Injection Methergine is given to a patient to treat PPH. Which nursing intervention is appropriate for this p… - AIIMS Raipur NO - 2017 (Shift-1)

AIIMS Raipur NO - 2017 (Shift-1)

Obstetrics & Gynaecology

Medium

Appeared in: AIIMS Raipur NO - 2017 (Shift-1)

Explanation

Methergine (methylergometrine) is an ergot alkaloid used to treat postpartum hemorrhage (PPH) by causing strong uterine contractions.
A primary side effect of Methergine is systemic vasoconstriction, which is the narrowing of blood vessels throughout the body.
This vasoconstriction increases peripheral resistance, leading to a significant and potentially dangerous rise in blood pressure (hypertension).
Therefore, monitoring the patient's blood pressure before and after administration is the most critical and specific nursing intervention related to this drug's safety profile.

Option A: Respiration is not directly affected by the pharmacological action of Methergine. Changes in respiration would indicate a different complication, such as a pulmonary embolism, rather than a side effect of the drug itself.
Option B: While pulse is a standard vital sign to monitor, Methergine's most significant cardiovascular side effect is hypertension, not a direct change in heart rate. Tachycardia (a rapid pulse) would more likely indicate ongoing blood loss or pain.
Option C: Methergine does not affect body temperature. An elevated temperature in the postpartum period would raise concerns for infection (puerperal sepsis), which is a separate complication from PPH or drug side effects.

Visual 1: Drug Information Card - A card for Methergine detailing its class (ergot alkaloid), mechanism of action (uterine contraction, vasoconstriction), primary indication (PPH), major side effects (hypertension), contraindications (preeclampsia, high BP), and key nursing interventions (monitor BP).
Visual 2: Diagram - A simple diagram comparing a normal blood vessel with a constricted blood vessel, illustrating how vasoconstriction increases blood pressure.

Clinical Relevance

Nursing practice connection: Use the key finding related to Nursing interventions and side effects of Methergine (methylergometrine) to guide bedside assessment, documentation, and the next nursing action.
The primary safety concern with Methergine is its potential to cause a hypertensive crisis. Nurses must assess the patient's blood pressure before administering the drug.
Methergine is strictly contraindicated in women with hypertension, pre-eclampsia, or eclampsia, as it can dangerously elevate their already high blood pressure.
What if? If a patient receiving Methergine develops a severe headache, blurred vision, or a sudden sharp rise in blood pressure, the nurse should immediately stop any ongoing infusion, notify the provider, and prepare to administer antihypertensive medications as ordered. This is a medical emergency.

How to Approach the Question

First, identify the drug mentioned in the question: Injection Methergine.
Recall the drug class and its primary mechanism of action. Methergine is an ergot alkaloid used for PPH.
Think about the drug's side effects. The most significant and potentially dangerous side effect of ergot alkaloids is vasoconstriction, which leads to hypertension.
Connect the primary side effect to the appropriate nursing intervention. Since the drug can cause high blood pressure, the most important nursing action is to monitor the patient's blood pressure.
Evaluate the given options. 'Blood Pressure' directly corresponds to the key side effect, making it the most appropriate intervention compared to monitoring respiration, pulse, or temperature, which are not primary effects of the drug.

Concept Tested & Keywords

Concept Tested: Nursing interventions and side effects of Methergine (methylergometrine).
Stem keywords: Injection Methergine, PPH, nursing intervention
Lead-in keywords: appropriate
Clinical cues: Patient receiving Methergine for PPH

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