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While you are taking Monique's vital signs and performing a postpartum assessment 4 hours after delivery, she tells you she is feeling lightheaded. She has a history of chronic hypertension and obesity.

Her vital signs are blood pressure 85/57 mm Hg, pulse 132, respirations 28, oxygen saturation 94%. Her uterus is boggy at midline, 1 cm above the umbilicus.
What would be your next steps and anticipated orders?

A.

Massage her fundus until firm and ensure IV access.

B.

Orders for methylergonovine (Methergine) 0.2 mg IM and an oxytocin bolus.

C.

Orders for carboprost tromethamine (Hemabate) 250 mcg IM. .

D.

Orders for carboprost tromethamine (Hemabate) 250 mcg IM. .

Question Solution

Correct Answer : A,B,C

Choice A rationale

Massaging the fundus helps to stimulate uterine contractions, reducing bleeding and promoting firmness in the uterus. Ensuring IV access is critical for administering medications and

fluids quickly.

 

Choice B rationale

Methylergonovine (Methergine) is used to prevent and control postpartum hemorrhage by promoting uterine contractions. Oxytocin bolus also helps stimulate contractions, preventing

further blood loss.

 

Choice C rationale

Carboprost tromethamine (Hemabate) is another uterotonic agent used to control severe postpartum hemorrhage by causing uterine contractions. Its use depends on the patient's

response to other treatments.


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View Related questions

Correct Answer is A

Explanation

Choice A rationale

Vaginal hematomas are usually associated with severe pain due to the accumulation of blood in the tissues.

Choice B rationale

Bleeding might be visible, but hematomas often cause internal accumulation, not external bleeding.

Choice C rationale

Warmth is not typically associated with hematomas; instead, pain and swelling are more common.

Choice D rationale

Redness may occur, but pain is the most consistent symptom.

Correct Answer is D

Explanation

Choice A rationale

Placental abruption is characterized by abdominal pain, vaginal bleeding, and uterine tenderness. It does not cause dyspnea, hypotension, frothy sputum, or loss of consciousness.

Choice B rationale

Uterine rupture typically presents with severe abdominal pain, abnormal fetal heart rate patterns, and vaginal bleeding. Shock can occur, but not frothy sputum or sudden dyspnea.

Choice C rationale

Uterine inversion leads to pain, hemorrhage, and shock. It does not present with frothy sputum or sudden dyspnea.

Choice D rationale

Anaphylactoid syndrome (amniotic fluid embolism) results from amniotic fluid entering maternal circulation, causing an anaphylactic reaction. Symptoms include sudden dyspnea, hypotension, frothy sputum, and loss of consciousness, matching the described scenario. .

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