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
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.
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