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 A
Explanation
Choice A rationale:
It is a belief common at this age. Rationale: The child's belief that she has cancer because God is punishing her for "being bad" and her fear of going to hell if she dies is consistent with magical thinking, which is common in children around the age of 8. Children at this age often have difficulty understanding cause and effect relationships, leading to magical or illogical thinking patterns. It is essential for the nurse to recognize this developmental aspect and respond empathetically and supportively.
Choice B rationale:
Choice C rationale:
The belief is suggestive of excessive family pressure. Rationale: There is no evidence in the scenario to suggest that the child's belief is related to family pressure. The child's statements are more consistent with age-appropriate magical thinking and fear related to concepts of punishment and the afterlife.
Choice D rationale:
The statement suggests a failed attempt to develop a conscience. Rationale: The child's belief does not indicate a failed attempt to develop a conscience. Instead, it reflects a typical developmental stage where children often have magical thoughts and fears. This stage is temporary and part of normal cognitive development.
Correct Answer is A
Explanation
Choice A rationale:
Assessing the parents' anxiety level and readiness to learn is the first action when planning to teach the parents of an infant with a congenital heart defect (CHD). Understanding the parents' emotional state and readiness to receive information is crucial in tailoring the teaching approach effectively.
Choice B rationale:
Gathering literature for the parents is a valuable resource, but it should come after assessing the parents' needs and readiness to learn. Providing information without considering the parents' emotional state and readiness may not be as effective.
Choice C rationale:
Securing a quiet place for teaching is important for minimizing distractions, but it is not the first action. Assessing the parents' readiness to learn comes before setting up the teaching environment.
Choice D rationale:
Discussing the plan with the nursing team is important for coordination, but it is not the first action. Assessing the parents' emotional state and readiness to learn guides the development of an effective teaching plan.
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