Magnesium Sulfate is being administered intravenously to a client for pregnancy-induced hypertension.
Which assessment finding should the nurse identify as a complication of this treatment?

Choice A rationale:

Afterbirth hemorrhage, or postpartum hemorrhage (PPH), is a significant concern after childbirth. One of the common causes is retained placental fragments. When placental tissue is not completely expelled after delivery, it can lead to continuous bleeding. This condition requires prompt medical intervention, often through uterine exploration and removal of the retained tissue.

Choice B rationale:

Unrepaired vaginal lacerations can cause bleeding, but they are usually identified and repaired immediately after delivery. In this case, the woman gave birth 4 hours ago, so unrepaired lacerations would have been addressed during the delivery process.

Choice C rationale:

Uterine atony, which is the lack of normal uterine muscle tone, can cause postpartum hemorrhage. However, in this scenario, the woman was given Pitocin, which is an oxytocic medication used to prevent or treat uterine atony by inducing uterine contractions. Therefore, uterine atony is less likely to be the cause in this case.

Choice D rationale:

Puerperal infection, also known as postpartum infection, can cause fever, uterine tenderness, and foul-smelling discharge. While it can lead to complications, it is not the most likely cause of significant bleeding in this situation.

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.