A nurse is caring for a client who is postpartum and has received methylergonovine. Which of the following findings indicates that the medication was effective?
Fundus firm to palpation
Report of absent breast pain
Increase in lochia
Increase in blood pressure
The Correct Answer is A
Choice A reason:
Methylergonovine is used postpartum to prevent or control uterine bleeding by causing the uterus to contract. A firm fundus upon palpation indicates that the uterus is contracting well, which helps to compress the blood vessels and prevent excessive bleeding. This is the expected outcome when methylergonovine is effective.
Choice B reason:
The absence of breast pain is not directly related to the effectiveness of methylergonovine. Breast pain or engorgement typically occurs when milk comes in a few days postpartum and is not influenced by uterotonic medications.
Choice C reason:
An increase in lochia, or postpartum vaginal discharge, is not an indicator of methylergonovine's effectiveness. Lochia will naturally change and decrease as the postpartum period progresses and is not directly affected by the medication.
Choice D reason:
An increase in blood pressure is not an expected effect of methylergonovine and could indicate a side effect or complication. Methylergonovine can cause hypertension as a side effect, so an increase in blood pressure would warrant further assessment rather than indicating effectiveness.
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Correct Answer is A
Explanation
Choice a reason:
Methylergonovine is a medication used to prevent or control postpartum hemorrhage by contracting the uterus. However, it is contraindicated in patients with hypertension, as it can further increase blood pressure. Given that the client's blood pressure is already elevated at 146/94 mm Hg, administering methylergonovine could pose a risk. Therefore, this prescription requires clarification from the provider before administration.
Choice b reason:
Inserting an indwelling urinary catheter can be a standard procedure after vaginal birth if the client is unable to void or if accurate measurement of urine output is needed. This does not require clarification unless there are specific contraindications or the client's condition does not warrant it.
Choice c reason:
Obtaining a laboratory study of prothrombin and partial thromboplastin time is a common practice to assess the blood's clotting ability, especially if there is a concern for bleeding disorders or if the client is at risk for postpartum hemorrhage. This prescription is clear and does not require further clarification.
Choice d reason:
Administering oxygen by nonrebreather mask at 5 L/min may be indicated if the client is showing signs of respiratory distress or hypoxia. The client's current respiratory rate is within normal limits, but if there are concerns about oxygenation, this intervention would be appropriate.
Correct Answer is B
Explanation
Choice A reason:
Monitoring weight gain during pregnancy is important to ensure that the mother and baby are healthy. The expected weight gain during pregnancy varies depending on the mother's pre-pregnancy weight, but generally, a total gain of 25 to 35 pounds is considered normal for women of average weight.
Choice B reason:
While some nonprescription medications are safe during pregnancy, not all are, and it is crucial to consult with a healthcare provider before taking any medication, including over-the-counter ones. Certain medications can cause harm to the developing fetus and may lead to complications such as birth defects or other adverse outcomes.
Choice C reason:
Reducing stress is beneficial during pregnancy as high levels of stress can negatively impact both the mother and the developing fetus. Stress can lead to increased risks of preterm birth and low birth weight, and it can affect the baby's development. Therefore, implementing stress-reduction techniques is a positive step for a pregnant woman.
Choice D reason:
Informing the doctor before using home remedies for nausea is advisable. While many home remedies are safe and can be effective, such as ginger and peppermint, it is always best to discuss them with a healthcare provider to ensure they are appropriate and will not interfere with the pregnancy.
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