A client 6 hours postpartum following a dysfunctional labor says, 'I think I have changed my pad every 15 minutes.' This indicates:

• A. Dehydration
• B. Normal postpartum discharge.
• C. Allergy to pad material.
• D. Possible postpartum hemorrhage.

Answer: (D)

The situation is signaling postpartum hemorrhage. When a new mother reports changing her pad every 15 minutes just 6 hours after birth, that rapid rate of bleeding is not a normal postpartum lochia pattern. Lochia is typically steady at first but then gradually decreases; a pad being saturated this quickly means substantial vaginal blood loss and risks hypovolemia, so it warrants urgent assessment and intervention.

Key steps in response include checking the uterus to see if it’s firm; if the fundus is boggy, massage it to promote contraction and help control bleeding. Ensure the bladder is empty, monitor vitals, and establish IV access for fluids and medications. Prepare and administer uterotonic agents as ordered, and escalate care promptly if bleeding continues or the patient shows signs of shock. This scenario points to postpartum hemorrhage rather than dehydration, a pad allergy, or normal discharge.