A client who is now a G6 P6006 is 15 minutes postpartum from a normal vaginal delivery. The newborn weighed 10 lbs 13 ounces (4595 grams) at birth. Which of the following complications should the nurse monitor for in this client?

Choice A rationale A newborn weighing 10 lbs 13 ounces (4595 grams) is classified as macrosomic. The delivery of a macrosomic infant is a significant risk factor for postpartum hemorrhage. The uterus is overstretched due to the large fetus, which can lead to uterine atony. Uterine atony is the primary cause of postpartum hemorrhage, as the myometrium fails to contract effectively to compress the maternal blood vessels. Choice B rationale Thrombosis is a potential complication postpartum, but it is not the most significant risk associated with the birth of a macrosomic infant. The major risk factor linked specifically to a large baby is uterine atony, which leads to hemorrhage. While a P6006 client is at a higher risk for all postpartum complications due to high parity, the most immediate and specific risk here is hemorrhage due to uterine overdistention. Choice C rationale Seizures can occur postpartum, primarily in clients with preeclampsia or eclampsia. However, there is no information in the scenario to suggest the client has a history of preeclampsia. Therefore, while a possibility, it is not the most likely complication based on the given information. The birth of a macrosomic infant is directly linked to the risk of postpartum hemorrhage. Choice D rationale Postpartum infection is a potential complication, especially with a history of multiple deliveries and potential for birth trauma. However, this is not the most immediate or highest risk factor directly associated with the delivery of a macrosomic infant. The primary risk from uterine overdistention is the failure of the uterus to contract and control bleeding, making hemorrhage the most significant concern.