In the first 12 hours after delivery, a postpartum client with a small vulvar hematoma would have which specific intervention included in the plan of care?

• A. Inform health care provider of assessment findings
• B. Assess vital signs every 4 hours
• C. Measure fundal height every 4 hours
• D. Prepare an ice pack for application to the area

Answer: (D)

After delivery, a small vulvar hematoma is managed with cold therapy to limit bleeding into tissue, reduce swelling, and relieve pain. Applying an ice pack to the vulvar area in the first 24 hours causes vasoconstriction, which helps prevent hematoma expansion and provides comfort. This is the most specific, immediate intervention for a small hematoma.

Other postpartum actions, like routine vital signs at set intervals or measuring fundal height, are important for overall recovery but aren’t specific to managing a vulvar hematoma. Notifying the provider is appropriate if the hematoma enlarges, pain increases, or there are signs of hemodynamic instability, which would prompt further evaluation or intervention. Heat should be avoided initially because it can increase bleeding and swelling; cold therapy is preferred early on, with options like Sitz baths considered later as the acute phase passes.