Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
34 Cards in this Set
- Front
- Back
|
Benadryl
|
Contraindications: Use with caution in mothers with narrow angle glaucoma, hyperthyroidism, cardiovascular disease, hypertension, and asthma, lactation.
Nursing Considerations: Ambulate because it’s anti-cholinergic Monitor cardiovascular effects. Don’t mix with other CNS depressants. Use caution with breastfeeding. May cause dizziness/drowsiness so warn pt. |
|
|
Bicitra
|
Contraindications: Renal impairment or sodium restricted diets, electrolyte imbalance. Addison's disease, diabetes, heart or kidney disease, high blood pressure, hypocalcemia, intestinal blockage, or
Nursing Considerations: Monitor for SE’s. Warn it has a sweet/sour taste. Can be mixed with juice for better taste. Pertinent Lab Values: Monitor serum electrolytes, especially bicarbonate. |
|
|
Fentanyl
Generic: fentanyl Trade: Actiq, Duragesic, Fentora, Onsolis, Sublimaze Action: Binds to opioid receptors in CNS, reducing stimuli from sensory nerve endings, inhibits ascending pain pathways. Rationale in Labor and Delivery: May be used in Spinals, used for pain relief. Dose Range: IV/IM: 50-100mcg/dose q1-2h as needed (adjunct to general anesthesia: 2-50mcg/kg), Buccal (general): 100mcg, Buccal Soluble Film: 200mcg-1200mcg (no more than 4 doses per day, separate by at least 2 hours), Transdermal: 25mcg/hr initially, may increase after 3 days, Transmucosal: 200-400mcg for breakthrough pain, Epidural: Bolus of 100mcg followed by continuous infusion of 10mcg/ml concentration at 4-12ml/hr Safe Range: Route: IV, IM, Buccal, Transdermal, Transmucosal, Epidural |
Contraindications: Increased intracranial pressure (ICP), severe hepatic/renal impairment, severe respiratory depression. CAUTIONS- Bradycardia; renal, hepatic, respiratory disease; head injuries; altered LOC; use of MAOIs within 14 days; transdermal not recommended in those younger than 12 yrs or younger than 18 yrs and weighing less than 50kg.
Side Effects: (frequent) IV: postop drowsiness, nausea, vomiting. Transdermal: Headache, pruritus, nausea, vomiting, diaphoresis, dyspnea, confusion, dizziness, drowsiness, diarrhea, constipation, decreased appetite. (occasional) IV: Postop confusion, blurred vision, chills, orthostatic hypotension, constipation, difficulty urinating. Transdermal: Chest pain, arrhythmias, erythema, pruritus, syncope, agitation, skin irritations. Pertinent Lab Values: Creatinine Clearance RN Considerations and Interventions: Establish baseline B/P and respirations. Assess type, location, intensity, and duration of pain. Resuscitative equipment and opiate antagonist (naloxone 0.5 mcg/kg) must be available. Assist with ambulation, monitor respiratory rate, B/P, heart rate, O2 Sats. Assess for pain relief. Pregnancy Category C (or D if used for prolonged periods or at high dosages at term) |
|
|
Tylenol- Postpartum Medication
|
Contraindications: Hypersensitivity, intolerance to tartrazine (yellow dye#4), alcohol, table sugar, sacharin
Adverse Effect: Anaphylaxis, leucopenia, neutropenia hemolytic anemia, thrombocytopenia, pancytopenia, drowsiness, nausea, vomiting, abdominal pain, rash, urticaria, angioedema, cyanosis jaundice, delirium followed by vascular collapse, convulsions, com, death. Pertinent lab values: AST, ALT, bilirubin, creatitine, BUN, RN Considerations/Interventions: Assess and monitor liver functions studies: AST, ALT, bilirubin, creatinine; renal function studies: BUN, urine creatinine, occult blood, albumin, if patient is on long-term therapy. Presence or blood or albumin indicates nephritis. Blood studes: CBC, pro-time if patient is on long term. Pregnancy category: Pregnancy (B) |
|
|
Motrin- Postpartum Medication
|
Contraindications: Hypersensitivity, asthma, severe renal disease, severe hepatic disease. While lactating.
Adverse Effect: Tachycardia, peripheral edema, palpitations, dysrhythmias, headaches, dizziness, drowsiness, fatigue, tremors, confusion, insomnia, anxiety, depression, blurred vision, nausea, vomiting, diarrhea, jaundice, constipation, flatulence, cramps, dry mouth, peptic ulcer, hematuria, oliguria, purpura, rash pruritus , sweating. Pertinent lab values: Observe BUN, creatinine, AST (SGOT), ALT (SGPT), Hgb, RN Considerations/Interventions: Monitor for blurred vision, palpitations, blood pressure, pulse for character, quality, rhythm. Pregnancy category: Pregnancy (B) 1st and 2nd trimesters |
|
|
Generic Name: misoprostol
Trade Name: cytotec
|
Contraindications: prostaglandin allergy, don’t give during lactation (diarrhea in nursing baby), use in pregnancy for ↓risk of gastric ulcers from NSAIDS
S/E: diarrhea, abdominal pain, N&V, gas, dyspepsia, HA, uterine cramping, spotting Lab Values: obtain negative pregnancy test before safe administration, plasma levels ↓ if take with food RN Considerations/Interventions: *sound alike drug to mifepristone, metoprolol & cytosar. Give with food to ↓diarrhea, give after meal & at HS, take for duration of NSAID therapy, may increase mucus secretion in stomach, with abortion report ↑ bleed/ pain/ fever. |
|
|
Generic Name: nalbuphine hydrochloride
Trade Name: nubain
|
Contraindications: hypersensitivity
S/E: allergic reaction, resp depression, ↑↓ HR, cold/clammy skin, confusion, dizzy, weak, lightheaded, n&v, HTN Lab Values: interferes with opioid drug test RN Considerations/Interventions: watch resp depression, renal/hepatic patients, can cause withdrawl, |
|
|
Oxytocin
Trade Name: Pitocin
|
Contraindications: Inadequate uterine activity/progress. Not indicated for elective induction
RN Considerations & Interventions: Assess baseline VS and fetal heart rate. Monitor intrauterine pressure and contractions q15min. Notify MD: if contractions last more than 1min, occur more frequently than q2min, or stop. Maintain careful I&O and check for blood loss. Keep Pt and family informed of labor progress. |
|
|
Generic Name: dinoprostone
Trade Name: Cervidil/PREPIDIL
|
Contraindications: Hypersensitivity to prostaglandins or additives in the gel or suppository.Avoid in situations which prolonged uterine contractions should be avoided: previous C-section or uterine surgery, cephalopelvic disproportion, traumatic delivery or difficult labor, multiparity, hyperactive or hypertonic uterus, fetal distress, unexplained vaginal bleeding, placenta previa, vasa previa, active herpes genitalis, obstetric emergency requiring surgical intervention, situations which vaginal delivery in contraindidated, presence of acute PID or ruptured membranes, concurrent oxytocic therapy.
S/E: Gel: urterine contractile abnormalities, warm feeling in vagina. Suppository: headache, drowsy, dizzy, syncope, coughing, wheezing, dyspnea, hypotension, hyprertension, diarrhea, N/V. Allergic reaction:chills, fever, anaphylaxis. Lab Values: na. RN Considerations/Interventions: Monitor frequency, force and duration of contractions. Monitor VS. Ausculate breathe sounds! Wheezing and sensation of chest tightness could be sign of allergic reaction. Asses N/V, diarrhea, premedicate pt with antiemetic and antidiarrheal. Monitor amount and type of vaginal discharge. Notify physician IMMEDIATELY if symptoms of hemorrhage occur. Monitor uterine activity, fetal status, and dilation and effacement of cervix continuously throughout therapy. Insert should be removed at the onset of labor. |
|
|
Generic Name: naloxone
Trade Name: Narcan
|
Contraindications: hypersensitivity . in OB may cause acute withdrawal syndrome in mother and fetus if mother is opioid dependent.
S/E: Ventricular arrhythmias, hypertension, hypotension, N/V Lab Values: NA RN Considerations/Interventions: Monitor VS, Resp Rate, rhythm, depth, ECG, LOC,assess pain level, Assess for S& S of opioid withdrawal |
|
|
*Note* Zofran has not been approved by the FDA for obstetrical use. All route/dosage information is not necessarily consistent with off-label dosages prescribed by a physician who specializes in obstetrics and gynecology.
generic name: ondansetron (on-dan-se-tron) action: Blocks the effects of serotonin at 5-HT3-receptor sites (selective antagonist) located in vagal nerve terminal and the chemoreceptor trigger zone in CNS. |
contraindications: Pt. with hypersensitivity to the drug or its components.
adverse effect/side effects: HA, constipation, malaise, arrhythmias, hypotension, extrapyramidal effects pertinent lab values: ALT (SGPT), AST (SGPT), Bilirubin (direct and total), Chem 10 RN considerations/interventions: Pt with hepatic impairment should not be prescribed a daily dose that exceeds 8 mg. Pregnancy Category: B |
|
|
Magnesium sulfate
|
Fetal effects: none
Nursing Considerations: Monitor FHR and UCs Monitor serum mag levels. Assess lungs for s/s pulmonary edema. I&Os S/S of toxicity include: Absent DTRs, resp rate <14, hypotension, muscle relaxation, decreased LOC. |
|
|
Colace
Generic: docusate sodium
|
None
|
|
|
Morphine sulfate:
Trade Names: Duramorph
|
None
|
|
|
Rubella Vaccine
Trade: Meruvax Adverse effects: Erythema at injection site, injection site pain, rash, lymphadenopathy, arthralgia, myalgia, common cold, fever |
None
|
|
|
Tucks –Active ingredient: Witch hazel
Class: Astringent
|
None
|
|
|
Vitamin K
(Phytonadione)
Indication: Prevention of hemorrhagic disease of the newborn. |
Contraindications: Use cautiously with impaired liver function. Nursing Considerations: Monitor for frank and occult bleeding (guaiac stools, Hematest urine, and emesis). Monitorpulse and blood pressure frequently; Apply pressure to all venipuncture sites for at least 5 min; avoid unnecessary IMinjections AE: pain at site, hyperbilirubinemia if dose is too large, kernicterus, rash |
|
|
Erythromycin ophthalmic ointment
|
None
|
|
|
RhoGAM Prevention of sensitization to the RH factor in RH negativewomen and to prevent hemolytic disease in the newborn in subsequent pregnancies Dose: One vial IM within 72 hours of birth. Antepartal: One vialmicrodose RhoGAM IM at 28 weeks in RH- negative women, after amniocentesis, andspontaneous therapeutic abortion |
Soreness at injection site
Contraindicated in Rho (D) positive patient, thrombocytopenia, and bleeding disorders. Cautious use in pregnancy. Confirm criteria for administration is present. Ensure correct vial is used for the patient. Inject entire content of vial. Teach name of drug, expected action, possible adverse effect, report soreness at injection site to nurse, woman should carry information regarding RH status and dates of RhoGAM injections with her at all times. Chances of serum sickness is possible but only ~0.2% chance so teach pt. to report if they feel nauseated, or have a rash, or any change in condition after receiving injection. This medication comes from human serum. |
|
|
Bisacodyl (Dulcolax)
10 mg Supp 10 mg rectal PR |
Assess bowel status/fluid status
Therapeutic effect: Soft, formed BM Suppository may be inserted at time bowel movement is desired. Contraindicated in presence of anal or rectal fissures, ulcerated hemorrhoids, proctitis AE: constipation |
|
|
*Note* metoclopramide has not been approved by the FDA for obstetrical use. All route/dosage information is not necessarily consistent with off-label dosages prescribed by a physician who specializes in obstetrics and gynecology.metoclopramidegeneric name: metoclopramidetrade name: Reglan action: Blocks dopamine receptors in chemoreceptor trigger zone of the CNS. Stimulates motilityof the upper GI tract and accelerates gastric emptyingrationale of use in L&D: hyperemesis gravidarum, GERD, diabetic gastroparesisroute/dosage: (Adults) PO, IM, IV: A single dose of 20 mg. may be given preventatively. Otherwise 10-15 mg. 30 min. AC/HS (not to exceed 0.5/mg/kg/day). (Neonates, Infants, Children) PO, IM ,IV: 0.4-0.8 mg/kg/day in 4 divided dosessafe range: Safety not est. in pregnancy or lactation |
contraindications: hypersensitivity, possible GI obstruction or hemorrhage, HX of seizure disorders, pheochromocytoma, Prakinson’s disease adverse effect/side effects: pertinent lab values: Chem 10 (hyperemesis/ est. electrolyte values) RN considerations/interventions: Use cautiously in pt. with hx of depression, diabetes, renal impairment, OB, lactation, neonates ( high risk for methemoglobinemia), elderly (oversedation), pt. taking CNS depressants or with hx of alcohol or drug abuse. Assess respiratory status, look for signs of pyramidal effects.Pregnancy Category: B |
|
|
Methergine Generic: methylergonovine Trade: Methergine Action: Stimulates alpha-adrenergic, serotonin receptors, producing arterial vasoconstriction. Causes vasospasm of coronary arteries. Directly stimulates uterine muscle.Rationale in Labor and Delivery: Prevention or treatment of postpartum or postabortion hemorrhage due to atony, involution (not for induction, augmentation of labor). Off-Label: treatment of incomplete abortion. Dose Range: PO: 0.2 mg 3-4 times a day, continue for up to 7 days. IV/IM: Initially 0.2 mg after delivery of anterior shoulder, after delivery of placenta, or during puerperium. May repeat q2-4hr as needed.Safe Range: Route: PO, IV, IM |
Contraindications: Hypertension, pregnancy, toxemia, untreated hypocalcemia. CAUTIONS- Renal/hepatic impairment, coronary artery disease, occlusive peripheral vascular disease, sepsis. Side Effects: (frequent) Nausea, uterine cramping, vomiting. (occasional) Abdominal pain, diarrhea, dizziness, diaphoresis, tinnitus, bradycardia, chest pain. (rare) allergic reaction (rash, pruritus), dyspnea, severe or sudden hypertension. Pertinent Lab Values: May decrease serum prolactin. Serum calcium levelsRN Considerations and Interventions: Determine baseline serum calcium level, B/P, pulse. Assess bleeding before administration. Monitor uterine tone, bleeding, B/P, pulse q15min until stable (about 1-2 hrs). Assess extremities for color, warmth, movement, pain. Report chest pain promptly. Provide support with ambulation if dizziness occurs.Pregnancy Category C |
|
|
Dermaplast Pain Relieving Spray (OTC)Action: Benzocaine USP 20% and Menthol USP 0.5% work as a topical anesthetic. Rational: Used to relieve perineal pain and discomfort postpartum especially if the patient underwent an episiotomy. Dose/Safe Range: spray to affected area not more than 3 to 4 times dailyRoute: Topical |
Contraindications: Do not spray in eyes. Do not use with serious/deep cutsSide effects: N/APertinent lab values: N/ARN Considerations/InterventionsInstruct patient to keep the perineal area clean.Contact doctor if condition worsens. |
|
|
Hemabate preg cat: C - action: produces strong, prompt, contractions of uterine smooth muscle, possibly mediated by calcium and cAMP. used to terminate preganancy betweeen 13-20 weeks gestation. Also used for postpartum hemorrhage from uterine atony. - dose range: terminate preganacy:250 mcg 1.5-3.5 hours apart. should not exceed 12mg. postpartum hemorrhage: 250 mcg every 15-90 minutes as needed. Max dose is 2 mg. - nursing considerations: pretreating patient with antiemetics and antidiarrheals decrease risk of GI effects -Administered: IM injection |
- Side effects: fever, headache, anxiety, arrythimias, chest pain, blurred vision, vomiting, diarrhea, nausea, uterine rupture, endometritis, backache, leg cramps, coughing, wheezing, rash, breast tenderness, chills, hot flashes. - contraindications: patients with acute pelvic inflammatory disease, cardiac, pulmonary, renal, or hepatic disease. |
|
|
Drug name: Norco Generic name: Hydrocodone/acetaminophen 10mg/325 mg Action & Rationale: Moderate to moderately severe pain Dose Range: 1 tab every 4–6 hrs as needed Safe Range: max 6 tabs/day |
Contraindications: do not use with other narcotic analgesics S/E: CNS/respiratory depression, GI upset, constipation, lightheadedness, sedation, drowsiness, facial flushing, diaphoresis Lab values: serial liver and/or renal function tests for pt with severe hepatic or renal disease RN Considerations/interventions: obtain VS, if respirations are 12 or less withhold meds, suppresses cough reglex, crosses placenta, found in breast milk, may prolong labor if administered in first stage of labor, respiratory depression in neonate, may cause withdrawl symptoms in neonate if mother used regularly. |
|
|
*Note* Zofran has not been approved by the FDA for obstetrical use. All route/dosage information is not necessarily consistent with off-label dosages prescribed by a physician who specializes in obstetrics and gynecology. generic name: ondansetron (on-dan-se-tron)trade name: Zofran, Zofran ODTaction: Blocks the effects of serotonin at 5-HT3-receptorsites (selective antagonist) located in vagal nerve terminal and the chemoreceptor trigger zone in CNS. rationale of use in L&D: hyperemesis gravidarumroute/dosage: (Adults & Children > 11yr): PO: 8 mg Q8-12h IM: 4 mg. IV (Adults): 0.15 mg/kg safe range: a safe dosage range for pregnancy, lactation, ped. use has not been safely established |
contraindications: Pt. with hypersensitivity to the drug or its components. adverse effect/side effects: HA, constipation, malaise, arrhythmias, hypotension, extrapyramidal effectspertinent lab values: ALT (SGPT), AST (SGPT), Bilirubin (direct and total), Chem 10RN considerations/interventions: Pt with hepatic impairment should not be prescribed a daily dose that exceeds 8 mg. Pregnancy Category: B |
|
|
Darvocet – NO LONGER AVAILABLE AFTER NOV 19, 2010 PER FDA Class: Opioid/Acetaminophen Combination |
none |
|
|
Percocet – Acetamenophen/oxycodone Class: Opioid/Acetaminophen combination Indications: Moderate to moderate/severe pain Preg Cat: C Dosage: Acetaminophen 325 mg to 650 mg/oxycodone 2.5mg to 10mg ORALLY every 6 hours as needed; MAX 4000 mg acetaminophen/day |
Adverse Effects: N/V, dizziness, lightheadedness, sedation, somnolence Nursing considerations: Pain reduction, mental and repiratory status, bowel movements, BP, renal function, LFT, CBC (long term use) |
|
|
Ferrous Sulfate – Iron supplement |
none |
|
|
Lidocaine Hydrochloride |
XylocaineIndications: Local Anesthetic at skin puncture site. Contraindication:Known history of hypersensitivity, use with caution if there is inflammation, or sepsis or both at proposed site of injection. Complications: Drowsiness, Nervousness, blurred vision, tremors, seizures, resp arrest, hypotension, bradycardia, cardiovascular depression. |
|
|
Demerol |
Meperidine Analgesic Indications: Pain, SedationContraindications: Hypersensitivity to drug, Asthma, Resp Depression. Complications: Tachycardia, Resp Depression, LIghtheadedness, dizziness, nausea, vomitting, hypotension, Seziures, increased intracranial pressure. Dose: 15-50 mg increments max of 150mg Route: Oral, Sub Q, IM, IVReversal: Narcan |
|
|
Toradol – Postpartum Medication Generic name: ketorolac Trade name: Toradol Action and Rationale: Inhibits prostaglandin synthesis by decreasing an enzyme needed for biosynthesis; analgesic, anti-inflammatory, antipyretic effects. It is used for mild to moderate pain Dose range/ Safe range: Adult multiple dosing: IV BOL/IM 30 mg q6h max 120 mg/day, with transition of 20 mg PO, then 10 mg q4-6h; Single dose: IV BOL/IM 30 mg IV or 60 mg IM, then 20 mg transition dose, not to exceed 40 mg/day then 10 mg q4-6h Route: IM, IV, Opthalmic solution, PO |
Contraindications: Hypersensitivity, asthma, sever renal disease, severe hepatic disease, peptic ulcer disease, L&D, lactation, CV bleeding. Adverse Effect: Hypertension, flushing, syncope, pallor, edema, vasodilation, dizziness, drowsiness, tremors, tinnitus, hearing loss, blurred vision, nausea, anorexia, vomiting, diarrhea, constipation, flatulence, cramps, dry mouth, peptic ulcer, GI bleeding, perforation, taste change, neprhotoxicity, dysuria, hamaturia, oliguria, azotemia, blood dyscrasias, prolonged bleeding, purpura, rash pruritus, sweating. Pertinent lab values: Assess and monitor BUN, creatinine, AST (SGOT), ALT (SGPT) Hbg before treatment, test for occult blood in urine. RN Considerations/Interventions: Assess eyes for redness, swelling, tearing, itching, bleeding, blurred vision, tinnitus, jaundice, yellow sclera and skin, clay-colored stools, hypertension, cardiac conditions. Administer IM/IV for 5 days or less. Pregnancy category: Pregnancy (C) |
|
|
Mylicon – Postpartum medication Generic name: simethicone Trade name: Gas-X Action and Rationale: Disperses, prevents gas pockets in HI system; does not decrease gas procuction. It is commonly used to relief postpartum flatulence or bloating. Dose range: Adult and child >12 years PO 40-100 mg pc, hs; Infants: PO 20 mg qidSafe range: Chew tabs 40, 80mg; tabs 50, 60, 95, 125mg; drops 40mg/0.6ml; caps 125mgRoute: PO |
Contraindications: Hypersensitivity Adverse Effect: GI-Belching, rectal flatusPertinent lab values: N/A RN Considerations/Interventions: Asses for excess gas production, decreased bowel sounds, recent surgery, other GI conditions Pregnancy category: N/A |
|
|
Tdap |
Tetanus, diphtheria, and acellular pertussis vaccination |
