Emergency C-section questions

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I am working on a packet with a hypothetical patient. She was admitted for an emergency c-section. We only recently began pregnancy so I am unsure of a few things I have run into. First of all what is the different between a boggy and firm fundus? Why is a firm fundus good? Also what helps relieve the discomfort of breast enorgment? in one section it says that that her fundus is firm 1/U...what is the 1/U? Lastly, is a moderate amount of blood lochia to be expected or is this a sign of hemorrhage? Any help would be greatly appreciated.

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I am working on a packet with a hypothetical patient. She was admitted for an emergency c-section. We only recently began pregnancy so I am unsure of a few things I have run into. First of all what is the different between a boggy and firm fundus? Why is a firm fundus good? Also what helps relieve the discomfort of breast enorgment? in one section it says that that her fundus is firm 1/U...what is the 1/U? Lastly, is a moderate amount of blood lochia to be expected or is this a sign of hemorrhage? Any help would be greatly appreciated.

A boggy fundus is an indicator of bleeding and a uterus that has not yet contracted. A firm fundus is good, because it indicated that the uterus is contracting and not bleeding. To relieve the discomfort of breast engorgement, you can use hand expression of milk, ice or even frozen cabbage leaves. 1/U means that the uterus is 1 fingerswidth above the umbilicus. How far out postpartum is she? that would be a big factor concerning the amount of lochia..

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It has only been about 16 hours since the c-section.

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It has only been about 16 hours since the c-section.

If she is 16 hrs post-partum, a moderate amount of lochia is too much, you need to know if the fundus is boggy or firm. If the fundus is boggy, the uterus should be massaged and you could possibly administer Methergine.

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The fundus is firm and she has an order for Pitocin. Sorry I am trying to sort through all of this information to find what is important and what isn't. Most of it I am not even fully sure of the meaning as we have not had all of this in class yet. Thanks for the help though!!

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Specializes in Emergency Department.
I am working on a packet with a hypothetical patient. She was admitted for an emergency c-section. We only recently began pregnancy so I am unsure of a few things I have run into. First of all what is the different between a boggy and firm fundus? Why is a firm fundus good? Also what helps relieve the discomfort of breast enorgment? in one section it says that that her fundus is firm 1/U...what is the 1/U? Lastly, is a moderate amount of blood lochia to be expected or is this a sign of hemorrhage? Any help would be greatly appreciated.

I would add warmth as an engorgement comfort measure (but have never seen ANYONE engorged at 16 hrs PP and often see lactogenesis delayed after sections as many as four days). I wonder if 1/U = 1 finger breadth below the umblicus versus above since her fundus is firm. You should get clarification on the shorthand being used.

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Specializes in L&D,surgery,med/surg,ER,alzheimers.

Oh, my, how can you do this without a real patient? I had 4 c-sections myself and then scrubbed and circulated for c-sections as my job for 2 years while I was in nursing school. You really need hands on experience to have these things make sense. Is there a way you can get some experience in clinicals?

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Specializes in Med/Surg, Academics.

Everyone here has given good info, but I'm going to give you advice for when you inevitably come upon something you don't know in the future. We all face things in clinical that haven't been covered yet in class or in our required readings. I assume that you have a book for mom-baby. When you run across something that is unfamiliar to you, you need to be able to use the resources you have to find it because there won't always be someone around to ask.

Use your table of contents, your index, etc. If your instructor provides class slides all at once, look ahead, using the headings as a guide. Obviously, this was part of post-partum assessment, and there will probably be a part of your book dedicated to it.

If you don't know how to use these locator tools, maybe your tutoring department in your school can teach you. Ask your librarian to give you a tour of the library and the search tools available to students.

Good luck in school! :)

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Specializes in Med/Surg, Academics.
If she is 16 hrs post-partum, a moderate amount of lochia is too much, you need to know if the fundus is boggy or firm. If the fundus is boggy, the uterus should be massaged and you could possibly administer Methergine.

Sixteen hours post-partum with moderate lochia wouldn't be too much, in my opinion. :) Of course, it depends on other factors too, as you noted.

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