Maternal / Newborn Question #28


The nurse is assessing a woman following vaginal delivery without episiotomy. The fundus is firm, two fingerbreadths below the umbilicus and the perineal pad has a steady trickle of red blood. The client is concerned about the trickling of blood that is unlike the lochia she has been experiencing. The nurse explains which probable cause for the trickling blood?


  1. Vaginal laceration
  2. Boggy uterus
  3. Uterine involution
  4. Low platelets


The correct answer is A. Vaginal, perineal, or cervical laceration may be caused as a result of tearing during the delivery. Risks of tearing are higher without episiotomy, and bleeding may occur with steady trickle onto the perineal pad. Selection B is incorrect since the assessment revealed firm fundus, not boggy fundus. Selection C is incorrect since uterine involution involves normal lochia, not trickles of blood. Selection D is incorrect since low platelets could be a problem; however, it is rarer while most common problems arise from laceration.