A nurse is caring for a client who is 5 hr postpartum following a vaginal birth of a newborn weighing 9 lb 6 oz. The nurse should recognize that this client is at risk for which of the following postpartum complications?

A. Postpartum infection: While all postpartum clients are at some risk for infection, this typically develops later and is not immediately associated with a large infant or the first few hours after birth. B. Retained placental fragments: Retained placental tissue can cause bleeding and infection, but careful inspection of the placenta after delivery usually rules this out. There is no indication in the scenario that fragments remain. C. Thrombophlebitis: Thromboembolic risk increases postpartum, especially with immobility, obesity, or a history of thrombosis. Although this client may have some risk factors, immediate concern in the first hours postpartum is more directly related to uterine tone. D. Uterine atony: Delivery of a macrosomic infant (9 lb 6 oz) increases the risk of uterine overdistention, which can lead to poor uterine contraction and uterine atony. Uterine atony is the most common cause of early postpartum hemorrhage and requires close monitoring and intervention.