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:
Do not administer pancreatic enzymes if the child is receiving antibiotics. Rationale: There is no specific contraindication to administering pancreatic enzymes while the child is receiving antibiotics. Pancreatic enzymes are essential for the digestion and absorption of nutrients in children with cystic fibrosis, and they should be continued even if the child is on antibiotics.
Choice B rationale:
Decrease dose of pancreatic enzymes if the child is having frequent, bulky stools. Rationale: Bulky, foul-smelling stools are common in cystic fibrosis due to malabsorption of nutrients. Pancreatic enzyme replacement therapy is crucial to aid in the digestion of fats and proteins. If the child is experiencing frequent, bulky stools, it may indicate inadequate enzyme dosage, and the healthcare provider should be consulted to adjust the dosage or formulation of pancreatic enzymes. Choice
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.
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