During the initial acute distress phase of grieving, parents still must make unexpected and unwanted decisions about funeral arrangements and even naming the baby. What is the nurse's role at this time?

A. Fundus soft, 2 cm above the umbilicus: A soft (boggy) fundus is an abnormal finding and suggests uterine atony, which can lead to postpartum hemorrhage. At 12 hours postpartum, the fundus may be at or slightly above the umbilicus, but it should be firm. A soft uterus requires immediate intervention such as fundal massage.

B. Fundus soft, 1 cm to the right of the umbilicus: Deviation of the uterus to the right side often indicates a full bladder, which can impede uterine contraction and increase the risk of hemorrhage. A soft and displaced fundus at 12 hours postpartum is concerning and not expected.

C. Fundus firm, at the level of the umbilicus: This is the expected and normal finding 12 hours postpartum. The uterus should be firm to ensure effective involution and to prevent hemorrhage. It typically remains at the level of the umbilicus or slightly above before beginning its descent into the pelvis over the next several days.

D. Fundus present, to the left of the umbilicus: Similar to right deviation, leftward displacement may suggest bladder distention or other structural influences. The fundus should remain midline and firm. Any lateral deviation is a cue for the nurse to assess bladder status and encourage voiding.

A. To ensure that the parents, themselves, approve the final decisions: Supporting parental autonomy is essential, even in times of intense grief parents retain the right to make decisions about their child. Ensuring that parents are the ones making final decisions helps them begin to process the loss and assert some control during an emotionally chaotic time, which can aid in long-term emotional healing.

B. To take over as much as possible to relieve the pressure: Although well-intentioned, taking over decision-making may inadvertently strip the parents of their agency. This can lead to feelings of disempowerment or regret later on, as these decisions are deeply personal and form an important part of the grieving process.

C. To leave them alone to work things out: Completely withdrawing support during this critical moment may lead parents to feel abandoned or overwhelmed. While some time alone may be helpful, the nurse should remain present, compassionate, and available to guide and support when needed but allow the parents to maintain control..

D. To encourage the grandparents to take over: Involving extended family inappropriately can interfere with the grieving parents' right to process the loss in their own way. While grandparents may be emotionally invested, decisions surrounding naming and funeral arrangements are primarily the parents' to make.