The nurse is assisting the primary care provider (PCP) with the third stage of a vaginal delivery. The patient is multiparous, experienced a precipitous birth, and has a history of hypertension.
Which medical prescription does the nurse anticipate for this patient?
Methylergonovine (Methergine).
Magnesium sulfate.
Carboprost-tromethamine (Hemabate).
Fresh frozen plasma (FFP).
The Correct Answer is A
Choice A rationale
Methylergonovine (Methergine) is used to manage postpartum hemorrhage by stimulating uterine contractions. It is especially useful in cases like this where rapid uterine tone is needed.
Choice B rationale
Magnesium sulfate is used to prevent seizures in preeclamptic patients, not to manage postpartum hemorrhage. This choice is incorrect in this context.
Choice C rationale
Carboprost-tromethamine (Hemabate) is also used for treating postpartum hemorrhage but is typically a secondary option to methylergonovine and may have more side effects.
Choice D rationale
Fresh frozen plasma (FFP) is used to replace clotting factors in cases of coagulopathy, not as a primary intervention for postpartum hemorrhage in this patient.
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Correct Answer is ["A","B","C","D","E"]
Explanation
Choice A rationale
Hypertensive disorders, such as preeclampsia, increase the risk of placental abruption. They can cause changes in the blood vessels of the placenta, reducing blood flow and increasing the likelihood of separation.
Choice B rationale
Uterine fibroids, which are noncancerous growths in the uterus, can interfere with the proper attachment of the placenta, raising the risk of placental abruption.
Choice C rationale
Cigarette smoking contributes to placental abruption by reducing oxygen supply to the placenta, causing placental insufficiency and increasing the risk of premature separation.
Choice D rationale
Abdominal trauma, such as from a fall or car accident, can cause mechanical disruption of the placenta, leading to abruption.
Choice E rationale
Methamphetamine use can cause vasoconstriction and hypertension, which compromise placental blood flow and increase the risk of abruption.
Correct Answer is B
Explanation
Choice A rationale
While infection prevention is vital, ensuring breathing function is more critical after ASP.
Choice B rationale
ASP affects the respiratory system severely; thus, restoring normal breathing is a primary goal.
Choice C rationale
Gastrointestinal function is less immediately affected by ASP compared to respiratory issues.
Choice D rationale
Voiding without pain is important, but respiratory stability takes precedence.