During a postpartum assessment, clots larger than 1 cm are found in the lochia. What is the most appropriate action?

• A. Document the findings
• B. Increase intake of fluids
• C. Reassess the client in 2 hours
• D. Notify the physician

Answer: (D)

Abnormal lochia with sizable clots indicates a potential risk for postpartum hemorrhage and requires prompt medical input. Clots larger than 1 cm suggest the uterus may not be contracting effectively, or there may be retained placental tissue, both of which can lead to ongoing bleeding. The best action is to notify the physician so orders can be placed for further evaluation and appropriate intervention (such as uterotonic medications, uterine massage per orders, or assessment for retained tissue).

Documenting the finding alone doesn't initiate treatment, and waiting to reassess or simply increasing fluids would not address the risk. The nurse should continue close monitoring of uterine tone, lochia characteristics, and vital signs while awaiting orders.