A prescription for Methylergonovine 0.2mg IM has been ordered for a client in stage three of labor who is experiencing a hemorrhage.
Using the information from the medical chart below, why is this medication contraindicated for this patient? Patient - J.L. DOB - 4/2/1990.
Allergies - Penicillin.
G-5 T-4 P-0 A-0 L-4. Vital Signs - T-98.6°F P-128 R-22 B/P-155/95. Medication - Methyldopa 250mg PO Q8h.
The medication is contraindicated due to the client's blood pressure.
The medication is contraindicated due to the multigravity of the client.
The medication is contraindicated due to the client's drug allergy.
The medication is contraindicated due to the client's heart rate.
The Correct Answer is A
Choice A rationale:
The medication, Methylergonovine 0.2mg IM, is contraindicated due to the client's blood pressure. The patient's blood pressure reading is 155/95 mmHg, which indicates hypertension (high blood pressure). Methylergonovine is a medication used to manage postpartum hemorrhage by causing uterine contractions and reducing bleeding. However, it is contraindicated in patients with hypertension because it can significantly raise blood pressure, leading to complications such as stroke, heart attack, or hypertensive crisis. Administering this medication to a patient with high blood pressure can worsen their condition and pose serious risks.
Choice B rationale:
The multigravity (G-5) of the client (having had 5 pregnancies) is not a contraindication for Methylergonovine. The number of pregnancies a patient has had does not impact the contraindication criteria for this medication.
Choice C rationale:
The client's drug allergy to penicillin is not a contraindication for Methylergonovine. Allergies to specific medications do not affect the use of Methylergonovine for postpartum hemorrhage.
Choice D rationale:
The client's heart rate, which is not provided in the medical chart, does not directly contraindicate Methylergonovine. However, hypertension (elevated blood pressure) is the primary concern in this scenario, making choice A the correct answer.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Leaving the infant in the room with the mother may not be appropriate, especially given the difficult delivery and the risk of complications, such as hypoglycemia.
Choice B rationale:
Taking the infant immediately to the nursery without monitoring vital signs and glucose levels could lead to missed signs of distress or hypoglycemia.
Choice C rationale:
Performing a gestational age assessment is important, but the immediate concern for this infant is the risk of hypoglycemia due to macrosomia (large birth weight). This choice does not address the immediate issue at hand.
Choice D rationale:
The correct answer. Macrosomic infants, especially those born after a difficult delivery, are at risk of hypoglycemia due to the excessive insulin production in response to high blood glucose levels. It is crucial to monitor the infant's blood glucose levels frequently and observe closely for signs of hypoglycemia, such as jitteriness, poor feeding, and lethargy.
Correct Answer is C
Explanation
Choice A rationale:
Ribbon-like stools are not characteristic of intussusception. Intussusception is a medical emergency where one portion of the intestine invaginates or telescopes into another. This condition can lead to intestinal obstruction and compromised blood flow, causing severe abdominal pain, vomiting, and bloody stools. The characteristic stool appearance associated with intussusception is "currant jelly" stools. These stools contain mucus, blood, and sloughed mucosal tissue, giving them a characteristic dark, sticky, and jelly-like appearance. This occurs due to the mixture of blood and mucus within the intestines.
Choice B rationale:
Hard stools positive for guaiac indicate the presence of occult blood in the stool, but this finding is not specific to intussusception. Occult blood in the stool can be a sign of gastrointestinal bleeding from various causes, such as ulcers, gastritis, or colorectal polyps. It is not a characteristic feature of intussusception.
Choice D rationale:
Loose, foul-smelling stools are nonspecific and can occur due to various gastrointestinal disorders, dietary issues, or infections. This description does not specifically indicate intussusception.
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