A postpartum patient is receiving methylergonovine to prevent ...

[kwoodring]

A postpartum patient is receiving methylergonovine to prevent hemorrhage. The nurse assesses the patient and notes a heart rate of 76 beats per minute, a respiratory rate of 16 breaths per minute, and a blood pressure of 120/80 mm Hg.
 
  The patient's uterus is firm. The patient com-plains of mild to moderate cramping. Bleeding is minimal. What will the nurse do? a. Continue to monitor and tell the patient to report increased cramping.
  b. Notify the provider of possible uterine hypertonicity.
  c. Notify the provider of the patient's blood pressure.
  d. Request an order to administer the methy-lergonovine intravenously.

Question 2

A nurse performing an admission history on a patient learns that the patient is taking orlistat Xenical, warfarin Coumadin, and levothyroxine Synthroid. What will the nurse do?
 
  a. Contact the provider to discuss increasing the warfarin dose.
  b. Give the levothyroxine at least 4 hours before giving the orlistat.
  c. Suggest that the patient avoid fatty foods while taking these medications.
  d. Tell the patient to take the orlistat on an empty stomach.

[kthug]

Answer to Question 1

A
This patient is showing signs of a desired response to the drug, so the nurse should continue to monitor. Increased cramping may be a sign of overdose, so the patient should know to notify the nurse if this occurs. A firm uterus with minimal bleeding is the desired effect. The blood pressure is within normal limits. There is no indication for giving this drug intravenously, because that method poses significant risks and is indicated only with severe hemorrhage.

Answer to Question 2

B
Orlistat may cause hypothyroidism in patients taking levothyroxine; these two drugs should be administered at least 4 hours apart. The vitamin K deficiency that can occur with orlistat may compound the effects of warfarin, so coagulation should be monitored; it is more likely that the warfarin dose would need to be reduced. The patient may still consume foods containing fat, as long as fat accounts for about 30 of the total intake. Orlistat should be taken with food.

[kwoodring]

TY

[kthug]

You're welcome