If the uterus is boggy after delivery, what is the appropriate initial nursing action?

• A. Provide comfort measures
• B. Administer oxytocin
• C. Massage the fundus gently until firm
• D. Massage vigorously

Answer: (C)

Uterine atony after delivery leads to a boggy uterus, which means the uterus isn’t contracting enough to compress bleeding vessels. The immediate nursing action is to massage the fundus gently in a circular motion to stimulate contractions and help the uterus become firm and midline. This direct stimulation of the myometrium is what stops the bleeding at its source. Do this with one hand supporting the lower uterus to prevent inversion, and massage until the uterus feels firm. If it remains boggy or bleeding increases, call for help and follow protocol for uterotonic medications. Avoid vigorous massage, as it can cause tissue injury and doesn’t promote effective contraction.