A fundus is located to the left of the midline after a fundal assessment. What action is appropriate?

• A. Ask the client to empty her bladder
• B. Straight catheterize the client immediately
• C. Call the client's health provider for direction
• D. Straight catheterize the client for half of her uterine volume

Answer: (A)

A full bladder is the most likely reason the fundus appears off the midline after birth. The uterus should sit midline and firm; a distended bladder pushes it sideways and can impair contraction, increasing the risk of postpartum hemorrhage. The best first step is to have the client empty her bladder and then recheck the fundus. After voiding, the fundus should return to the midline and feel firm; if it remains displaced or boggy, follow the facility protocol for further assessment and interventions. Catheterization or contacting the provider is not the initial move unless voiding isn’t possible or the problem persists after voiding.