Which nursing intervention promotes a firm uterus after delivery and prevents PPH?

Which nursing intervention promotes a firm uterus after delivery and prevents PPH?

• A. Massage uterus but ignore bladder
• B. Fundal massage and ensuring the bladder is empty
• C. Keep fundus unassessed and restrict fluids
• D. Apply tight abdominal binder only

Answer: (B)

Promoting a firm uterus after delivery hinges on helping the uterus contract and stay in the midline. Massaging the fundus stimulates myometrial contractions, which compress the uterine vessels and stop bleeding. An empty bladder is essential because a full bladder can push the uterus upward and to the side, preventing effective contraction and leaving the uterus boggy. When both actions are done together, the uterus remains firm, reducing the risk of postpartum hemorrhage. Massaging without addressing bladder status won’t resolve displacement or atony, and failing to assess the fundus or relying on a binder alone doesn’t actively promote contraction or control bleeding.

Promoting a firm uterus after delivery hinges on helping the uterus contract and stay in the midline. Massaging the fundus stimulates myometrial contractions, which compress the uterine vessels and stop bleeding. An empty bladder is essential because a full bladder can push the uterus upward and to the side, preventing effective contraction and leaving the uterus boggy. When both actions are done together, the uterus remains firm, reducing the risk of postpartum hemorrhage. Massaging without addressing bladder status won’t resolve displacement or atony, and failing to assess the fundus or relying on a binder alone doesn’t actively promote contraction or control bleeding.