Methergine is prescribed for a woman to treat postpartum hemorrhage.
Before administration of this medication, the priority nursing assessment is to check the:

• White blood cell count: Expected—mild leukocytosis is normal postpartum due to physiological stress.
• Blood clot size: Expected—small clots, like a pea-sized clot, are common and not concerning unless excessive bleeding occurs.
• Uterine findings: Expected—firm and midline uterus indicating effective involution.
• Lochia findings: Expected—progressing normally without signs of infection (no foul odor).
• Calf findings: Expected—a single varicose vein without tenderness or swelling is not concerning.
• Blood pressure: Expected—within normal postpartum range.

Choice A rationale

Cocaine is a stimulant that typically causes fetal tachycardia (an elevated fetal heart rate) due to its sympathomimetic effects, increasing maternal and subsequently fetal heart rate and blood pressure. It does not usually lead to fetal bradycardia.

Choice B rationale

Prolonged umbilical cord compression can lead to fetal bradycardia because it restricts oxygenated blood flow to the fetus. The baroreceptors in the fetus respond to decreased oxygen by slowing the heart rate in an attempt to conserve oxygen and maintain perfusion to vital organs.

Choice C rationale

Fetal anemia, a decrease in red blood cell count, can lead to fetal tachycardia as the heart attempts to compensate for reduced oxygen-carrying capacity by increasing cardiac output. Bradycardia is not a typical initial response to fetal anemia.

Choice D rationale

Terbutaline is a tocolytic medication used to relax the smooth muscle of the uterus and prevent preterm labor. Its side effects often include maternal and fetal tachycardia due to its beta-adrenergic agonist activity.