Upon finding a client's uterus is not firmly contracted during a postpartum assessment, what should the nurse do first?

The first action the nurse should take when discovering that a client's uterus is not firmly contracted during a postpartum assessment is to massage the uterine fundus. This step is critical because a poorly contracted uterus can lead to postpartum hemorrhage, which is a significant risk during the immediate postpartum period.

By massaging the fundus, the nurse stimulates uterine contractions, promoting firming and reducing the risk of excessive bleeding. This action addresses the immediate concern of uterine atony, which is one of the primary causes of postpartum hemorrhage.

It is important for the nurse to act quickly, as the safety and well-being of the client are paramount. While monitoring vital signs, documenting findings, and informing the healthcare provider are necessary steps that will follow, the priority in this situation is to ensure that the uterus is contracting properly to prevent complications. Therefore, initiating fundal massage directly targets the immediate issue at hand.