In the event of a boggy fundus and heavy bleeding shortly after a vaginal birth, what should the nurse prioritize?

In the context of postpartum management, the presence of a boggy fundus and heavy bleeding indicates a possible uterine atony, which is a leading cause of early postpartum hemorrhage. The primary focus in this situation is to address the source of the bleeding and to promote uterine contraction to reduce blood loss.

When the fundus is boggy, it signifies that the uterus is not contracting effectively, which can lead to the continuation of heavy bleeding. One of the immediate interventions a nurse can take is to perform fundal massage to help stimulate uterine contraction. However, it's also vital to assess the client's comfort and needs during this critical time. Assisting the client with using a bedpan can provide necessary relief, especially if they're experiencing discomfort or urgency related to either bleeding or the effects of medications used during labor.

While administering oxygen may be beneficial in instances of significant blood loss and to prevent hypoxia, it does not directly address the cause of the bleeding or the fundal status. Similarly, obtaining a blood count is important for evaluating blood loss and guiding further interventions, but it can be a secondary priority to immediate actions to control bleeding. Starting an IV of oxytocin can be a crucial treatment for uterine atony, as oxytocin