Stage 5 — Take action. Categorize each treatment by the medication-safety decision the nurse should make for this client.
Matrix Multiple Choice
Choose your responses, then check the answer.
Explanation
Oxytocin, tranexamic acid, and isotonic crystalloid can proceed under the active protocol. Methylergonovine should be clarified because of hypertension, carboprost because of asthma, and oral iron is not an immediate hemostatic intervention.
Quick answer Proceed with the safe bundle components, clarify methylergonovine and carboprost against this client's risks, and reject oral iron as acute control.
Why this is correct Medication safety requires both urgency and contraindication screening. A protocol does not remove the nurse's duty to identify a drug that conflicts with hypertension or asthma.
Easy analogy or mental picture Sort the orders through two filters at once: does it stop bleeding now, and is it safe for this client's pressure and airway history?
Memory hook Hemorrhage urgency never cancels contraindication checks.
NCLEX decision rule In an emergency bundle, execute safe active orders promptly and clarify patient-specific contraindications without delaying the other appropriate interventions.
Why the other choices are wrong A chronic iron-replacement plan cannot substitute for hemostasis, and known hypertension or asthma makes automatic administration of the flagged uterotonics unsafe.
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 updateSeveral emergency orders appear together. The nurse checks each against the client's current hemorrhage, hypertension, and asthma history.