Which intervention is inappropriate when the fundus is boggy and hemorrhage risk is high?

• A. Massaging the uterus
• B. Pushing gently on the uterus
• C. Assisting the woman to urinate
• D. Scheduling an abdominal hysterectomy

Answer: (D)

When the fundus is boggy, the priority is to stimulate uterine contraction to control hemorrhage. The best action is fundal massage, which helps express any clots and firms the uterus to stop bleeding. Ensuring the bladder is empty by assisting the woman to urinate is important because a full bladder can prevent effective contraction. Scheduling an abdominal hysterectomy is not appropriate as an initial intervention; it’s a drastic, irreversible measure reserved only after all conservative medical management and less invasive procedures have failed to control ongoing hemorrhage. Pushing gently on the uterus isn’t the preferred approach because the goal is to stimulate contraction through massage, not apply external pressure.