How it Works
Try Naxlex NCLEX-RN (Free-Trial)

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.

A.

The medication is contraindicated due to the client's blood pressure.

B.

The medication is contraindicated due to the multigravity of the client.

C.

The medication is contraindicated due to the client's drug allergy.

D.

The medication is contraindicated due to the client's heart rate.

Answer and Explanation

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.


Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Free Nursing Study Resources

Related Questions

Correct Answer is A

Explanation

To calculate the estimated date of confinement (EDC) using Nagele's rule, follow these steps:

  1. Take the first day of the last menstrual period (LMP).

  2. Add 7 days to that date.

  3. Count back 3 months.

  4. Add 1 year to the resulting date, and that will be the EDC.

In this case, the client's LMP started on December 1.

  1. December 1

  2. December 8 (adding 7 days)

  3. September 8 (counting back 3 months)

  4. Add 1 year: September 8 of the following year

So, the most accurate EDC for the client using Nagele's rule would be September 8 of the following year.

Correct Answer is B

Explanation

Choice A rationale:
It is not inappropriate because of the child's age. Simple magic tricks, especially those using familiar items like gauze, can capture the attention and cooperation of young children. Age-appropriate distractions can be highly effective in engaging pediatric patients during medical procedures.
Choice B rationale:
Using a simple magic trick with gauze is a way to establish rapport with the child. Children often respond well to creative and playful approaches, making them feel more comfortable and cooperative during medical procedures. Establishing rapport is crucial for gaining trust and ensuring a positive healthcare experience.
Choice C rationale:
It is not too distracting when cooperation is important. Distractions, when used judiciously, can enhance cooperation during medical procedures. The key is to strike a balance between engaging the child and ensuring the procedure's effectiveness. A simple magic trick with gauze is generally not overly distracting and can be a helpful technique in pediatric nursing.
Choice D rationale:
Adequate time is important, but the appropriateness of the magic trick is not solely dependent on time. While having adequate time is beneficial for implementing creative approaches, the effectiveness of using a magic trick depends more on the nurse's skill, the child's response, and the overall context of the situation.

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Register