A postpartum client is 24 hours after delivery and fundus is 2 cm above the umbilicus. Which action is most appropriate to address this finding?

• A. Massage the fundus gently
• B. Ambulate the client to the bathroom
• C. Administer oxytocin as ordered
• D. Place the patient in Trendelenburg

Answer: (B)

A postpartum uterus that sits above the umbilicus usually means the bladder is distended and is pushing the uterus upward, preventing it from contracting effectively. The quickest, most effective fix is to relieve that bladder fullness. Encouraging or assisting the client to void (ambulating to the bathroom) allows the uterus to descend to its proper position and begin contracting again, which helps stop bleeding and reduces the risk of uterine atony. If, after voiding, the fundus is still high or feels boggy, you would next perform fundal massage to stimulate contraction and follow the ordered plan for uterotonic medications like oxytocin. Placing the patient in Trendelenburg isn’t appropriate here, and while fundal massage is important for a boggy uterus, emptying the bladder is the immediate first step to address the elevated fundal height.