Author Question: Following a difficult vaginal birth of a singleton pregnancy, the client starts bleeding heavily. ... (Read 49 times)

plus1 · **on:** Jun 28, 2018

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 · **Reply #1 on:** Jun 28, 2018

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).