A nurse is caring for a client who is 5 hr postpartum following a vaginal birth of a newborn weighing 9 lb 6 oz (4252 g). The nurse should recognize that this client is at risk for which of the following postpartum complications?

Choice A rationaleThrombophlebitis, while a postpartum risk, is more commonly associated with factors like immobility, hypercoagulability of pregnancy, and cesarean birth. The immediate postpartum period after a vaginal birth is a lower risk time compared to later in the puerperium.Choice B rationalePuerperal infection typically manifests 24 hours or more postpartum, with signs like fever, uterine tenderness, and foul-smelling lochia. While the client is at risk in the coming days, it is not the immediate primary concern at 5 hours postpartum.Choice C rationaleRetained placental fragments can lead to postpartum hemorrhage and infection, but the immediate risk after a vaginal birth of a large baby is more related to the uterus's ability to contract effectively. Signs would typically include persistent heavy bleeding.Choice D rationaleUterine atony, a failure of the uterus to contract adequately after birth, is a significant risk in the immediate postpartum period, especially following the delivery of a large infant (macrosomia). The overdistension of the uterus during pregnancy with a large fetus can impair its ability to contract firmly, leading to postpartum hemorrhage.