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Before administering methylergonovine, if the client's medical history includes which condition, the nurse should contact the primary health care provider?

Hypotension

Hypothyroidism

Diabetes mellitus

Peripheral vascular disease

The key idea is that methylergonovine is a strong uterotonic that also causes vasoconstriction throughout the body. In someone with peripheral vascular disease, those already narrowed or blocked vessels can be further constricted, bringing a real risk of reduced blood flow to limbs and other tissues. That potential for ischemia is why the nurse should contact the primary health care provider before giving methylergonovine when peripheral vascular disease is part of the patient’s history. Other conditions listed don’t carry the same immediate risk for tissue ischemia from vasoconstriction, though monitoring and caution are still important.

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