A nurse is assessing a client who received methylergonovine to treat uterine atony in the fourth stage of labor.
Which of the following findings should the nurse identify as an adverse effect of the medication?
Seizures.
Hypertension.
Tachycardia.
Water retention.
The Correct Answer is B
Choice A rationale
While seizures are a serious adverse effect of ergot alkaloids, they are primarily associated with the most severe form of ergotism, which is an overdose or prolonged exposure, or in clients with severe preeclampsia/eclampsia. Methylergonovine's more common and immediate adverse effect is its potent vasoconstrictive property, leading to elevated blood pressure.
Choice B rationale
Methylergonovine is an ergot alkaloid that acts as a potent vasoconstrictor and smooth muscle contractor, primarily on the uterus to treat postpartum hemorrhage and uterine atony. Its generalized vasoconstrictive effect, however, can lead to a significant elevation in blood pressure, making hypertension (blood pressure greater than 140/90 mmHg or an increase of 20 mmHg or more) a major and frequent adverse effect.
Choice C rationale
Methylergonovine's potent vasoconstrictive action typically causes an increase in peripheral vascular resistance, which often results in bradycardia (heart rate less than 60 beats/min) as a reflex response to the elevated blood pressure. Tachycardia (heart rate greater than 100 beats/min) is not a typical adverse effect of this medication.
Choice D rationale
Methylergonovine acts mainly on the smooth muscle of the uterus and blood vessels; it does not typically cause water retention. Water retention is more commonly associated with conditions like preeclampsia or medications such as glucocorticoids. The adverse effects of methylergonovine center around vasoconstriction and uterine cramping.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Erb-Duchenne palsy, a form of brachial plexus injury (C5-C6), primarily affects the nerves controlling the shoulder and upper arm muscles. It generally does not affect cranial nerves (such as IX and X, which control swallowing) or the muscles of the mouth, thus typically preserving the ability to suck and swallow.
Choice B rationale
The Moro (startle) reflex involves symmetrical extension and abduction of the arms followed by adduction and flexion. An injury to the brachial plexus on one side impairs the motor function of that arm, resulting in the characteristic absence of the reflex in the affected extremity, which is a key diagnostic finding.
Choice C rationale
The Babinski reflex is a normal neurological finding in infants up to about 2 years old, reflecting immature corticospinal tracts. It is a foot reflex and is unrelated to a brachial plexus injury in the neck and shoulder area; thus, its presence is not a specific finding for Erb-Duchenne palsy.
Choice D rationale
Cleft palate is a congenital craniofacial malformation resulting from incomplete fusion of the palatine shelves during fetal development. It is a structural anomaly of the mouth and is not a finding or complication associated with Erb-Duchenne palsy, which is a neuromuscular injury sustained, most commonly, during birth.
Correct Answer is ["0.25"]
Explanation
Step 1 is: Determine the number of tablets by dividing the prescribed dose by the available dose per tablet. (50 mcg÷ 200 mcg/tablet) = 0.25 tablet. The final calculated answer is 0.25 tablet.
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