A nurse is preparing to administer methylergonovine to a client who has postpartum hemorrhage.
Which of the following assessments should the nurse perform before giving the medication?
Blood pressure
Temperature
Respiratory rate
Blood glucose
The Correct Answer is A
The nurse should perform a blood pressure assessment before giving methylergonovine to a client who has postpartum hemorrhage because methylergonovine can cause hypertension and cerebrovascular accidents. The nurse should administer methylergonovine over more than one minute and monitor blood pressure.
Choice B. Temperature is wrong because temperature is not affected by methylergonovine and is not a priority assessment for postpartum hemorrhage.
Choice C. Respiratory rate is wrong because respiratory rate is not affected by methylergonovine and is not a priority assessment for postpartum hemorrhage.
Choice D. Blood glucose is wrong because blood glucose is not affected by methylergonovine and is not a priority assessment for postpartum hemorrhage.
Postpartum hemorrhage is severe vaginal bleeding after childbirth that can lead to shock and death.
The major causes of postpartum hemorrhage are uterine atony, lacerations, retained placenta or clots, and clotting factor deficiency.
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Correct Answer is A
Explanation
Massaging the fundus stimulates uterine contractions and helps to stop the bleeding.
This is the first action the nurse should take to manage uterine atony.
Choice B is wrong because administering oxytocin is a pharmacological intervention that can be used after massaging the fundus if bleeding persists.
Oxytocin is a hormone that also stimulates uterine contractions and reduces blood loss.
Choice C is wrong because inserting an indwelling urinary catheter is not a priority action for postpartum hemorrhage.
A full bladder can interfere with uterine contractions and cause displacement of the uterus, but it is not the main cause of uterine atony.
Choice D is wrong because starting an IV infusion of lactated Ringer’s solution is a supportive measure that can be used to replace fluid loss and maintain blood pressure in postpartum hemorrhage.
However, it does not address the underlying cause of bleeding and should not be done before massaging the fundus.
Correct Answer is C
Explanation
This is because a low platelet count (<150,000/mm3) indicates thrombocytopenia, which can increase the risk of bleeding and hemorrhage.
The nurse should report this finding to the provider as it may require treatment or transfusion.
Choice A is wrong because hemoglobin 10 g/dL is within the normal range for postpartum women (10-14 g/dL) and does not indicate hemorrhage.
Choice B is wrong because hematocrit 30% is also within the normal range for postpartum women (30-39%) and does not indicate hemorrhage.
Choice D is wrong because white blood cells 12,000/mm3 is slightly elevated but not abnormal for postpartum women, who may have a physiological leukocytosis due to stress, inflammation, or infection.
This finding does not indicate hemorrhage.
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