What should a nurse do first if the fundus is found above the umbilicus and displaced to the right during a postpartum assessment?

After the birth of a child, the assessment of the fundus is a critical component of postpartum care. If the uterus is found above the umbilicus and is displaced to the right, it is often indicative of bladder distention, which can prevent proper uterine contraction and increase the risk of complications such as uterine atony and hemorrhage.

Assisting the client to the bathroom to void is the most appropriate initial action in this scenario. By emptying the bladder, the nurse allows for the uterus to return to its proper position as the bladder being full can push the fundus upwards and to the side. Once the bladder is emptied, it is likely that the fundus will be assessed as midline and at the appropriate height. This action directly addresses the underlying issue contributing to the abnormal fundal position.

Following this, the nurse can reassess the fundus to confirm repositioning and firmness. Notifying the physician or applying pressure to the fundus would not address the immediate cause of the displacement and could lead to delays in managing the patient effectively.