A nurse is receiving a report on a new postpartum admission. Her medical history includes chronic hypertension.
The client is asking about postpartum orders.
Which of the following would be contraindicated based on the client's medical history?
Methylergonovine (Methergine).
Oxytocin (Pitocin).
Carboprost (Hemabate).
Misoprostol (Cytotec).
Misoprostol (Cytotec).
The Correct Answer is A
Choice A rationale
Methylergonovine (Methergine) is contraindicated in clients with hypertension because it can cause severe hypertension by increasing vascular resistance, leading to potential complications such as stroke.
Choice B rationale
Oxytocin (Pitocin) is used to induce labor and control postpartum hemorrhage and does not significantly increase blood pressure, making it safe for use in hypertensive patients.
Choice C rationale
Carboprost (Hemabate) is used to control severe postpartum hemorrhage and does not have significant effects on blood pressure. It is generally safe for hypertensive patients.
Choice D rationale
Misoprostol (Cytotec) is used for postpartum hemorrhage management and does not significantly affect blood pressure, making it safe for hypertensive patients.
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View Related questions
Correct Answer is A
Explanation
Choice A rationale
Anaphylactoid syndrome of pregnancy (also known as amniotic fluid embolism) occurs when amniotic fluid, fetal cells, hair, or other debris enter the mother's bloodstream, triggering
a serious reaction. It can cause sudden shortness of breath, cardiovascular collapse, and other severe symptoms immediately after a rupture of membranes and is a rare but critical
obstetrical emergency.
Choice B rationale
Abruptio placentae involves the premature separation of the placenta from the uterine wall, which leads to bleeding and potential fetal and maternal distress. However, it does not
typically present with sudden cardiorespiratory collapse or shortness of breath immediately following membrane rupture.
Choice C rationale
Uterine rupture refers to a tear in the wall of the uterus, usually due to trauma, labor stress, or previous surgical scars. While it is a severe condition, it usually presents with
abdominal pain, vaginal bleeding, and fetal distress rather than sudden respiratory failure.
Choice D rationale
Disseminated intravascular coagulation (DIC) is a condition affecting blood clotting processes, often secondary to other conditions like severe preeclampsia, sepsis, or trauma. It
generally presents with bleeding and clotting issues but not sudden respiratory or cardiovascular collapse.
Correct Answer is B
Explanation
Choice A rationale
Precipitous labor is a rapid labor that typically lasts less than 3 hours. While it can result in trauma and complications, it does not inherently increase the risk for an operative delivery,
which is more often related to other factors like fetal distress or failure to progress.
Choice B rationale
Postpartum hemorrhage (PPH) is a significant concern with precipitous labor due to the rapid and forceful contractions that can cause uterine atony, leading to increased bleeding
after birth.
Choice C rationale
In a precipitous labor, the rapid delivery can cause vaginal lacerations, not a decreased risk. The swift passage of the baby through the birth canal increases the risk of tears and
trauma.
Choice D rationale
Neonatal sepsis is related to infections acquired during delivery but is not specifically linked to the speed of labor. The primary concern in precipitous labor is maternal trauma and
hemorrhage, not infection.