For a patient experiencing postpartum hemorrhage, which action is critical for the nurse to perform first?

In the context of postpartum hemorrhage, the priority action for a nurse is to perform fundal massage. This technique involves applying pressure to the uterus through the abdomen to stimulate contractions and help the uterus return to its pre-pregnancy size, thus reducing the risk of further bleeding. When the uterus is atonic (not contracting effectively), it can lead to increased blood loss, making timely intervention crucial.

Fundal massage is a primary intervention that can be immediately performed by the nurse at the bedside. The effectiveness of this action can significantly impact the patient's condition since controlling uterine atony is key to reducing the volume of hemorrhage. By initiating fundal massage, the nurse addresses the most common cause of early postpartum hemorrhage, which is uterine atony.

While other actions such as beginning IV fluid replacement, checking vital signs, and notifying the healthcare provider are important components of managing postpartum hemorrhage, these steps can be secondary to the immediate need to promote uterine contraction through fundal massage. Effective and rapid intervention is essential in emergent situations like postpartum hemorrhage, prioritizing actions that directly address the underlying cause of the issue.