Health Promotion and Maintenance
41. A 23-year-old client, who is gravida 3, para 2, delivered a baby by vacuum-assisted vaginal delivery 2 days ago. As part of the discharge teaching class, for which conditions should a nurse instruct the client to call a physician? Select all that apply.
. Pain that is not well controlled by prescription pain medication.
. Pain in her calves when walking.
. Foul-smelling lochia.
. Lochia serosa that is soaking less than a pad every 3 hours.
. Soaking more than a pad an hour with lochia.
Test-Taking Tip
Reportable conditions are: "pain," "foul-smelling," and "soaking more . . . ."
Content Area: Maternity, Postpartum; Integrated Process: Nursing Process, Implementation; Cognitive Level: Analysis; Client Need/Subneed: Physiological Integrity/Reduction of Risk Potential/Potential for Alterations in Body Systems
Health Promotion and Maintenance
. . . .
Answer 1 is correct because pain that is not well controlled by pain medication can be indicative of a postpartum complication, such as endometritis, and the physician should be notified. Answer 2 is correct because pain in her calves while walking may be a sign of thrombophlebitis, and the physician should be notified. Answer 3 is correct because foul-smelling lochia is a symptom of endometritis, and the physician should be notified. Answer 4 is incorrect because lochia serosa that is soaking less than a pad every 3 hours is normal for a client who is postpartum, and does not need to be reported to the physician. Answer 5 is correct because soaking more than a pad an hour may be a sign of retained placental fragments, and the physician should be notified.