A boggy uterus, an unexpectedly elevated fundus on palpation, and profuse lochia are all indicators of uterine atony. The nurse must report a PPH right away and get ready to administer intravenous fluids and oxygen while inserting a large-bore intravenous catheter if one isn't already there.
Continue massaging and giving uterotonics to a swampy uterus to promote uterine contraction. Give 20–40 units of oxytocin, an analog of the hormone with the same name found in the body, in 1 L of lactated Ringer (LR) at a rate of 600 mL/h to sustain uterine contraction and manage hemorrhage. (b) Firmly massage the fundus if it is squishy (do not over-massage, this fatigues the muscle). (c) Until the patient's vital signs are stable, check on them every 15 minutes. (d) Avoid bladder enlargement.
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