Stage 4 — Generate solutions. Which prescribed interventions belong in the immediate hemorrhage plan? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
Oxytocin, prompt tranexamic acid, isotonic fluid, and blood-product readiness belong in the active response. Methylergonovine requires clarification with hypertension, carboprost requires clarification with asthma, and testing or oral iron must not delay hemorrhage control.
Quick answer Use oxytocin, early tranexamic acid, isotonic fluid, and protocol-directed blood support; clarify uterotonics that conflict with asthma or hypertension.
Why this is correct The first-response bundle controls tone and clot breakdown while restoring circulation. Medication history changes which additional uterotonic can be given safely.
Easy analogy or mental picture The hemorrhage cart offers several tools, but the client's asthma and hypertension place warning labels on two of them.
Memory hook Oxytocin and TXA now; screen pressure and asthma before extra uterotonics.
NCLEX decision rule When selecting postpartum-hemorrhage medications, treat promptly while checking hypertension and asthma contraindication risks; do not wait for imaging to start the bundle.
Why the other choices are wrong Methylergonovine can worsen hypertension, carboprost can provoke bronchospasm, and delayed uterotonics or oral iron alone cannot control active major bleeding.
References
1WHO Consolidated Guidelines for Postpartum HaemorrhageEarly recognition and bundled uterine massage, uterotonic, tranexamic acid, fluid, examination, and escalation
2ACOG Practice Bulletin 183: Postpartum HemorrhageUterine atony, hypovolemia, quantified blood loss, and escalation of hemorrhage care
Case updateThe client has gestational hypertension and active asthma. The hemorrhage team requests medication and fluid preparation while uterine massage continues.