The nurse is palpating a patient’s uterus 12 hours after a vaginal delivery. For which reason does the nurse place one hand just above the symphysis pubis?

The correct answer is choice A.Retained placental fragments are the most common cause of subinvolution.Subinvolution is a condition where the uterus does not return to its normal size after childbirth.Retained placental fragments prevent the uterus from contracting properly and cause prolonged bleeding and infection.

Choice B is wrong because infection is not the most common cause of subinvolution, but it can be an aggravating factor.Infection can cause inflammation and interfere with the healing of the uterine lining.

Choice C is wrong because uterine fibroids are not the most common cause of subinvolution, but they can be a predisposing factor.Uterine fibroids are benign tumors that can distort the shape of the uterus and impair its contraction.

Choice D is wrong because multiparity is not the most common cause of subinvolution, but it can be a predisposing factor.Multiparity means having given birth more than once, which can weaken the uterine muscles and reduce their ability to contract.

Normal ranges for uterine involution are as follows:

• Uterus weight: decreases from about 1000 g at delivery to about 60 g at six weeks postpartum.

• Uterus height: decreases from about 20 cm above the pubic bone at delivery to about 12 cm at one week postpartum, and then descends into the pelvis by six weeks postpartum.

• Uterus size: decreases from about 20 times its normal size at delivery to about its normal size at six weeks postpartum.

The correct answer is choice C. Interdependent.According to Mercer’s theory of maternal role attainment, the interdependent phase is when the mother redefines her relationship with her older child and integrates the new baby into the family.She also reestablishes her role in society and resumes her pre-pregnancy activities.

Choice A is wrong because dependent is the first phase of maternal role attainment, when the mother is focused on her own needs and recovery after childbirth.She relies on others for support and guidance.

Choice B is wrong because dependent-independent is the second phase of maternal role attainment, when the mother begins to take charge of her own care and learns how to care for the baby.She seeks information and validation from health professionals and experienced mothers.

Choice D is wrong because independent is the fourth and final phase of maternal role attainment, when the mother has a strong sense of identity and competence in her maternal role.She develops her own style of mothering and feels confident and comfortable with her baby.