I put together these medical challenges. The cases are hypothetical and do not necessarily represent actual or typical presentations of medical diseases. Disclaimer is at the bottom of this page.
Monday, May 28, 2012
Route
You are delivering twins to a G1P0 34 year old woman at 38 weeks with a prolonged labor. Because of uterine atony, you write an order in the chart: "Methylergonovine 0.2mg x1 now." You are called ten minutes later because the patient's blood pressure is suddenly 180/100 and she has a facial droop and a weak arm and leg.
Challenge: What happened?
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Methylergonovine initiates transient hypertension and the mother suffered from cerebral hypoxic ischemic injury?
ReplyDeleteyes - exactly right
ReplyDelete-
Route
If methergine is given intravenously rather than intramuscularly, there is a risk of hypertension and cerebrovascular accident.
Sources: UpToDate; Wikipedia.