Ob Drugs Part 1

Front 1

CNS agent, analgesic, narcotic agonist/antagonist
common side effects: sedation
Life threatening reactions: resp. depression
contraidications: drug abuse, breastfeeding

Back 1

Stadol

Front 2

CNS agent, analgesic, narcotic agonist/antagonist
common side effects: sedation, sweaty , clammy skin, N/V.
Life threats:resp depression
Contraindications:
hypersensitivity. drug abuse

Back 2

Nubain

Front 3

crosses placenta, mostly IV
10MG/70KG occurs in 2-3 minutes

Back 3

nubain

Front 4

assess sensitivity to sulfites, and history of asthma, drug abuse
assess: resp rate, quality of resp, and FHR. use a bedpan b/c of urinary urgency and sedation and dizziness.

Back 4

nubain nursing mgmnt

Front 5

Powerful drug, 7x morphine. not for drug abusers, IV 1-2mg, onset is rapid, can cause mom.baby resp depression, can be reversed with narcan, urinary retention side effect, asses bladder for distention, use sterile in/out cath,
SIDE EFFECTS-somnlonence, dizziness, dysphoria,

Back 5

stadol Nursing mgmt.

Front 6

opoid antagonist, reverses effects of narcotic toxicity, resp depre, analgesia, depression, sedation, hypotension, pupilary constriction.

Back 6

narcan

Front 7

0.1ml/kg, given thru umb. vein, or ET tube, give over 1min.IV push, reverses effects faster with IM, 15 min, IV-1-2min.
may be repeated in 3-5 minutes.

Back 7

narcan route dosage frequency

Front 8

do not give to drug addicated moms/babies, may bring on withdrawal syndromes, increased HR, BP, vomiting.
NEO Side effects: irritability, crying, Increased PTT, tachycardia.

Back 8

narcan contraindications

Front 9

Monitor resp, rate and depth FOR improved RESP. EFFORT, assess for possible return o resp depression and effect of narcotics reappear. Hva resuscitative equipment, 02, and vent equipment. COmpatible with heparin, protect from light, store at room temp.

Back 9

Narcan nursing considerations

Front 10

prophylaxis treatment of vit k def or hemorraghic disease of the newborn, promotes liver formation of clotting factors 2,7,9,10. Newborn does not have bacteria in colon necessary for synthesizing fat soluble VIT K,

Back 10

aqaumephyton, vit K

Front 11

IM, vastus lateralus thigh muscle
one time only 0.5-1mg within 1 hr of birth. If mom was on anticoagulants, addtl dose may be ordered and given 6-8hrs after the 1st injection

Back 11

Aquamephyton R/D/F

Front 12

protect from light, observe for local signs of inflammation, observe for jaundice and kernictercures, give before circumscion, observe for bleeding on 2nd-3rd day, umb cord, nose, assess PT and INR.

Back 12

Aquamephyton nursing considerations

Front 13

Glucocorticoid that induces pulm maturation and decreases the incidence of resp distress syndrome. Stimulates and enzyme that synthesizes surfactant II. Thins interalveolar septa and helps improve o2 exchange.

Back 13

celestone/dexamethasone

Front 14

IM 12mg once a day x 2. 6mg q12 x4doses. Birth shld be delayed for 24 hrs after first round of treatment.

Back 14

celestone/dexamethasone R/D/F

Front 15

inability to delay birth, inadeqaute LS ratio, infection, DM, Gestational age greater than 34 weeks.
infection only in premature ROM, maternal hyperglycemia, increase risk of pulm edema,

Back 15

celestone/dexamethasone contraindications and side effects.

Front 16

lowered cortisol levels at birth but rebound after 2hrs, hypoglycemia, increased risk of sepsis

Back 16

celestone/dexamethasone effects on fetus/newborn

Front 17

give deep into gluteal muscle, avoid deltoid(atrophy). evalute bp, weight, edema assess lab date for electrolytes and blood glusocose. DONT USE WITH TOCOLYTICS

Back 17

celestone/dexamethasone nursing considerations

Front 18

long acting progestin, birth control for 3months single IM of 150mg in deltoid muscle, can be ginve to nursing mothers, contains no estrogen. provides levels of progesterone high enough to block the lutenizing hormone, thereby stopping ovulation. Thickens cervical mucus to block sperm penetration.

Back 18

DEPO-PROVERA

Front 19

menstrual irregularities, headache, weight gain, hair loss, depression. fertility http://www.flashcardexchange.com/editcard?id=26301248delayed for 9 months. must not be used after 2years, calcium.

Back 19

depo provera

Front 20

prevention of sensitation to RH factor in Rh negative mom and to prevent hemolytic disease in newborn and subsequent pregnancies. Mother must be RH negative, infant must be Rh positive, direct antoglobulin negative.

Back 20

RHOGAM

Front 21

one vial 300 mcg within 72hrs of birth. Check as with blood products, cross match.

Back 21

RHOGAM dose/route one vial 300 mcg within 72hrs of birth.

Front 22

name of drug, expected action, soreness at injection site

Back 22

rhogam Nursing magmt

Front 23

stimulates uterine and vascular smooth muscle, used after labor to stimulate uterus to contract in order to decrease blood loss by clamping off uterine blood vessels. has constrictive effects effect on all blood vessels, especially larger arteries. May result in Hypertension.

Back 23

methergine

Front 24

rapid, orally or IM
0.2mg following expulsion of placenta. may be repeated every 2-4 hrs, up to 6doses.

Back 24

methergine R/D/F

Front 25

contra: pregnancy, use cautiously in hypersensitive, hepatic, renal, cardiac disease, hypertension, preeclampsia, lactation. Use extreme caution of used in 3rd stage of labor.
Side effects: hypertension, N/V headache, bradycardia, dissy, tinnitus, cramps, palpitations, chest pain.

Back 25

methergine contraindications, side effects

Front 26

monitor fundal height, amt anc characte rof lochia, notify provider if uterus remains boggy after adminitration, assess BP, advise about cramps, observe for ergotism toxicity: n/v headache, muscle pain, numb fingers and toes, NO SMOKING!

Back 26

methergine nursing mgmt

Front 27

acts as cns depressant decreasing acetycholine, reduces possibilty of convulsion, used in treating preeclampsia, secondarily relaxes smooth muscle, it may decrease the blood pressure, not considered an antihypertensive, decreases the frequency and intensity of contractions, used as a tocolytic in preterm labor.

Back 27

magnesium sulfate

Front 28

IV, painful and irritating to tissues if IM, IV pump for correct and fast action.
For preterm labor:4-6g over 20 minutes, maint.1-4g/hr
For Preeclampsia: 4-6 over 15-20, maint2g/hr based on renal levels, magnesium levels in blood.

Back 28

Mag sulfate R/D/F

Front 29

Myasthenia Gravis only absolute contra. HX of myocardial damage, or heart block bc of effects on nervves and muscle. extreme care in giving to women with impaired renal function, b/c drug is eliminated by the kidneys,

Back 29

Mag sulfate contra.

Front 30

lethargy and wekness related to neuromuscular blockage are common. sweating and feeling of warmth, flushing and nasal congestionmay be related to peripheral vasodlation.
Signs of toxicity- depression, absence of reflexes, oliguria, confusion, resp depression, circulatory collapse. Rapid administration of large doses may cause cardiac arrest.

Back 30

Mag sulfate side effects

Front 31

crosses placenta, FHR decrease may occur, does not really pose a threat, ill effects may be related to something else.

Back 31

Mag sulfate effects on newborn

Front 32

monitor bp
monitor mag levels q6-8hrs, 4-8mg/dl is okay.
monitor resp, shld not be less than 12
asses knee jerk for reflexes, loss of reflexes first sign of toxicity.
urinary output shld be 30ml/hr
calcium gluconate reverses effects, have nearby in case of toxicity, 1g IV over 3minutes.Monitor FHR at same time.
Continue infusion 24hrs after birth as prophylaxis against postpartum seizures if given for preeclampsia.
Newborn SHLD BE closely observed for signs of magnesium toxicity for 24-48 hrs.

Back 32

Mag sulfate nursing consideration

Front 33

Used to induce labor at term and to augment uterine contractions in first and second stage of labor. May also be used after birth to stimulate uterine contraction and control uterine atony.
selective stimulatory effect on the smooth muscle of the uterus and blood vessels. Effect myometrial cells of the uterus by increasing excitability of the musle cell and muscle contraction. takes 40 min to reach a steady state plasma concentration.
BP may first decrease then increase by 30%, CO AND SV increase, 20milliunit/min exerts antidiuretic effect decresing urine output.

Back 33

Pitocin

Front 34

FOr induction: 10 units(1ml) to 1000 IV fluids. start at 0.5-1milliunit/min and increase by 1-2 every 40-60 minutes

Back 34

Pitocin R/D/F

Front 35

severe preeclampsia-eclampsia
predisposition to uterine rupture ( in nullipara over 35, multigravida 4 or more,overdistention of uterus, previous major surgery of cervix or uterus
cephalopelvic disproportion, malpresentation or malpostion of fetus, prolapse cord, preterm infant, unripe cervix, placenta previa

Back 35

Pitocin contraindications

Front 36

hypercontractility:
rupture placenta
impaired blood flow leading to fetal hypoxia
rapid labor, leading to cervical lacerations, vagina, perineum, uterine atony, fetal trauma
water intoxication-N/V hypotension, tachycardia, cardiac arrythmia),

Back 36

Pitocin side effects

Front 37

decreased oxygen supply seen with decreased FHR, Hyperbilirubinemia, trauma form rapid birth

Back 37

pitocin effects on newborn

Front 38

explain procedure
apply fetal monitor/ nonstress test and obtain 15-20 min tracing before starting IV oxytocin.
start with primary IV and piggyback secondary IV w/ oxytocin and infusion pump.
Ensure continous monitoring of fetus and uterine contractions.
Max rate is 40miliunits/min, max dose is usually 16-40 millin.min
assess FHR, maternal BP, pulse and frequency and duration of uterine contractions, and resting tone b4 each increase of pitocin
Record all assesments and IV rate on monitor strip and on clients chart.
Record oxytocin infusion rate in miilliunit/min and ml/hr.

Back 38

Pitocin nursing consideration

Front 39

used to reduce blood loss secondary to uterine atony. Stimulates myometrail contractions to control postpartum hemorrhaging that is unresponsive to usual techniques. Can also be used to induce labor in cases of intrauterine fetal death

Back 39

hemabate

Front 40

increases of immediate postpartum hemorraghe IM dose 250mcg (1ml) every 1.5 to 3.5 hrs in atony persists, can increase to 500mcg/2ml if inadequate after several doses. not to exceed 12 mg no more than 48hrs.

Back 40

hemabate R/d/f

Front 41

active cardiac, pulmonary or renal disease. not to be given during pregnancy or acute PID. Shlpd be used with caution with women with asthma, adrenal disease, hypo/hypertension, DM, epilepsy, fibroids, cervical stenosis, previous uterine surgery.

Back 41

hemabate contra

Front 42

Most common: Nausea and diarrhea,
fever chills and flushing can occur,headache muscle joint, abdominal or eye pain can also occur.

Back 42

hemabate side effects

Front 43

shld be given in large muscle, aspiraton shld be performed,
after administration, monitor uterine status and bleeding carefully.
report excess bleeding
check vital signs routinely and look for elevated pulse/temp and decreased BP
Breast feeding shld be delayed for 24hrs.

Back 43

hemabate nurisng considerations