If uterine atony persists after massage and continues to cause heavy bleeding, what is the next nursing action?

If uterine atony persists after massage and continues to cause heavy bleeding, what is the next nursing action?

• A. Take the client's blood pressure
• B. Measure the amount of drainage on the peripad
• C. Contact the primary health care provider (PHCP)
• D. Ask the blood bank to prepare a unit of blood for the client

Answer: (C)

After massage, if the uterus is still not contracting and heavy bleeding continues, the priority is to involve the clinician who can authorize further treatment. Uterine atony is life-threatening if not controlled, so obtaining orders for additional interventions—such as uterotonic medications, IV fluids, labs, and possible blood products—is essential. The nurse should contact the primary health care provider to trigger these orders and coordinate the next steps, including preparation for potential rapid transfusion if needed. While waiting for orders, continue close monitoring, ensure IV access, assess the fundus and lochia, and support the patient’s hemodynamic stability. Taking vitals or measuring drainage are important ongoing assessments, but they don’t initiate the necessary treatment; requesting the PHCP’s orders is the next appropriate action. Preparing a blood product or contacting the blood bank only occurs after specific orders and crossmatching.

After massage, if the uterus is still not contracting and heavy bleeding continues, the priority is to involve the clinician who can authorize further treatment. Uterine atony is life-threatening if not controlled, so obtaining orders for additional interventions—such as uterotonic medications, IV fluids, labs, and possible blood products—is essential. The nurse should contact the primary health care provider to trigger these orders and coordinate the next steps, including preparation for potential rapid transfusion if needed.

While waiting for orders, continue close monitoring, ensure IV access, assess the fundus and lochia, and support the patient’s hemodynamic stability. Taking vitals or measuring drainage are important ongoing assessments, but they don’t initiate the necessary treatment; requesting the PHCP’s orders is the next appropriate action. Preparing a blood product or contacting the blood bank only occurs after specific orders and crossmatching.