When palpating the child's cervical lymph nodes, the nurse notes that they are tender, enlarged, and warm.
The best explanation for this is.

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.

Choice A rationale:
Pulmonary stenosis is characterized by a systolic ejection murmur best heard at the upper left sternal border. It does not typically produce a continuous machinery-like murmur. Pulmonary stenosis results from narrowing at the pulmonary valve, obstructing blood flow from the right ventricle to the pulmonary artery.
Choice B rationale:
A continuous machinery-like murmur is characteristic of patent ductus arteriosus (PDA). PDA is a congenital heart defect where the ductus arteriosus, a fetal blood vessel that should close after birth, remains open, allowing continuous blood flow between the aorta and pulmonary artery. This murmur is often best heard in the left infraclavicular region.
Choice C rationale:
Ventricular septal defect (VSD) typically produces a harsh holosystolic murmur heard best at the lower left sternal border. VSD is a hole in the septum separating the ventricles, allowing blood to flow from the higher-pressure left ventricle to the lower-pressure right ventricle.
Choice D rationale:
Coarctation of the aorta causes a murmur due to increased blood flow across the aortic valve. However, this murmur is not continuous and is usually systolic and best heard in the back over the left scapula.