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.
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Correct Answer is D
Explanation
Choice A rationale:
Using maternity jargon might confuse the patient, especially if she has limited English proficiency. It is important to use simple and clear language to ensure the patient understands the information. Using jargon would not be effective in this situation.
Choice B rationale:
Speaking quickly and efficiently may further complicate communication, especially considering the patient's limited English proficiency. It is crucial to speak slowly, clearly, and allow time for the patient to process and respond. Rushing the conversation may hinder effective communication.
Choice C rationale:
Providing handouts can be helpful, but it should not be the sole method of communication, especially when dealing with a patient who has limited English proficiency. Handouts may not be available in the patient's language or may not address her specific concerns. Assessing direct understanding through conversation is essential.
Choice D rationale:
Assessing whether the patient understands the discussion is the most crucial step. This can be done through various methods, such as asking open-ended questions, using interpreters if necessary, and encouraging the patient to ask questions. Ensuring the patient comprehends the information provided is vital for her overall care and adherence to medical advice.
Correct Answer is A
Explanation
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.
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