Before administering methylergonovine (Methergine), what priority assessment finding would lead the nurse to hold the medication?

A. Pulse is 90 beats per minute is incorrect because a normal heart rate does not contraindicate methylergonovine. The medication’s primary cardiovascular effect is on vascular smooth muscle, not directly on heart rate. B. Pulse is 110 beats per minute is incorrect because mild tachycardia alone is not a contraindication. However, the nurse should monitor heart rate during administration, especially if hypotension or other complications arise. C. Blood pressure of 120/70 is incorrect because this is a normal blood pressure and indicates it is safe to give the medication. D. Blood pressure of 150/90 is correct because hypertension is a contraindication for methylergonovine. Administering the drug to a hypertensive patient can precipitate severe hypertension, stroke, myocardial infarction, or other cardiovascular complications. The nurse must hold the medication, notify the healthcare provider, and implement alternative measures for postpartum bleeding management.