Which assessment on the third postpartum day would indicate to the nurse that a client is experiencing uterine subinvolution?

Choice A rationale A fundus 3 finger-breadths below the umbilicus after voiding on the third postpartum day is a normal finding. Fundal height typically descends approximately one finger-breadth per day following delivery. This physiological process, known as involution, involves myometrial contraction and autolysis, leading to the uterus returning to its pre-pregnant size. Choice B rationale Mild uterine cramping that resolves with NSAIDs is a normal postpartum finding. This cramping, often called afterpains, is caused by intermittent myometrial contractions. These contractions are stimulated by endogenous oxytocin and are essential for compressing uterine blood vessels and preventing postpartum hemorrhage. NSAIDs inhibit prostaglandin synthesis, which is a key mediator of pain and uterine contractions. Choice C rationale A fundus 2 finger-breadths above the pubic symphysis after voiding on the third postpartum day would be an extremely low finding and is not indicative of subinvolution. This position suggests that the uterus has already undergone a significant amount of involution, which is not the pathology of subinvolution. The fundus should still be palpable abdominally at this stage. Choice D rationale Uterine subinvolution is a condition where the uterus fails to return to its pre-pregnant state at the expected rate. A fundus palpated at the umbilicus on the third postpartum day is abnormal. The fundus should have descended approximately three finger-breadths below the umbilicus by this time. This assessment finding indicates a delay in the phys