Final answer:
The nurse should withhold methylergonovine maleate if hypertension is present, as it can cause vasoconstriction and exacerbate the condition. Other symptoms like difficulty locating the uterine fundus, saturation of more than one pad per hour, and excessive lochia may indicate a need for treatment, but not if contraindications like hypertension exist. Uterine contractions aid in the prevention of blood loss postpartum.
Step-by-step explanation:
The nurse should withhold the next dose of methylergonovine maleate if the postpartum client exhibits signs of hypertension. Methylergonovine maleate is given to treat uterine atony by stimulating uterine contractions to prevent or control postpartum hemorrhage. However, because it can cause vasoconstriction, it should not be used in patients with hypertension as it could exacerbate the condition.
Difficulty locating the uterine fundus, saturation of more than one pad per hour, and excessive lochia are indications of ongoing postpartum hemorrhage and may require additional doses of uterine stimulants, but not in the presence of contraindicating conditions like hypertension.
Postpartum uterine contractions play a critical role in the involution process, where the uterus returns to its pre-pregnancy size. This process helps prevent excessive blood loss and repositions abdominal organs. Breastfeeding aids this process by releasing oxytocin, which further stimulates uterine contractions.