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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 B

Explanation

Choice A rationale

Magnesium sulfate is not given to increase diuresis; this is not its primary effect and is incorrect in the context of treating preeclampsia.

Choice B rationale

Magnesium sulfate is administered to prevent seizures in patients with preeclampsia. It acts as a central nervous system depressant and helps in preventing eclampsia.

Choice C rationale

Although magnesium sulfate may have a mild effect on reducing blood pressure due to its vasodilatory properties, this is not its primary purpose in the management of preeclampsia.

Choice D rationale

Magnesium sulfate is not used to slow the process of labor; its main role is seizure prophylaxis in preeclampsia.

Correct Answer is C

Explanation

Choice A rationale

The hemoglobin level of 11.6 g/dL is within the normal range for a pregnant woman. While placenta previa requires monitoring, it is not immediately life-threatening.

Choice B rationale

Type 2 diabetes mellitus requires regular monitoring and management, but a single fasting blood glucose level does not indicate an immediate emergency unless it is extremely high or low.

Choice C rationale

Partial placental abruption can lead to significant complications for both the mother and fetus, including hemorrhage and fetal distress, making it the priority for immediate assessment.

Choice D rationale

An Rh-negative status and a recent cerclage placement are important for ongoing monitoring but do not present an immediate life-threatening condition that demands the first assessment.

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