The nurse is assessing a patient after delivery and finds the uterine fundus boggy and 1 centimeter above the umbilicus. Which of the following is the priority nursing intervention?

Explanation

• Using the A-B-C Framework, the nurse skips airway and breathing and moves to an intervention to control bleeding in this situation.

• If there is uterine atony, the first priority intervention of the nurse is to control hemorrhage by attempting uterine massage to encourage contraction. This stimulates uterine contraction, which compresses the vessels and reduces blood flow.

• Incorrect: Second priority is to notify the physician if the uterus remains uncontracted. The physician will order oxytocics to help the uterus maintain tone.

• Incorrect: When the uterus is firm, observe the perineum for passage of clots and blood.

• Incorrect: Assess vital signs after ensuring that the uterus is well-contracted.

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