Maternity Nursing: Postpartum Q 16

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Methergine or Pitocin are prescribed for a client with PP hemorrhage. Before administering the medication(s), the nurse contacts the health provider who prescribed the medication(s) in which of the following conditions is documented in the client’s medical history?

  

     A. Peripheral vascular disease

     B. Hypothyroidism

     C. Hypotension

     D. Type 1 diabetes

    

    

Correct Answer: A. Peripheral vascular disease.

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These medications are avoided in clients with significant cardiovascular disease, peripheral disease, hypertension, eclampsia, or preeclampsia. These conditions are worsened by the vasoconstriction effects of these medications. Patients with coronary artery disease or risk factors for coronary artery disease (e.g., smoking, obesity, diabetes, high cholesterol) may be more susceptible to developing myocardial ischemia and infarction associated with methylergonovine-induced vasospasm.

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Option B: Before using this medication, tell the doctor or pharmacist about the medical history, especially of: kidney disease, liver disease, high blood pressure, heart disease (such as venoatrial shunts, mitral valve stenosis, chest pain, recent heart attack), diabetes, high cholesterol, smoking/tobacco use, blood vessel disease (such as Raynaud’s disease), complications during pregnancy (such as preeclampsia, eclampsia).

Option C: This drug may make the client dizzy. Do not drive, use machinery, or do any activity that requires alertness until the client is sure he can perform such activities safely. Limit alcoholic beverages.

Option D: This medication may decrease the amount of breast milk. Methylergonovine passes into breast milk in small amounts and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.

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