A prescription for Methylergonovine 0.2mg IM has been ordered for a client in stage three of labor who is experiencing a hemorrhage.
Using the information from the medical chart below, why is this medication contraindicated for this patient? Patient - J.L. DOB - 4/2/1990.
Allergies - Penicillin.
G-5 T-4 P-0 A-0 L-4. Vital Signs - T-98.6°F P-128 R-22 B/P-155/95. Medication - Methyldopa 250mg PO Q8h.
The medication is contraindicated due to the client's blood pressure.
The medication is contraindicated due to the multigravity of the client.
The medication is contraindicated due to the client's drug allergy.
The medication is contraindicated due to the client's heart rate.
The Correct Answer is A
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
The child's fever in Kawasaki disease is typically unresponsive to antibiotics. The disease primarily affects blood vessels and can lead to the development of coronary artery aneurysms. Antibiotics are not the mainstay of treatment for Kawasaki disease.
Choice B rationale:
Kawasaki disease does not primarily involve the joints. It is a systemic vasculitis that affects medium-sized arteries throughout the body, including the coronary arteries. Joint involvement is not a characteristic feature of this condition.
Choice C rationale:
Aspirin is actually a crucial part of the treatment for Kawasaki disease. High-dose aspirin therapy (80-100 mg/kg/day) is administered until the child is afebrile, then the dose is reduced and continued for several weeks to prevent blood clots and inflammation in the coronary arteries.
Choice D rationale:
This is the correct answer. The therapeutic management of Kawasaki disease includes the administration of intravenous immunoglobulin (IVIG) and aspirin. IVIG helps reduce inflammation and prevent coronary artery abnormalities, while high-dose aspirin is used for its anti-inflammatory and antiplatelet effects. This combination of treatments has been shown to be effective in reducing the risk of coronary artery complications associated with Kawasaki disease.
Correct Answer is B
Explanation
Choice A rationale:
Telling the patient that she should have felt the baby move by now might cause unnecessary anxiety if she hasn't experienced fetal movement yet. Fetal movement can vary, and some women might not feel it until later in their pregnancy. This statement does not provide accurate and reassuring information.
Choice B rationale:
Around 14 to 25 weeks of gestation, most women begin to feel fluttering sensations, which are the early movements of the baby. By stating that the patient should start feeling these sensations within the next month or so, the nurse provides an accurate and reassuring response based on the typical timeline for fetal movement.
Choice C rationale:
This statement is incorrect. While the baby is moving, it might not be perceivable to the mother due to various factors such as the position of the placenta or the baby's own activity patterns. Simply stating that the baby is moving does not address the patient's concern about feeling the movements.
Choice D rationale:
Some babies are indeed quiet, and their movements might not be as noticeable to the mother. However, this statement does not provide a specific timeframe or address the patient's immediate concern about when she will start feeling the baby move. It is essential to provide a more informative and reassuring response.
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