The initial independent nursing actions for the uterine atony

Perform Fundal Massage. Massage the soft and boggy uterus to help expel clots of blood and it
is also used to check the tone of the uterus and ensure that it is clamping down to prevent
excessive bleeding. However, do not overly massage because the excessive stimulation to
contract it will tire the uterine muscle and worsen uterine atony. Once the uterus is firmly
contracted, it should be left alone but still assessed regularly to make sure that the uterus will
not relax again.
Nipple stimulation either manually, using a breast pump, or by encouraging the baby to suckle.
It is one method to reduce postpartum bleeding since it increases the secretion of the hormone
called ‘oxytocin’. When oxytocin is released, it causes uterine contractions, which in turn can lead
to reduction of postpartum bleeding.
Apply an ice pack if indicated. The cold application reduces blood flow to the area/promotes
vasoconstriction. Cold also numbs the area and makes the client more comfortable. Apply an ice
pack covered with a towel to prevent thermal injury to the skin to prevent further bleeding.
Place the patient on bed rest with legs elevated at 20-30°/Trendelenburg Position. Elevation of
the lower extremities increases venous return, slows bleeding and ensuring greater
availability/circulation of blood to other vital organs to prevent further bleeding.
Recommend the client be seated when holding the infant and change position slowly when
lying down or seated.
To prevent orthostatic hypotension because it puts the client at risk of falls. Advise the client to
dangle their legs first on the side of their bed after sitting up before attempting to ambulate.