Pharmacology Reproductive & Maternity Meds #1

Question

A postpartum client is experiencing excessive bleeding within the first 24 hours after delivery. Which medication does the registered nurse expect the physician to order to help reduce bleeding?

Answers

  1. Estrogen
    • Rationale:

      This answer is not correct because estrogen does not contract the uterus to decrease bleeding. Estrogen is not usually administered to the postpartum client unless utilized as a form of a birth control method. Birth control pills with estrogen are not usually started until 3 weeks after birth, depending on the health needs of the client.

  2. Betamethasone
    • Rationale:

      This answer is not correct because betamethasone is not used to cause involution of the uterus. Betamethasone is usually given to the mother prior to birth to help mature the lungs of the preterm infant.

  3. Methylergometrine
    • Rationale:

      This answer is correct because methylergometrine is used to prevent postpartum hemorrhage by improving uterine muscle tone and strength of the contractions needed to involute the uterus. Postpartum hemorrhage can occur when the uterus does not contract appropriately. The assessment findings of subinvolution include a boggy, non-firm uterus and excessive vaginal bleeding. Hypovolemia and shock can occur in a very short time, so pharmacologic management is important along with immediate fundal massage.

  4. Magnesium sulfate
    • Rationale:

      This answer is not correct because magnesium sulfate is used to either slow down preterm labor or help prevent seizure activity in the preeclamptic client. Magnesium sulfate is not administered to improve uterine muscle tone of a postpartum client experiencing excessive vaginal bleeding.

Overview

Methylergometrine is an ergot alkaloid medication used to prevent hemorrhage in postpartum women.

Explanation

Learning Outcomes

Methylergometrine is used to prevent postpartum hemorrhage by improving uterine muscle tone and strength of the contractions needed to involute the uterus. Involution is the postpartal process the uterus goes through to transform from the postpartum uterus to the pre-pregnancy state of the uterus. Postpartum hemorrhage can occur when the uterus does not contract appropriately. The assessment findings of subinvolution include a boggy, non-firm uterus and excessive vaginal bleeding. Hypovolemia and shock can occur in a very short time, so pharmacologic management is important along with immediate fundal massage.

Test Taking Tip

Always look for what the nurse should do immediately to help the client address ABC (aiwary, breathing, and circulation) issues. Raising the head of the bed or massaging a boggy fundus may save a client’s life and is what should be done first, before call the health care provider.

Video Rationale