A postpartum client with a boggy uterus displaced above and to the right of the umbilicus is most likely caused by which condition?

• A. Bladder distention
• B. Excessive uterine contractions
• C. Retained placental tissue
• D. Uterine inversion

Answer: (A)

After delivery, the uterus should feel firm and be located midline around the umbilicus. A boggy uterus indicates inadequate contraction (atony), which can lead to ongoing bleeding. If that uterus is displaced above and to the right of the umbilicus, the displacement is a strong clue that the bladder is distended and pushing the uterus upward and to the side. A full bladder prevents the uterus from contracting effectively and shifts its position, which is why bladder distention is the most likely cause in this scenario.

Nursing actions focus on relieving the distention: assess and empty the bladder (or obtain a catheter if needed) and then recheck the fundus to ensure it becomes firm and midline. If the uterus remains boggy after emptying, reassess for other causes such as continued atony, retained placental tissue, or inversion, but the positional clue here points to bladder distention.