Maternity Nursing: Postpartum Q 21
Which of the following findings would be expected when assessing the postpartum client?
A. Fundus 1 cm above the umbilicus 1 hour postpartum.
B. Fundus 1 cm above the umbilicus on a postpartum day 3.
C. Fundus palpable in the abdomen at 2 weeks postpartum.
D. Fundus slightly to the right; 2 cm above umbilicus on postpartum day 2.
Correct Answer: A. Fundus 1 cm above the umbilicus 1 hour postpartum.
Within the first 12 hours postpartum, the fundus usually is approximately 1 cm above the umbilicus. Immediately postpartum, the uterine fundus is palpable at or near the level of the maternal umbilicus. If the fundus is found above the navel, the mother probably needs to pass urine. Call a midwife if the uterus feels soft or is not descending.
Option B: The fundus should be below the umbilicus by PP day 3. By approximately one-hour post-delivery, the fundus is firm and at the level of the umbilicus. The fundus continues to descend into the pelvis at the rate of approximately 1 cm or finger-breadth per day and should be nonpalpable by 14 days postpartum.
Option C: The fundus shouldn’t be palpated in the abdomen after day 10. Thereafter, most of the reduction in size and weight occurs in the first 2 weeks, at which time the uterus has shrunk enough to return to the true pelvis. Over the next several weeks, the uterus slowly returns to its nonpregnant state, although the overall uterine size remains larger than prior to gestation.
Option D: The uterus should feel firm and should feel about the size of a grapefruit for the first few days. The fundus (top portion of the uterus) should be felt at the level of the belly button or lower. The mother can attempt to feel her fundus by gently pressing on her abdomen. The uterus shrinks at about the rate of one cm. per day. By day 10 it can no longer be felt above the pubic bone.