Editing Maternal and Newborn Nursing – RN Practice Questions (section)

==Question 6==
A postpartum client with a boggy uterus and continued bleeding has received oxytocin without adequate response. The provider orders methylergonovine 0.2 mg IM. Which assessment finding requires the nurse to '''hold''' the medication and contact the provider?
# Blood pressure 158/98 mm Hg
# Pulse 104 beats per minute
# History of asthma
# Report of severe afterpains

'''Answer:''' 1 (A). Blood pressure 158/98 mm Hg.

''Rationale:'' Methylergonovine is an ergot alkaloid that causes generalized vasoconstriction and can precipitate a dangerous rise in blood pressure, seizure, or stroke. It is contraindicated in hypertension and preeclampsia, so the blood pressure is checked before every dose. Tachycardia (option 2) is an expected sign of blood loss and reinforces the need for a uterotonic. Asthma (option 3) is the contraindication for '''carboprost''', not methylergonovine, and is a classic distractor pairing. Afterpains (option 4) are expected with uterine contraction and are treated with analgesia, not by withholding the drug.