LPN Nursing · Postpartum Complications · Practice question
The nurse is caring for the postpartum client with uterine atony. What medication should the nurse anticipate the healthcare provider to order?
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Terbutaline (Brethine)
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Betamethasone (Diprolene AF)
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✓
Methylergonovine (Methergine)
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Magnesium sulfate (MgSO4)
Answer & explanation
Correct: Methylergonovine (Methergine)
Uterine atony is the most common cause of postpartum hemorrhage and occurs when the uterus fails to contract adequately after delivery. Methylergonovine (Methergine) is an ergot alkaloid that causes sustained uterine contraction and is a first-line uterotonic agent used specifically to treat postpartum hemorrhage due to uterine atony. It works by directly stimulating smooth muscle of the uterus, producing firm, prolonged contractions that help control bleeding. Terbutaline (Brethine) is a beta-2 agonist that actually relaxes uterine smooth muscle; it is used to treat preterm labor and would worsen atony by further inhibiting contraction. Betamethasone (Diprolene AF) is a corticosteroid used to promote fetal lung maturity in preterm gestations or as a topical anti-inflammatory — it has no role in managing postpartum hemorrhage. Magnesium sulfate is a tocolytic and anticonvulsant used in preeclampsia and preterm labor management; it also has uterine-relaxing properties and would be contraindicated in uterine atony because it can inhibit contraction. Understanding the mechanism of each uterotonic agent — oxytocin, methylergonovine, carboprost, and misoprostol — is essential for safe postpartum management, as selecting the wrong agent can dangerously worsen hemorrhage.
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