The nurse has received shift report on the postpartum unit. Which patient should the nurse see first?

A) Postpartum blues are transient and usually occur within the first week after delivery:
Postpartum blues, also known as "baby blues," are common and generally transient. They typically occur within the first few days to a week after delivery and can last for a few days to a week or two. Symptoms may include mood swings, irritability, crying, anxiety, and difficulty sleeping. These feelings are normal and typically resolve without the need for medical intervention. It's important for the nurse to provide reassurance that this is a common experience for many new mothers and that it is usually temporary.

B) Medications are available to relieve the symptoms:
While medications may be necessary for more severe postpartum mood disorders, such as postpartum depression, they are not typically required for postpartum blues. Since postpartum blues are mild and transient, most women do not need medications. Psychosocial support and rest are usually sufficient. Medications, especially antidepressants, are considered for women who develop postpartum depression, which is more persistent and severe than postpartum blues.

C) The father may become sad and weepy:
While fathers can experience emotional changes during the postpartum period, the phenomenon of postpartum blues is specific to the mother due to the hormonal and physiological changes related to childbirth and breastfeeding. Fathers may experience mood changes due to the stresses of parenthood, but postpartum blues is typically not recognized as a condition affecting men. However, men can experience postpartum depression or anxiety, which warrants different attention and support.

D) Very few women experience postpartum blues:
On the contrary, postpartum blues is very common, affecting a large percentage of women after childbirth. Studies show that 50-80% of women experience some form of postpartum blues. This makes the statement incorrect. It's important to normalize the experience and emphasize that it is a common and temporary reaction to the changes associated with childbirth.

A) Rubra, serosa, alba:
The normal progression of lochia, the vaginal discharge after childbirth, follows a predictable sequence of stages. Lochia rubra is the initial stage, occurring within the first few days postpartum. It is bright red and consists primarily of blood, tissue, and debris from the placenta. After 3-4 days, the discharge changes to lochia serosa, which is pinkish-brown and contains a mixture of blood, serous fluid, and mucous. After 10-14 days, it progresses to lochia alba, which is white or pale yellow and consists mostly of leukocytes (white blood cells), mucus, and epithelial cells. This is the expected progression, which marks the natural healing process after childbirth.

B) Rubra, alba, serosa:
This order is incorrect because lochia serosa comes before lochia alba in the normal sequence. Lochia alba occurs after lochia serosa, not before. This progression would not accurately reflect the typical stages of lochia.

C) Serosa, alba, rubra:
This sequence is incorrect as lochia rubra is the first stage, not lochia serosa. The initial discharge following childbirth is always red and blood-tinged, which is lochia rubra. Serosa and alba come later in the progression, so this order does not follow the correct timeline.

D) Alba, rubra, serosa:
This order is completely incorrect. Lochia rubra (red blood discharge) is the first stage, not lochia alba (white discharge). After childbirth, rubra occurs first, followed by serosa, and then finally alba. This sequence does not reflect the normal postpartum discharge process.