Which medication is indicated to promote uterine contractions in clients with a soft uterus and increased lochial flow?

The medication that is indicated to promote uterine contractions in clients with a soft uterus and increased lochial flow is oxytocin.

Oxytocin is a naturally occurring hormone that is critically involved in uterine contractions during labor and the postpartum period. It stimulates the smooth muscles of the uterus, promoting contraction and thus helping to reduce the risk of hemorrhage due to increased lochial flow, which can be indicative of uterine atony. In cases where the uterus is soft and there is abnormal bleeding, administering oxytocin can effectively encourage the uterus to contract firmly, thereby controlling bleeding and promoting uterine involution.

The other medications mentioned do not serve the same purpose in this context. Methylergonovine is used to treat postpartum hemorrhage but is typically indicated when there is already significant uterine tone, rather than specifically promoting contractions in cases of a soft uterus. Magnesium sulfate is primarily used as a tocolytic to relax uterine contractions, which would be counterproductive in addressing atony. Terbutaline is also a tocolytic agent used to inhibit contractions, making it unsuitable for promoting uterine tone and contraction.

Understanding the appropriate use of these medications is crucial in managing postpartum care effectively.