Question

8. Methylergonovine (Methergine) 0.2 mg is ordered to be administered intramuscularly to a woman who gave birth vaginally 1 hour ago for a profuse lochial flow with clots. Her fundus is boggy and does not respond well to massage. She is still being treated for preeclampsia with intravenous magnesium sulfate at 1 g/hr. Her blood pressure, measured 5 minutes ago, was 155/98. In fulfilling this order, the nurse would do which of the following?

a. Measure the woman's blood pressure again 5 minutes after administering the medication.
b. Question the order based on the woman's hypertensive status.
c. Recognize that Methergine will counteract the uterine relaxation effects of the magnesium sulfate infusion the woman is receiving.
d. Tell the woman that the medication will lead to uterine cramping.

Answer 1

The nurse should question the order of Methylergonovine due to the woman's hypertensive status and recognize that it will counteract the uterine relaxation from magnesium sulfate, also informing the patient about possible uterine cramping.

Step-by-step explanation:

In answering the question of what the nurse should do after Methylergonovine (Methergine) 0.2 mg is ordered for a woman with a profuse lochial flow and a boggy fundus postpartum who is also being treated for preeclampsia:

• Questioning the order based on the woman's hypertensive status is important, as Methylergonovine can further increase blood pressure, which could be dangerous in a patient already experiencing hypertension.
• Furthermore, acknowledging that Methergine is a medication that will counteract the uterine relaxation effects of magnesium sulfate is correct, as Methergine is designed to induce uterine contractions and reduce bleeding.
• Informing the woman about potential uterine cramping as a side effect of the medication would also be part of appropriate patient education.