Final answer:
If the fundus is boggy, the immediate action is to perform a fundal massage to stimulate the uterus to contract. If this does not resolve the issue, administering uterotonic medications and further interventions by health care providers might be required to control bleeding and prevent complications.
Step-by-step explanation:
The first thing you do if the fundus is boggy is to perform a fundal massage. A boggy uterus often indicates uterine atony, where the uterus fails to contract after childbirth, leading to excessive bleeding or postpartum hemorrhage. The fundal massage helps to stimulate the uterus to contract and thus reduce bleeding.
Following the fundal massage, if the uterus does not become firm and bleeding continues, additional interventions might be necessary, including administering uterotonic medication, such as oxytocin, to promote uterine contractions. Ongoing monitoring and assessment of the mother's vital signs and blood loss are crucial to ensure prompt treatment and to prevent complications.
If the initial interventions do not control the bleeding or if the fundus remains soft despite massage, it may be necessary to escalate care to a health care provider who can perform more advanced interventions, possibly including manual exploration of the uterus, removal of retained placental tissue, or surgery.