I am working as a nurse tech in OB this summer caring for postpartum couplets. I am doing great so far with most of my duties, but am having trouble sometimes with fundal checks. Sometimes, especially on a larger patient, I have such a hard time feeling the fundus. I am so afraid of hurting the patient that I feel like I'm taking too long, or not pushing hard enough to really feel it. And the C-section moms are very tough b/c they are in such pain when I do those checks.
Any tips for a newbie like me? I have been working with a primary nurse and she is double checking me, and sometimes I'm still not feeling it in the right spot.
HELP! (and thanks!)
Jun 25, '05
If you support the uterus right above the pubic bone with one hand you can find the fundus with the other quit easily. The bladder should be empty because if it is not the uterus will be displaced to the left. As for the larger women, yeah, you do have to mash harder but they should be use to this fact now; and we cant very well let them bleed out, or have undetected uterine inversion because we dont want to hurt their feelings. By the time they get to PP you should just have to feel to check placement. If it is not firm, then you will need to massage.
And as for not checking c/s, why not!!!!! We had a woman dang near bleed to death after her c/s. She was evauluated, every thing was fine; then, 5 min later the family came out and said "there is blood at the foot of the bed." There was sooo much blood, it looked as though she passed 3 additional placentas. More times than not the uterus is nice and firm before the pt gets to RR. However it is ACOG that states we must assess fundal positon, bleeding and dsg assessment every 10 minutes for at least 1 full hour after c/s. Again, alot of times it is just a gentle touch to check for placement and firmness. If it is not right then you must massage, which causes more pain, but is necessary none the less.
Last edit by CarrieAnne on Jun 25, '05