Following a difficult vaginal birth of a singleton pregnancy, the ...

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Following a difficult vaginal birth of a singleton pregnancy, the client starts bleeding heavily. Clots are expressed and a Foley catheter is inserted to empty the bladder because the uterine fundus is soft and displaced laterally from midline.
 
  Vital signs are 99.8 F, pulse 90 beats/min, respirations 20 breaths/min, and BP 130/90 mm Hg. Which pharmacologic intervention is indicated?
 
  a. Oxytocin (Pitocin) to be administered in a piggyback solution
  b. Administration of methylergonovine (Methergine)
  c. Administration of prostaglandin analogue
  d. Increase in parenteral fluids

Question 2

A sign of thrombophlebitis is:
 
  a. visible varicose veins.
  b. positive Homans sign.
  c. pedal edema in the affected leg.
  d. local tenderness, heat, and swelling.

[zoeyesther]

Answer to Question 1

ANS: C
Prostaglandin analogues can be administered intramuscularly to stop uterine bleeding. Although Pitocin may be indicated in an attempt to stop uterine bleeding, it is not administered in a piggyback solution. Methergine is contraindicated in the presence of hypertension. Increasing fluids will not stop uterine bleeding.

Answer to Question 2

ANS: D
Tenderness, heat, and swelling are classic signs of thrombophlebitis that appear at the site of the inflammation. Varicose veins may predispose the client to thrombophlebitis, but are not a sign. A positive Homans sign is indicative of deep vein thrombosis (DVT).

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TYSM

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