Maternity Nursing: Postpartum Q 15

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Methergine or Pitocin is prescribed for a woman to treat PP hemorrhage. Before administration of these medications, the priority nursing assessment is to check the:

  

     A. Amount of lochia

     B. Blood pressure

     C. Deep tendon reflexes

     D. Uterine tone

    

    

Correct Answer: B. Blood pressure

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Methergine and Pitocin are agents that are used to prevent or control postpartum hemorrhage by contracting the uterus. They cause continuous uterine contractions and may elevate blood pressure. A priority nursing intervention is to check blood pressure. The physician should be notified if hypertension is present. Methergine is in a group of drugs called ergot alkaloids. It affects the smooth muscle of a woman’s uterus, improving the muscle tone as well as the strength and timing of uterine contractions. Methergine is used just after a baby is born, to help deliver the placenta (also called the “afterbirth”).

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Option A: Methergine is administered in the postpartum period to help deliver the placenta and to help control bleeding and other uterine problems after childbirth. It is indicated following delivery of the placenta, for routine management of uterine atony, hemorrhage, and subinvolution of the uterus. For control of uterine hemorrhage in the second stage of labor following delivery of the anterior shoulder.

Option C: Methergine (methylergonovine maleate) acts directly on the smooth muscle of the uterus and increases the tone, rate, and amplitude of rhythmic contractions. Thus, it induces a rapid and sustained titanic uterotonic effect which shortens the third stage of labor and reduces blood loss.

Option D: Caution should be exercised in the presence of sepsis, obliterative vascular disease. Also, use caution during the second stage of labor. The necessity for manual removal of a retained placenta should occur only rarely with proper technique and adequate allowance of time for its spontaneous separation.

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