Question

4. Uterine Assessment a. Describe how a nurse would perform an assessment of fundus b. What is the difference between a "firm" fundus and a "bogey" fundus? Which type requires medical intervention? d. List FIVE types of medical intervention used.

Answer 1

4) a. Assessment of fundus by nurse :-

-select a time that will provide the most accurate data. For example: palpating the fundus when the woman has a full bladder may give false information about the progress of involution. So ask the woman to void before the assessment.

-consider need for pre-medication before any painful massage of the fundus

-provide explanation of purpose of assessment

-document and report results

-take appropriate precautions to prevent exposure to body fluids

b. The difference between firm and boggy fundus is that firm fundus is the normal finding which is compulsory for the torn blood vessels to stop bleeding on the placental bed .

While boggy fundus is an emergency situation in which the fundus is soft because uterine atony is present and causes hemorrhage because of improper involution .

c. Boggy fundus requires medical intervention

d. Five types of medical intervention :-

- massage of uterus

- assess the amount of bleeding and vitals every five minutes

- bimanual compression

- may need oxygen

- assess the lab values and urine output

- IV gluids and medication ( oxytocin )