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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 D

Explanation

Choice A rationale

A low transverse uterine scar is considered the safest type of uterine incision for a VBAC because it is less likely to rupture compared to other types of scars. Therefore, a low transverse uterine scar would not disqualify the patient for VBAC.

Choice B rationale

Patient asking multiple questions does not disqualify her for VBAC. Patient education and ensuring the patient’s understanding and agreement with the procedure is an essential part of the process.

Choice C rationale

Induction of labor in the first pregnancy does not automatically disqualify a patient from attempting VBAC. The success of VBAC depends on multiple factors including the reason for the initial cesarean section.

Choice D rationale

A cesarean due to pelvic abnormalities would disqualify the patient for VBAC because the underlying pelvic condition that necessitated the initial cesarean section is likely still present and would increase the risk of complications during vaginal birth.

Correct Answer is ["A","B","D","E"]

Explanation

Choice A rationale

Impaired intellectual development in children born to mothers with diabetes can occur due to fluctuating blood glucose levels, which can affect brain development.

Choice B rationale

Development of metabolic syndrome is more likely in children born to mothers with diabetes due to genetic predispositions and prenatal exposure to hyperglycemia.

Choice C rationale

Shoulder injury related to birth size, although a possible immediate complication, is not typically considered a long-term effect of maternal diabetes.

Choice D rationale

Changes in genetic expression can occur due to epigenetic modifications from exposure to maternal diabetes, potentially leading to various health issues later in life.

Choice E rationale

Increased risk for chronic illnesses, such as type 2 diabetes and cardiovascular diseases, is higher in children born to mothers with diabetes, due to genetic and environmental factors.

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