The nurse is observing a client who gave birth yesterday. Where should the nurse expect to find the top of the client’s fundus?
The nurse should expect to find the top of the client's fundus at or just below the level of the client's umbilicus (belly button). This is because immediately after childbirth, the fundus is typically located at the level of the umbilicus and then gradually descends back into the pelvis over the next few days.
1. The fundus is the top portion of the uterus.
2. After giving birth, the location of the client's fundus changes gradually.
3. Immediately after delivery, the nurse can expect the fundus to be located at the level of the umbilicus or slightly above it.
4. As the uterus involutes or shrinks, the fundus will gradually descend.
5. Within the first 24 hours after giving birth, the nurse can expect the fundus to be about one fingerbreadth below the umbilicus.
6. In the following days, the fundus will continue to descend approximately one fingerbreadth per day.
7. By the 10th day after delivery, the nurse would typically expect the fundus to return to its pre-pregnancy size and become non-palpable.
8. The nurse can assess the fundus by gently palpating the client's abdomen, starting at or just above the client's umbilicus, and moving downward.
To determine the location of the top of the client's fundus, which refers to the upper part of the uterus, the nurse can follow these steps:
1. Positioning: Ensure that the client is lying flat on her back with her knees slightly bent.
2. Hand hygiene: Before examining the client, the nurse should perform proper hand hygiene to prevent the spread of infection.
3. Equipment: Gather a measuring tape or a ruler to measure the distance from the symphysis pubis to the top of the fundus.
4. Locate the symphysis pubis: The symphysis pubis is the bony prominence found at the lowest part of the abdomen, just above the pubic area.
5. Palpate the abdomen: Use gentle pressure with the fingertips to determine the position and size of the uterus. Start palpating from the symphysis pubis and move upwards.
6. Identify the fundus: The fundus is usually felt as a firm, rounded mass located midway between the symphysis pubis and the umbilicus (belly button). The nurse can assess the fundal height by measuring the distance between the top of the fundus and the symphysis pubis. The measurement in centimeters provides an estimation of the gestational age timeline.
In summary, the nurse should expect to find the top of the client's fundus, or upper part of the uterus, somewhere between the symphysis pubis and the umbilicus, typically midway between the two. Proper positioning, hand hygiene, and palpation techniques will assist in locating the fundus and measuring its height accurately.