The nurse is calculating the estimated date of confinement (EDC) using Nagele's rule for a client whose last menstrual period started on December 1. Which date is most accurate?

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.

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The correct answer is choice C. Visible peristalsis and weight loss.

Choice A rationale:

Abdominal rigidity and pain on palpation are not typically indicative of pyloric stenosis. These symptoms could be associated with a variety of other gastrointestinal conditions.

Choice B rationale:

A rounded abdomen and hypoactive bowel sounds are not specific to pyloric stenosis. These symptoms could be seen in various gastrointestinal disorders.

Choice C rationale:

Visible peristalsis and weight loss are classic symptoms of pyloric stenosis. The condition causes a narrowing of the opening from the stomach to the small intestine, preventing food from passing through. This leads to vomiting after feeding, persistent hunger, and weight loss since very little food passes to the small intestines.

Choice D rationale:

Distention of the lower abdomen and constipation are not typically indicative of pyloric stenosis. These symptoms could be associated with a variety of other gastrointestinal conditions.