A nurse is caring for a client who has just delivered a baby and is experiencing postpartum hemorrhage due to uterine atony.
Which of the following medications should the nurse anticipate administering? Select all that apply:
Methylergonovine maleate (Methergine)
Magnesium sulfate (MgSO4)
Oxytocin (Pitocin)
Carboprost tromethamine (Hemabate)
Misoprostol (Cytotec)
Correct Answer : A,C,D,E
The correct answer is choice A, C, D and E. These medications are all uterotonic agents that can stimulate uterine contractions and reduce bleeding.
They act on different receptors in the uterus and have different side effects and contraindications.
Choice B is wrong because magnesium sulfate is a tocolytic agent that can relax uterine muscles and prevent preterm labor.
It is not indicated for postpartum hemorrhage and can worsen uterine atony.
Normal ranges for postpartum blood loss are less than 500 mL for vaginal delivery and less than 1000 mL for cesarean delivery.
Uterine atony is the most common cause of postpartum hemorrhage and occurs when the uterus fails to contract adequately after delivery.
Risk factors include prolonged or rapid labor, overdistension of the uterus, multiparity, retained placenta, infection and anesthesia.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D"]
Explanation
• Choice A: Administering oxytocin.Oxytocin is a uterotonic agent that stimulates uterine contractions and reduces bleeding from the placental site.It is the most effective intervention for preventing and treating postpartum hemorrhage.
• Choice B: Administering methylergonovine maleate.Methylergonovine maleate is another uterotonic agent that causes sustained uterine contraction and vasoconstriction.It can be used as an alternative or adjunct to oxytocin for postpartum hemorrhage.
• Choice C: Administering carboprost tromethamine.Carboprost tromethamine is a prostaglandin analog that induces strong and prolonged uterine contractions and decreases blood loss.
It can be used as a second-line treatment
Correct Answer is ["B","D","E"]
Explanation
The correct answer is choice B, D and E. The nurse should include the following information in the teaching:
• Increase iron-rich foods in the diet.This can help replenish the blood loss and prevent anemia.
• Report any signs of infection, such as fever or foul-smelling lochia.These can indicate a serious complication that needs immediate medical attention.
• Resume sexual intercourse as soon as desired.There is no evidence that sexual activity increases the risk of bleeding or infection after postpartum hemorrhage.
Choice A is wrong because increasing fluid intake to at least 3 L per day is not necessary for postpartum hemorrhage recovery.Fluid intake should be based on thirst and urine output.
Choice C is wrong because avoiding strenuous activities for 6 weeks is not a specific recommendation for postpartum hemorrhage.The nurse should advise the client to gradually resume normal activities as tolerated and to rest when needed.
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