A nurse is assessing a client who is 6 hr following a vaginal birth and experienced a placental abruption. Which of the following findings should the nurse report to the provider?

Choice A reason: Moderate lochia rubra is expected within the first 24 hours postpartum. Lochia rubra consists of blood and decidual tissue and should be moderate in amount. This finding is normal and does not indicate a complication. It would only be concerning if the lochia were excessive, foul-smelling, or accompanied by large clots, which could suggest postpartum hemorrhage or infection. Choice B reason: 1+ nonpitting ankle edema is a common finding in the immediate postpartum period due to fluid shifts and increased vascular volume during pregnancy. Mild edema is not unusual and typically resolves as diuresis occurs in the days following delivery. This finding does not require immediate provider notification unless it progresses to severe edema or is associated with hypertension, which could indicate preeclampsia. Choice C reason: A urine output of 400 mL within two voids is within normal limits. Postpartum women often experience diuresis as the body eliminates excess fluid retained during pregnancy. Adequate urine output indicates good renal perfusion and hydration status. Oliguria (less than 30 mL/hr) would be concerning, but this finding does not meet that threshold. Choice D reason: Petechiae under the blood pressure cuff are abnormal and concerning. Petechiae suggest capillary fragility or a coagulation disorder, which may occur in the context of disseminated intravascular coagulation (DIC). Placental abruption is a known risk factor for DIC because of the release of thromboplastin into maternal circulation, which can trigger widespread clotting and subsequent bleeding. This finding requires immediate provider notification because it may indicate a life-threatening complication.