A nurse is caring for a client who is 1 hr postpartum and observes a large amount of lochia rubra and several small clots on the client's perineal pad. The fundus is midline and firm at the umbilicus. Which of the following actions should the nurse take?

A. Encourage the client to empty her bladder: A full bladder typically displaces the uterus (usually to the right) and prevents it from contracting, leading to a "boggy" (soft) fundus. Since this client’s fundus is midline and firm, the bladder is not distended. B. Increase the frequency of fundal massage: Fundal massage is the intervention for uterine atony (a boggy/soft uterus) to stimulate contraction and stop bleeding. Because the fundus is already firm, massage is unnecessary and could be uncomfortable or cause muscle fatigue. C. Notify the client's provider: The findings are within normal limits for 1 hour postpartum. Lochia rubra (red discharge) with small clots is expected. While a "large amount" warrants close monitoring, the fact that the uterus is firm indicates the muscles are clamping down on the blood vessels correctly. Immediate provider notification is reserved for signs of hemorrhage (e.g., boggy uterus that won't firm up, soaking a pad in <15 minutes, tachycardia/hypotension). D. Document the findings and continue to monitor: The client presents with a firm, midline fundus and lochia rubra, which are expected findings 1 hour after birth. The presence of small clots is also normal as pooling occurs in the vagina while supine. The nurse should record this as a normal assessment and continue the standard protocol.