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 ["A","C","E"]
Explanation
Choice A rationale
Oxytocin use for labor induction or augmentation is a significant risk factor for uterine atony, the most common cause of postpartum hemorrhage (PPH). Prolonged or high-dose exposure can lead to receptor downregulation or overstimulation, resulting in a fatigued or poorly contracting uterus, which fails to clamp down on the blood vessels at the placental site after delivery.
Choice B rationale
A history of Human Papillomavirus (HPV), a sexually transmitted infection, is not recognized as an independent risk factor for increasing the likelihood of postpartum hemorrhage. The physiological mechanisms leading to PPH are primarily related to uterine function, trauma, or coagulation disorders, which HPV infection does not directly influence.
Choice C rationale
A history of uterine atony in a previous pregnancy significantly increases the risk for recurrence in subsequent deliveries because it suggests an underlying predisposition for the myometrium to fail its contractile function. Uterine atony prevents the spiral arteries from being compressed, leading to excessive blood loss, which defines postpartum hemorrhage.
Choice D rationale
The average newborn weight in Western populations is approximately 3.4 kg (7.5 lb), with a normal range generally considered between 2.5 kg and 4.0 kg. A newborn weight of 2.948 kg (6 lb 8 oz) is within the normal range and does not constitute a risk factor for PPH, unlike macrosomia (birth weight > 4000 g or 8 lb 13 oz) which overdistends the uterus.
Choice E rationale
Vacuum-assisted delivery, a form of operative vaginal delivery, increases the risk of PPH primarily due to associated genital tract trauma (e.g., cervical, vaginal, or perineal lacerations) and potentially compounding the risk of uterine atony from prolonged labor or necessary manual maneuvers. Trauma contributes to bleeding that is non-uterine in origin.
Correct Answer is B
Explanation
Choice A rationale
A nonreactive nonstress test (NST), defined by having fewer than two accelerations of at least 15 beats per minute (BPM) above baseline, lasting at least 15 seconds, within a 20-minute window, indicates potential fetal compromise or sleep state, leading to a maximum score of 0 on this component, thus not indicating well-being.
Choice B rationale
The biophysical profile (BPP) scores fetal movement with a maximum of 2 points for three or more discrete body or limb movements within a 30-minute period. The finding of four limb movements clearly meets this criterion and earns the full 2 points, reflecting an intact central nervous system and adequate fetal oxygenation, which is a sign of fetal well-being.
Choice C rationale
The BPP criterion for fetal breathing movements requires at least one episode of sustained movements for 30 seconds within the 30-minute observation period to score 2 points. The finding of 20 seconds is insufficient to meet this 30-second threshold, resulting in a score of 0 points for this component and thus not indicating full well-being.
Choice D rationale
The amniotic fluid index (AFI) measures the sum of the deepest vertical pockets of amniotic fluid in the four quadrants of the uterus. An AFI of 1 cm is significantly below the normal range of 5 cm to 25 cm, indicating oligohydramnios (low fluid). This finding scores 0 points on the BPP and suggests potential chronic fetal compromise or renal issues.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.