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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Correct Answer is C
Explanation
Choice A rationale
G4T1 P1 A1 L2 implies the client has been pregnant 4 times, with 1 term birth, 1 preterm birth, 1 abortion, and 2 living children. This does not include the correct number of
pregnancies or abortions for this client.
Choice B rationale
G5T2 P0 A2 L2 indicates 5 pregnancies, 2 term births, no preterm births, 2 abortions, and 2 living children. This does not correctly account for the preterm birth and abortion history
provided.
Choice C rationale
G5T1 P1 A2 L2 is the correct answer, as it denotes 5 pregnancies (including the current one), 1 term birth, 1 preterm birth, 2 abortions, and 2 living children, aligning with the client's
history.
Choice D rationale
G5T1 P1 A1 L3 indicates 5 pregnancies, 1 term birth, 1 preterm birth, 1 abortion, and 3 living children. The client has only 2 living children, so this is incorrect.
Correct Answer is B
Explanation
Choice A rationale
Uteroplacental insufficiency typically results in late decelerations, not a sudden drop in fetal heart rate, which is more commonly caused by umbilical cord compression.
Choice B rationale
Umbilical cord compression can cause variable decelerations, which are characterized by a sudden drop in fetal heart rate. This occurs due to the umbilical cord being compressed,
leading to decreased blood flow and oxygen to the fetus.
Choice C rationale
Maternal bradycardia refers to a slow maternal heart rate and does not directly cause changes in the fetal heart rate pattern.
Choice D rationale
Fetal head compression typically causes early decelerations, which are gradual decreases in fetal heart rate that occur with contractions and are usually benign.