A nurse is caring for a client who is experiencing a postpartum hemorrhage and has a prescription for methylergonovine. Which of the following findings should the nurse identify as a contraindication to the administration of this medication?
A.
WBC count 12.000/mm3
B.
History of asthma
C.
Hgb 11.2 g/dL.
D.
Blood pressure 154/98 mm Hg
The correct answer and Explanation is :
The correct answer is D. Blood pressure 154/98 mm Hg.
Explanation:
Methylergonovine is a medication commonly used to manage postpartum hemorrhage by promoting uterine contractions. However, its use is contraindicated in certain situations, primarily related to cardiovascular health.
Methylergonovine and Contraindications:
- Cardiovascular Concerns:
Methylergonovine can cause vasoconstriction and increase blood pressure. Consequently, it is contraindicated in individuals with hypertension or pre-existing cardiovascular conditions. A blood pressure reading of 154/98 mm Hg indicates hypertension, which is a significant contraindication for methylergonovine administration. Administering this medication could exacerbate the patient’s high blood pressure, increasing the risk of cardiovascular complications. - White Blood Cell Count (WBC):
A WBC count of 12,000/mm³ is slightly elevated but not significantly abnormal for postpartum patients, who often have increased WBC counts due to the stress of labor and delivery. This finding alone does not contraindicate the use of methylergonovine. - History of Asthma:
While methylergonovine is not typically contraindicated in asthma, caution is advised because the medication can cause bronchoconstriction in some patients. However, a history of asthma alone does not constitute a strict contraindication unless the patient has significant respiratory symptoms or exacerbations. - Hemoglobin Level (Hgb):
An Hgb level of 11.2 g/dL is lower than normal but not usually a contraindication for methylergonovine. Postpartum anemia can occur and should be managed, but it is not a direct contraindication for the use of this medication.
In summary, due to its potential to elevate blood pressure, methylergonovine should be avoided in patients with elevated blood pressure readings. The elevated blood pressure reading of 154/98 mm Hg in this scenario is a clear contraindication for administering methylergonovine.