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 C
Explanation
Choice A rationale:
Cough. While a cough can be a side effect of inhaled steroids, it is not a significant concern compared to other potential risks. Long-term use of inhaled steroids can lead to slowed growth in children, making choice C the correct answer.
Choice B rationale:
Osteoporosis. Osteoporosis is a potential side effect of long-term use of inhaled steroids. These medications can affect bone density and increase the risk of osteoporosis, especially in individuals who are already at risk due to other factors such as age, gender, or family history.
Choice C rationale:
Slowed growth. Long-term use of inhaled steroids can lead to slowed growth in children. It's important for healthcare providers to monitor the growth of children with asthma who are taking these medications regularly. If slowed growth is observed, healthcare providers might consider adjusting the treatment plan.
Choice D rationale:
Cushing's syndrome. Cushing's syndrome is a rare but serious side effect of long-term steroid use. It is characterized by a collection of signs and symptoms caused by prolonged exposure to high levels of cortisol (a steroid hormone). While it's a potential risk, slowed growth is a more common concern in children taking long-term inhaled steroids.
Correct Answer is D
Explanation
This question assesses the nurse's ability to differentiate between pathological apnea and normal physiological variations in preterm neonates. Understanding neonatal respiratory development is crucial for distinguishing between clinical distress and common, benign breathing patterns observed in the premature population.
Choice A rationale: Apnea in infants is clinically defined as a cessation of breathing lasting 20 seconds or longer, or shorter if associated with bradycardia or cyanosis. Shorter pauses are considered periodic breathing, which is distinct from true apneic episodes.
Choice B rationale: While preterm infants have immature cardiovascular regulation, brief respiratory pauses followed by rapid breathing do not directly indicate fluctuating blood pressure. These patterns are primary reflections of an underdeveloped brainstem control of the respiratory rhythm and ventilation.
Choice C rationale: Maintaining a neutral thermal environment is vital for preventing cold stress, which increases oxygen consumption. However, this periodic breathing pattern is a developmental neurological phenomenon rather than a direct metabolic or thermoregulatory compensation for thermal instability.
Choice D rationale: Periodic breathing, characterized by brief pauses followed by rapid respiration, is a common and typically benign pattern in premature infants. It is attributed to the immaturity of the respiratory center in the brain and generally resolves as the infant matures.
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