A nurse has administered methergine (methylergonovine) 0.2 mg to a grand multipara (G7, P6) who delivered vaginally 30 minutes earlier. Which of the following outcomes indicates that the medication is effective?
Pulse rate 80 and regular.
Fundus firm at umbilicus, lochia moderate.
Blood pressure 120/80.
Increase in prothrombin time.
The Correct Answer is B
Choice A rationale
A pulse rate of 80 and regular does not directly indicate Methergine's effectiveness. Normal pulse ranges from 60 to 100 beats per minute. This could result from overall stabilization rather than medication effect.
Choice B rationale
A firm uterine fundus at the umbilicus and moderate lochia indicate effective uterine contraction and hemostasis, reflecting successful intervention with Methergine in managing postpartum hemorrhage.
Choice C rationale
A blood pressure of 120/80 is within the normal adult range but does not specifically reflect Methergine's uterotonic action. Blood pressure monitoring is essential but not the primary efficacy indicator.
Choice D rationale
An increase in prothrombin time reflects coagulation changes but is unrelated to Methergine's mechanism of action. It focuses on hemostatic effects via uterine contractions rather than coagulation pathways.
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Related Questions
Correct Answer is B
Explanation
Choice A rationale
Difficulty breathing can indicate an anaphylactic reaction, a rare but serious side effect of Hemabate. It involves bronchoconstriction triggered by prostaglandin administration, usually necessitating emergency interventions.
Choice B rationale
Diarrhea is common due to prostaglandin's stimulation of smooth muscle in the gastrointestinal tract, leading to increased motility. This adverse effect often accompanies other systemic effects like cramping.
Choice C rationale
Hypotension, while possible, is less frequent and usually transient. It may result from the vasodilatory properties of prostaglandins but is not a primary side effect.
Choice D rationale
Palpitations occur less commonly and may arise if Hemabate induces systemic changes affecting heart rate, including reflex tachycardia secondary to other hemodynamic shifts.
Correct Answer is ["B","C","D","E"]
Explanation
Choice A rationale
Deep sleep is not a characteristic of neonatal abstinence syndrome; rather, infants tend to exhibit irritability and disturbed sleep patterns due to central nervous system hyperirritability caused by opioid withdrawal.
Choice B rationale
A high-pitched cry occurs due to central nervous system overstimulation and hyperirritability, which are hallmark features of neonatal abstinence syndrome and a direct result of opioid withdrawal in neonates.
Choice C rationale
Poor feeding is common in neonatal abstinence syndrome due to uncoordinated suck reflexes and gastrointestinal disturbances, leading to difficulty maintaining adequate nutrition and hydration in affected neonates.
Choice D rationale
Neonates with neonatal abstinence syndrome often exhibit tremors or shaking as a result of central nervous system hyperirritability, which is a hallmark symptom of opioid withdrawal in newborns.
Choice E rationale
Excessive sweating is a manifestation of autonomic nervous system dysregulation caused by opioid withdrawal in neonates, commonly observed in infants with neonatal abstinence syndrome.
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