A primary nursing responsibility when caring for a woman experiencing an obstetric hemorrhage associated with uterine atony is to:
a. Establish venous access.
b. Perform fundal massage.
c. Prepare the woman for surgical intervention.
d. Catheterize the bladder.
ANS: B
The initial management of excessive postpartum bleeding is firm massage of the uterine fundus. Although establishing venous access may be a necessary intervention, the initial intervention would be fundal massage. The woman may need surgical intervention to treat her postpartum hemorrhage, but the initial nursing intervention would be to assess the uterus. After uterine massage the nurse may want to catheterize the client to eliminate any bladder distention that may be preventing the uterus from contracting properly.
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