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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?

A.

Methylergonovine (Methergine).

B.

Magnesium sulfate.

C.

Carboprost-tromethamine (Hemabate).

D.

Fresh frozen plasma (FFP).

Answer and Explanation

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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View Related questions

Correct Answer is B

Explanation

Choice A rationale

Oral rehydration therapy is not used in place of feedings for infants undergoing phototherapy for elevated bilirubin levels. It's crucial to maintain proper nutrition and hydration through regular feedings.

Choice B rationale

Rotating the baby helps ensure even exposure to the bili lights, which aids in breaking down bilirubin effectively across the baby's body.

Choice C rationale

Applying restraints is inappropriate and unnecessary. It could cause distress and is not a standard practice for phototherapy.

Choice D rationale

Administering intravenous fluids is not typically needed unless there's a risk of dehydration or other medical indications as per the doctor's orders.

Correct Answer is B

Explanation

Choice A rationale

Administering oxytocin during shoulder dystocia can exacerbate the problem by increasing uterine contractions, making it harder to deliver the baby's shoulder.

Choice B rationale

Flexing the client's thighs sharply toward her abdomen, known as the McRoberts maneuver, helps to widen the pelvis and can often resolve shoulder dystocia by changing the angle of the pelvic bones.

Choice C rationale

While applying oxygen is a standard practice to improve maternal and fetal oxygenation, it does not specifically address shoulder dystocia and is not a primary intervention.

Choice D rationale

Applying downward pressure on the fundus is contraindicated as it can worsen shoulder dystocia by further impacting the shoulder against the pelvic bone.

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