IGNOU PB. Bsc. Nsg. Entrance-2025
Obstetrics & Gynaecology
Medium
In case the uterus becomes boggy after one hour of delivery, the immediate action of the midwife should be to :
Appeared in: IGNOU PB. Bsc. Nsg. Entrance-2025
Explanation
- A boggy (soft and poorly contracted) uterus after delivery indicates uterine atony, the leading cause of postpartum hemorrhage (PPH).
- The immediate, first-line nursing action is to perform fundal massage.
- Massaging the uterus stimulates the myometrial fibers to contract, which constricts the open blood vessels at the former placental site, thus controlling the bleeding.
- This is a critical, life-saving intervention that a midwife or nurse can and must perform immediately without waiting for a physician's order.
Why Other Options Were Wrong
- Option A: Notifying the obstetrician is an important step in escalating care, but it is not the immediate, hands-on action required to stop the bleeding. The midwife must intervene first.
- Option B: Checking blood pressure is an assessment, not an intervention. While vital for monitoring the patient's hemodynamic status and detecting shock, it does not address the cause of the bleeding.
- Option D: Observing the amount of bleeding is a passive assessment. In the case of a boggy uterus, active intervention is required immediately to prevent life-threatening hemorrhage.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Immediate management of postpartum uterine atony as background academic context rather than a clinical decision trigger.
- Postpartum hemorrhage (PPH) is a leading cause of maternal mortality worldwide. Prompt recognition of uterine atony (a boggy uterus) and immediate fundal massage are critical skills for every nurse and midwife.
- The sequence of actions is crucial: first, intervene to control the bleeding (massage), then assess (vitals, blood loss), and then call for help/notify the physician.
- A full bladder is a common cause of uterine atony. Always ensure the bladder is empty. If the patient cannot void, catheterization is necessary.
How to Approach the Question
- Identify the core problem: The question describes a 'boggy uterus' one hour after delivery.
- Recognize the diagnosis: A boggy uterus is the hallmark sign of uterine atony.
- Recall the immediate priority: Uterine atony leads to postpartum hemorrhage, which is a life-threatening emergency.
- Evaluate the options based on 'intervention' vs. 'assessment'. The question asks for the 'immediate action'.
- Analyze the options: 'Notify', 'check', and 'observe' are all forms of assessment or communication. 'Massage' is the only direct, therapeutic intervention that addresses the root cause of the problem.
- Select the most immediate, life-saving intervention. Fundal massage directly stimulates uterine contraction to stop the bleeding.
Concept Tested & Keywords
- Concept Tested: Immediate management of postpartum uterine atony.
- Stem keywords: boggy uterus, after delivery, immediate action, midwife
- Lead-in keywords: immediate action
- Clinical cues: A boggy uterus is a classic sign of uterine atony, a medical emergency requiring prompt intervention.
Question ID
QVMVCV7Dal1Y8YDkmomyh9
Reference Book
E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 65-81
E6 Obstetrics Williams p. 48-69
Practise the full IGNOU PB. Bsc. Nsg. Entrance-2025
Attempt every question from this paper in a timed mock, then review the full solution for each one.
More Complications of the Third Stage of Labor Questions
- Post-partum women having bleeding within 24 hrs after delivery is called:
- Which of the following drug is preferrably administered immediately after delivery of baby?
- How is blood loss measured in Post-partum hemorrhage?
- Which of the following medication is used in PPH (Post-Partum Hemorrhage)?
- Duration of secondary PPH?
- The nurse in the postpartum unit is caring for a client who has just delivered a newborn infant following a pregnancy with placenta previa. The nurse…
- What nursing interventions should be performed during uterine Fundus Examination after post partum?
- Post-partum women having bleeding from 1st day after delivery is called as?
- The condition where the uterus turns inside out is called?
- Postpartum haemorrhage is the condition in which there is loss of more than ml vaginal blood?
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