client redefines her role within the family and society, and integrates the newborn into her life.

Choice B reason:
Uterine atony is the failure of the uterus to contract and retract after delivery, which can lead to excessive bleeding and hemorrhage. The client is at risk for uterine atony due to delivering a large newborn, which can overstretch the uterine muscles and reduce their tone.

Choice A reason:
Puerperal infection is an infection of the reproductive tract that occurs within six weeks after delivery. The client is not at increased risk for puerperal infection due to delivering a large newborn, unless there are other factors such as prolonged labor, multiple vaginal exams, or episiotomy.

Choice C reason:
Thrombophlebitis is an inflammation of a vein with a blood clot formation. The client is not at increased risk for thrombophlebitis due to delivering a large newborn, unless there are other factors such as immobility, dehydration, or trauma.

Choice D reason:
Retained placental fragments are pieces of the placenta that remain in the uterus after delivery, which can cause bleeding and infection. The client is not at increased risk for retained placental fragments due to delivering a large newborn, unless there are other factors such as abnormal placental atachment, manual removal, or incomplete separation.