When a 2-day postpartum mother complains of severe vulvar pain and pressure, what should the nurse prioritize assessing?

In the scenario of a 2-day postpartum mother experiencing severe vulvar pain and pressure, the most critical assessment to prioritize is checking the vulva for a hematoma. This is due to the fact that the perineal region can be susceptible to trauma during delivery, which can lead to the development of a hematoma. A hematoma is a localized collection of blood outside of blood vessels that can cause significant pain, pressure, and even complications if not addressed promptly.

In the postpartum period, particularly in the first few days, symptoms such as severe pain in the vulvar area may signal an underlying issue such as a hematoma rather than routine healing discomfort. By prioritizing the assessment of the vulva for a hematoma, the nurse can quickly evaluate whether there is a need for further intervention, such as surgical evaluation or treatment, while ensuring that any potential complications are managed effectively.

While assessing for uterine involution, measuring vital signs, and observing for signs of infection are all important aspects of postpartum care, they may not provide immediate insight into the specific complaint of severe vulvar pain and pressure. Given the potential urgency associated with a hematoma, focusing on the vulvar area allows for timely identification and management of a potentially serious complication.