For postpartum hemorrhage caused by uterine atony, before administering methylergonovine the nurse should check which client parameter as the most important?

For postpartum hemorrhage caused by uterine atony, before administering methylergonovine the nurse should check which client parameter as the most important?

• A. Lochial flow
• B. Urine output
• C. Temperature
• D. Blood pressure

Answer: (D)

The key concept is safety screening before giving a potent uterotonic. Methylergonovine is a strong vasoconstrictor used to treat postpartum hemorrhage from uterine atony, but it can raise blood pressure dramatically and precipitate a hypertensive crisis or stroke in someone with hypertension. Because of this, the most important parameter to assess before administration is the patient’s blood pressure to ensure there isn’t unmanaged hypertension or a contraindication to the drug. If the blood pressure is high or there are hypertensive risks, the medication may be withheld and an alternative approach used. Lochial flow, urine output, and temperature are important for overall postpartum status, but they do not directly address the immediate safety concern posed by this drug’s vasoconstrictive effect.

The key concept is safety screening before giving a potent uterotonic. Methylergonovine is a strong vasoconstrictor used to treat postpartum hemorrhage from uterine atony, but it can raise blood pressure dramatically and precipitate a hypertensive crisis or stroke in someone with hypertension. Because of this, the most important parameter to assess before administration is the patient’s blood pressure to ensure there isn’t unmanaged hypertension or a contraindication to the drug. If the blood pressure is high or there are hypertensive risks, the medication may be withheld and an alternative approach used. Lochial flow, urine output, and temperature are important for overall postpartum status, but they do not directly address the immediate safety concern posed by this drug’s vasoconstrictive effect.