Final Answer:
Thirty minutes after birth, the nurse assesses a woman's fundus as soft and boggy. The nurse's priority action is to b. Massage the fundus.
Step-by-step explanation:
In the immediate postpartum period, the assessment of a woman's fundus plays a crucial role in determining her uterine tone and preventing complications such as postpartum hemorrhage. A soft and boggy fundus, 30 minutes after birth, suggests uterine atony, where the uterus fails to contract adequately. Massaging the fundus is the priority action because it stimulates uterine contractions, promoting hemostasis by reducing the risk of excessive bleeding. The nurse should position her gloved hand just above the symphysis pubis, applying gentle but firm pressure, allowing the uterus to contract effectively.
b.Massage of the fundus initiates the process of involution, where the uterus returns to its pre-pregnant state. This is crucial for preventing excessive bleeding and ensuring the woman's postpartum well-being. It promotes the expulsion of clots and helps the uterus regain its firmness. The nurse must monitor the fundus continuously to ensure it remains firm and well-contracted.
While other actions, such as taking the blood pressure, notifying the provider or nurse-midwife, or placing the woman in the Trendelenburg position, may be important in certain situations, they are not the priority in the given scenario. The immediate focus should be on addressing the uterine atony through fundal massage to prevent complications and promote a safe postpartum recovery.