A nurse is caring for a client who is postpartum and has a new prescription for
methylergonovine for vaginal bleeding refractory to fundal massage and oxytocin. When

reviewing the client's medical history, the nurse should recognize which of the following diagnoses as a contraindication to the administration of methylergonovine?

A. This response may come across as confrontational and could potentially shut down further communication. It's important to offer support and empathy rather than immediately probing with questions.

B. While saying, "You can trust me and tell me what you are thinking," may foster trust, it is too vague and does not focus on assessing the client’s level of suicidal ideation or intent. Effective responses should prioritize safety by exploring specific details about the client’s thoughts.

C. "I need to know what you mean by misery" focuses on understanding the client’s emotional state but does not address the immediate concern of suicidal thoughts. While exploring the client’s feelings is important, it is secondary to assessing imminent risk.

D. Asking, "Do you have a plan to end your life?" is appropriate because it directly assesses the client’s risk for suicide. Determining whether the client has a specific plan, the means to carry it out, and intent to act is essential for evaluating the severity of the situation and implementing safety measures.

A. Taking the client to the bathroom after a preoperative injection may be unsafe because many preoperative medications can cause sedation or dizziness, increasing the risk of falls.
B. Verification of the surgical site should occur before administration of preoperative medications, as the client may be sedated and unable to participate accurately afterward.
C. Teaching deep breathing and coughing exercises is most effective before sedation, when the client is alert and able to learn and follow instructions.
D. Raising the side rails on the bed is a priority safety measure after administering preoperative sedatives, as it helps prevent falls and injury while the client is drowsy or unsteady.