A nurse is assessing a client who is 8 hour postpartum. Where should the nurse expect to find the fundus?

A) G5 T1 P2 A1 L2:
G (Gravida): Gravida refers to the total number of pregnancies, including the current pregnancy. In this case, the woman is currently pregnant and has had 4 previous pregnancies (one miscarriage at 10 weeks, one at 22 weeks, and two live births). Therefore, her Gravida (G) is 5.
T (Term births): Term births are those that occur at or after 37 weeks of gestation. The woman delivered an 18-month-old daughter who was born 2 days after her due date, which is a term birth. Thus, her Term (T) is 1.
P (Preterm births): Preterm births occur between 20 and 36 weeks of gestation. The woman had a son born at 35 weeks, which is classified as a preterm birth. Therefore, the Preterm (P) is 2.
A (Abortions or miscarriages): Abortions refer to pregnancies that ended before 20 weeks of gestation. The woman experienced two miscarriages, one at 10 weeks and one at 22 weeks. Thus, the Abortions (A) is 1.
L (Living children): Living children are those who are currently alive. The woman has a 3-year-old son and an 18-month-old daughter, so the Living (L) is 2.
Thus, the correct GTPAL classification is G5 T1 P2 A1 L2.

B) G5 T2 P2 A1 L2:
This is incorrect because the woman had only one term birth (not two). She delivered her daughter at term, but the son was preterm (born at 35 weeks). Therefore, her Term (T) should be 1, not 2.

C) G4 T1 P2 A2 L2:
This is incorrect because the woman is currently pregnant, so her Gravida (G) is 5, not 4. Additionally, the woman had 1 abortion, not 2.

D) G4 T1 P1 A2 L2:
This is also incorrect because the woman is currently pregnant, so her Gravida (G) is 5, not 4. Furthermore, the woman had 2 preterm births, not 1.

A) At the umbilicus:
After delivery, the fundus is typically located at or just below the umbilicus in the immediate postpartum period, but it will gradually descend over the next few days. By 8 hours postpartum, the fundus is often slightly below the umbilicus, not directly at the umbilicus. The fundus will continue to shrink in size and move downward toward the pelvic region as the uterus contracts and involutes.

B) At a non-palpable depth:
A fundus that is non-palpable is generally expected later in the postpartum period, typically by 10-14 days after delivery, as the uterus contracts and returns to its pre-pregnancy size. At 8 hours postpartum, the fundus is still palpable, generally just below the umbilicus, and should be evaluated for firmness and position.

C) Just above the symphysis pubis:
The fundus is usually higher than the symphysis pubis at 8 hours postpartum, as it is still in the process of descending from the higher position it occupied during pregnancy. It would be expected to be just below the umbilicus or about 1 to 2 finger widths below it. By the second or third day postpartum, the fundus begins to move lower toward the symphysis pubis as it continues to involute.

D) Just below the umbilicus:
Eight hours after delivery, the nurse should expect to palpate the fundus just below the umbilicus. This is a typical finding as the uterus begins to contract and shrink after the delivery of the placenta. The fundus will descend about 1-2 cm per day postpartum, so by 8 hours, it is usually just slightly below the level of the umbilicus.