Following a Difficult Vaginal Birth of a Singleton Pregnancy, the Client

Multiple Choice

Following a difficult vaginal birth of a singleton pregnancy, the client starts bleeding heavily. Clots are expressed and a Foley catheter is inserted to empty the bladder because the uterine fundus is soft and displaced laterally from midline. Vital signs are 99.8° F, pulse 90 beats/min, respirations 20 breaths/min, and BP 130/90 mm Hg. Which pharmacologic intervention is indicated?

A) Oxytocin (Pitocin) to be administered in a piggyback solution
B) Administration of methylergonovine (Methergine)
C) Administration of prostaglandin analogue
D) Increase in parenteral fluids