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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?

A.

Methylergonovine (Methergine).

B.

Oxytocin (Pitocin).

C.

Carboprost (Hemabate).

D.

Misoprostol (Cytotec).

E.

Misoprostol (Cytotec).

Answer and Explanation

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 A

Explanation

Choice A rationale

Uteroplacental insufficiency leads to late decelerations, which are characterized by a gradual decrease in fetal heart rate after the peak of a contraction. This indicates compromised blood flow between the uterus and placenta, affecting the fetus.

Choice B rationale

Umbilical cord compression usually causes variable decelerations, not late decelerations.

Choice C rationale

Maternal bradycardia does not cause changes in fetal heart rate patterns like late decelerations.

Choice D rationale

Fetal head compression causes early decelerations, which coincide with contractions, not late decelerations.

Correct Answer is B

Explanation

Choice A rationale

Umbilical cord compression typically results in variable decelerations in the fetal heart rate, not moderate variability or regular accelerations. It can lead to changes in fetal heart rate

patterns, but not regular mild contractions.

Choice B rationale

Dysfunctional labor refers to an abnormal labor pattern, including irregular uterine contractions. The described symptoms fit this condition, as they can cause mild pain and be

managed by ambulation, showers, and rest.

Choice C rationale

Chorioamnionitis is an infection of the fetal membranes and amniotic fluid, leading to fever, uterine tenderness, and foul-smelling amniotic fluid, not mild contractions and moderate

variability in FHR.

Choice D rationale

Iron deficiency anemia in pregnancy can cause fatigue, pallor, and shortness of breath but does not affect uterine contractions or fetal heart rate.

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