Methylergonovine is prescribed for postpartum hemorrhage. Before administration, what is the priority assessment?

• A. Uterine tone
• B. Blood pressure
• C. Amount of lochia
• D. Deep tendon reflexes

Answer: (B)

Before giving methylergonovine, the priority is to check the patient’s blood pressure. This medication can cause significant vasoconstriction and a rise in blood pressure, so administering it to someone who is hypertensive or has uncontrolled BP can trigger a hypertensive crisis or stroke. If the blood pressure is not within a safe range, you withhold the drug and address the hypertension first or choose an alternative uterotonic.

Uterine tone and the amount of lochia tell you about the effectiveness and ongoing bleeding, but they don’t address the immediate safety risk of the medication. Deep tendon reflexes are monitored with magnesium sulfate, not with methylergonovine.