A client who gave birth 15 days ago has returned to the emergency room with reports of a gush of foul-smelling rubra lochia and a temperature of 39°C (102.2°F). The nurse suspects postpartum hemorrhage and understands that this is most likely caused by

A. Coagulation disorders cause excessive bleeding but are not associated with foul-smelling lochia or fever. B. Cervical lacerations cause continuous bright red bleeding rather than foul-smelling lochia. C. A hypertonic uterus (overly contracted) is more associated with prolonged labor but does not cause foul-smelling discharge. D. Correct. Endometritis is a postpartum infection of the uterine lining, often presenting with foul-smelling lochia, fever, uterine tenderness, and elevated white blood cell count.