Your postpartum patient is experiencing a hemorrhage. Vital signs are 156/94, heart rate 87, O2 saturation 95%. You increase the Pitocin drip wide open and prepare to give what medication to the patient next?

Choice A rationale

Magnesium sulfate is primarily used for seizure prophylaxis in preeclampsia or eclampsia. It does not manage hemorrhagic conditions or uterine atony effectively, making it unsuitable for controlling postpartum hemorrhage.

Choice B rationale

Hemabate or Tranexamic Acid (TXA) addresses postpartum hemorrhage by promoting uterine contraction or inhibiting fibrinolysis. Hemabate is a prostaglandin, while TXA is an antifibrinolytic, both effective in hemorrhagic control.

Choice C rationale

Methergine (methylergonovine) induces uterine contraction to manage postpartum hemorrhage effectively but is contraindicated in hypertensive patients due to the risk of exacerbating hypertension or inducing stroke.

Choice D rationale

Nifedipine is a calcium channel blocker used to treat hypertensive disorders or preterm labor. It has no role in treating postpartum hemorrhage or enhancing uterine tone in such cases.

Choice A rationale

Tight swaddling does not address hypoglycemia but may increase the infant’s stress. Hypoglycemia requires immediate correction through feeding or IV glucose, as low glucose levels can impair neonatal neurologic function.

Choice B rationale

Feeding provides immediate glucose replenishment, correcting hypoglycemia, which manifests as trembling. Rechecking glucose ensures effective correction. Normal neonatal glucose levels are 45–65 g/dL, with intervention needed below 40 g/dL.

Choice C rationale

Monitoring urinary output is insufficient for managing neonatal hypoglycemia. Trembling indicates an acute need for glucose, requiring prompt feeding or IV glucose rather than passive observation of output.

Choice D rationale

Immediate NICU transfer is unnecessary unless hypoglycemia remains uncorrected or other complications arise. Prompt feeding and glucose recheck are adequate to stabilize the neonate in most cases.