How should the nurse assess for uterine atony in a postpartum client?

The assessment of uterine atony—an inability of the uterus to contract effectively after childbirth—is primarily accomplished through palpation of the fundus. A firm fundus is indicative of proper uterine tone and contraction, which helps control postpartum bleeding. During the postpartum period, the nurse will palpate the abdomen to locate the fundus and assess its firmness. If the fundus is soft or boggy, this is a sign of uterine atony, which can lead to hemorrhage. Therefore, feeling for a firm fundus is a critical assessment to identify the risk of complications related to uterine atony in postpartum clients.

The other assessment methods, such as measuring orthostatic blood pressure, evaluating lochial discharge, or observing the client's level of alertness, are important in monitoring for other complications, but they do not directly evaluate uterine tone or contraction status. They might provide insights into the overall well-being of the patient or signs of hemorrhage but are not the primary indicators for assessing uterine atony specifically.