Which of the following is an indication for the administration of ...

[stephzh]

Which of the following is an indication for the administration of methylergonovine?
 
  a. Boggy uterus that does not respond to massage and oxytocin therapy
  b. Woman with a large hematoma
  c. Woman with a deep vein thrombosis
  d. Woman with severe postpartum depression

Question 2

The perinatal nurse notifies the physician of the findings related to Juanita's assessment. The first step in care will most likely be to:
 
  a. Prepare Juanita for surgery
  b. Administer intravenous fluids
  c. Apply ice to the perineum
  d. Insert a urinary catheter

[Natalie4ever]

Answer to Question 1

ANS: a
Feedback
a. Methylergonovine (methergine) is ordered for PPH due to uterine atony or subinvolution. It is used when massage and oxytocin therapy have failed to contract the uterus.
b. Hematoma occurs when blood collects within the connective tissues of the vagina or perineal areas related to a vessel that ruptured and continues to bleed. Methylergonovine stimulates contraction of the smooth muscle of the uterus and would not have an effect on the vaginal or perineal areas.
c. Heparin is usually prescribed for treatment of thrombosis.
d. Methylergonovine is prescribed for treatment of uterine atony.

Answer to Question 2

ANS: c
If the hematoma is less than 3 to 5 centimeters in diameter, the physician usually orders palliative treatments such as ice to the area for the first 12 hours along with pain medication. After 12 hours, sitz baths are prescribed to replace the application of ice. However, a hematoma larger than 5 centimeters may require incision and drainage with the possible placement of a drain.