A nurse has administered methergine (methylergonovine) 0.2 mg to a grand multipara (G7, P6) who delivered vaginally 30 minutes earlier. Which of the following outcomes indicates that the medication is effective?
Pulse rate 80 and regular.
Fundus firm at umbilicus, lochia moderate.
Blood pressure 120/80.
Increase in prothrombin time.
The Correct Answer is B
Choice A rationale
A pulse rate of 80 and regular does not directly indicate Methergine's effectiveness. Normal pulse ranges from 60 to 100 beats per minute. This could result from overall stabilization rather than medication effect.
Choice B rationale
A firm uterine fundus at the umbilicus and moderate lochia indicate effective uterine contraction and hemostasis, reflecting successful intervention with Methergine in managing postpartum hemorrhage.
Choice C rationale
A blood pressure of 120/80 is within the normal adult range but does not specifically reflect Methergine's uterotonic action. Blood pressure monitoring is essential but not the primary efficacy indicator.
Choice D rationale
An increase in prothrombin time reflects coagulation changes but is unrelated to Methergine's mechanism of action. It focuses on hemostatic effects via uterine contractions rather than coagulation pathways.
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Related Questions
Correct Answer is C
Explanation
Choice A rationale
Hypoxia may contribute to tachypnea and distress, but it is unlikely the primary cause, as baseline fetal heart rate of 180 BPM indicates infection-related stress rather than isolated oxygen deprivation.
Choice B rationale
Respiratory distress syndrome predominantly affects preterm infants due to surfactant deficiency. At 37 weeks’ gestation, surfactant levels should be adequate, making this an unlikely cause of the newborn’s tachypnea and pallor.
Choice C rationale
Prolonged rupture of membranes increases the risk of neonatal sepsis. Signs such as tachypnea, pallor, and elevated fetal heart rate with marked variability suggest systemic infection requiring immediate evaluation and treatment.
Choice D rationale
Phrenic nerve injury typically causes diaphragmatic paralysis, leading to asymmetric chest movement and respiratory distress. However, it does not explain the systemic signs like pallor or elevated heart rate, making it an unlikely cause.
Correct Answer is B
Explanation
Choice A rationale
Difficulty breathing can indicate an anaphylactic reaction, a rare but serious side effect of Hemabate. It involves bronchoconstriction triggered by prostaglandin administration, usually necessitating emergency interventions.
Choice B rationale
Diarrhea is common due to prostaglandin's stimulation of smooth muscle in the gastrointestinal tract, leading to increased motility. This adverse effect often accompanies other systemic effects like cramping.
Choice C rationale
Hypotension, while possible, is less frequent and usually transient. It may result from the vasodilatory properties of prostaglandins but is not a primary side effect.
Choice D rationale
Palpitations occur less commonly and may arise if Hemabate induces systemic changes affecting heart rate, including reflex tachycardia secondary to other hemodynamic shifts.
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