QLexNursing

💎 The assessment findings — boggy, displaced uterus, heavy lochia with large clots, and decreasing blood pressure with elevated heart rate — indicate uterine atony, the leading cause of postpartum hemorrhage (PPH).

💎 A boggy fundus means the uterine muscles are not contracting effectively, allowing excessive bleeding. The displacement to the right side suggests a distended bladder, which interferes with uterine contraction.

💎 The priority nursing action is to perform a firm, gentle fundal massage until the uterus becomes firm, which promotes contraction and minimizes further blood loss.

💎 Once firmness is achieved, the nurse should assist the patient to void or catheterize if necessary, reassess bleeding, and then notify the healthcare provider if bleeding continues.

💎 Immediate intervention is crucial to prevent hypovolemic shock, maintain uterine tone, and safeguard the mother’s recovery.