NORCET 7 Prelims -2024
Obstetrics & Gynaecology
Easy
A nurse is administering carboprost to a patient with postpartum hemorrhage (PPH). What is the primary action of carboprost in managing PPH?
Appeared in: NORCET 7 Prelims -2024
Explanation
- Carboprost is a synthetic prostaglandin (15-methyl PGF2α) that functions as a potent uterotonic agent.
- Its primary mechanism of action is to stimulate strong, sustained contractions of the myometrium (uterine muscle).
- These contractions mechanically compress the bleeding blood vessels at the placental implantation site, which is the primary method for controlling postpartum hemorrhage caused by uterine atony.
Why Other Options Were Wrong
- Option B: Carboprost does not reduce blood pressure. In fact, a common and significant adverse effect is hypertension (high blood pressure).
- Option C: This describes the goal of fluid and blood product resuscitation, not the action of a uterotonic drug. Carboprost stops ongoing hemorrhage but does not replace lost volume or reverse hypovolemia.
- Option D: Carboprost's mechanism is mechanical compression via uterine contraction, not a pharmacological effect on the coagulation cascade. It is not an anticoagulant or a pro-coagulant.
Related Visual
- Visual 1: Diagram - Illustrating the mechanism of postpartum hemorrhage from uterine atony, showing dilated spiral arteries in a flaccid uterus versus compressed arteries in a contracted uterus. This helps visualize why stimulating contractions is effective.
- Visual 2: Table - Comparing the primary uterotonic agents (Oxytocin, Methylergonovine, Carboprost, Misoprostol), their class, mechanism, and key contraindications, providing a quick reference for clinical decision-making.
Clinical Relevance
- Nursing practice connection: Use the key finding related to Pharmacology of Uterotonic Agents for Postpartum Hemorrhage to guide bedside assessment, documentation, and the next nursing action.
- Carboprost is a critical second-line medication for PPH when first-line agents like oxytocin fail. Nurses must be prepared to administer it promptly under medical direction.
- A crucial nursing responsibility is to perform a rapid assessment for contraindications, especially a history of asthma, as carboprost can induce severe, life-threatening bronchospasm.
- Post-administration monitoring is vital. The nurse must closely watch for adverse effects such as hypertension, fever, vomiting, and severe diarrhea, and manage them accordingly.
How to Approach the Question
- This is a pharmacology-based factual recall question.
- First, identify the drug mentioned in the stem: Carboprost.
- Recall the drug class and its primary use. Carboprost (Hemabate) is a prostaglandin used in obstetrics to manage postpartum hemorrhage.
- Remember the primary mechanism of action for uterotonic agents in PPH: they cause the uterus to contract forcefully.
- Evaluate the options based on this primary action. Option A, 'Stimulating uterine contractions to reduce bleeding,' directly aligns with the known mechanism of uterotonic drugs.
- Systematically eliminate the other options. Recall that a major side effect of carboprost is hypertension, which makes option B incorrect. Differentiate between treating the cause of bleeding (contraction) and treating the effects of blood loss (volume replacement), making option C incorrect. Recognize that the mechanism is muscular contraction, not alteration of blood clotting, making option D incorrect.
Concept Tested & Keywords
- Concept Tested: Pharmacology of Uterotonic Agents for Postpartum Hemorrhage
- Stem keywords: carboprost, postpartum hemorrhage, PPH, primary action
- Lead-in keywords: primary action
- Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
- Negative lead-in flag: false
Question ID
QOZwiO1A4mSZ96PX4eMrKH
Practise the full NORCET 7 Prelims -2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
More Pharmacotherapeutics in Obstetrics Questions
- 22-year-old Megha comes to the doctor because of a missed menstrual period. She has hypothyroidism for which she takes thyroxine; she has an artifici…
- Paracervical block is associated with the danger of?
- Injection Methergine is given to a patient to treat PPH. Which nursing intervention is appropriate for this patient?
- After an epidural block is given to a pregnant mother, the nurse should check for?
- Which injection and dose are given during the active management of the 3rd stage of labor?
- A client is given oxytocin for induction of labor. The side effect of oxytocin is?
- What is the dose of Oxytocin in PPH?
- What is total dose of tab. misoprostol given for prevention of PPH?
- All of the following are teratogens that cause birth defects, except one.
- What drug is given to pregnant women in preterm labor?
More NORCET 7 Prelims -2024 Questions
- A patient with kidney failure has been found to have 4+ protein in their urine. The nurse recognizes this finding as indicating:
- Which of the following is a true statement regarding breast milk?
- Based on the image showing the placement of ECG electrodes, where should the V1 lead be placed?
- Which of the following conditions is most likely associated with macroblastic RBC?
- A nurse is caring for a patient with Chronic Obstructive Pulmonary Disease (COPD) and notices that the patient is using a CPAP machine. The nurse und…
- If a tracheostomy tube becomes dislodged, the nurse should:
- A nurse is assessing an endotracheal tube and needs to press the cricoid. This technique is known as:
- Which vaccine is typically given at the 6-week immunization visit?
- A patient is being administered general anesthesia. The nurse should assess the patient for:
- A nurse is using a non-rebreather mask on a patient, but the bag is not inflating. What should the nurse do next?