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Flashcards in OB Meds Deck (6)
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1
Q

Oxytocin (Pitocin, Syntocinon)

A

Indications- induction of labor at term, controls post-partum bleeding after expulsion of placenta
Actions-stimulates uterine smooth muscle to commence uterine contractions, stimulates mammary gland smooth muscle commencing lactation, has vasopressor and diuretic effects
Therapeutic effects- induces labor, decreases post-partum bleeding, induces breast milk let down
Contraindications/Precautions- CPD or deliveries that require conversion, use w/caution in 1st and 2nd stages of labor
Side effects- painful contractions, increased uterine motility, may contribute to maternal coma, seizures, and hypotension; may contribute to fetal asphyxia and arrhythmias
Route- IM or IV
Nursing Implications- assess fetal maturity, presentation, and maternal pelvis adequacy; monitor contractions and resting uterine tone, monitor maternal BP, pulse, and FHR, monitor uterus for firmness/boggy, monitor lochia, monitor s/s of water intoxication and electrolyte status
*Reversal agent: Terbutaline

2
Q

Magnesium sulfate

A

Indications- anticonvulsant in severe preeclampsia/eclampsia; unlabeled use for preterm labor
Action- neurotransmission and muscular excitability
Therapeutic effects- resolution of eclampsia
Contraindications/Precautions- hypermagnesmia/calcemia/anuria, heart block, active labor w/in 2 hrs of labor; cautiously with any degree of renal insufficiency
Side effects- drowsiness, decreased respirations, arrhythmias, hypotension, bradycardia, diarrhea, flushing, sweating, hypothermia
Route/Dosage- IVPB w/LR solution, loading dose 4-6g over 15-30mins, maintenance 1-3g/hr
Nursing implications- explain purpose and side effects; explain warm feeling, N/V, visual blurring, H/A; monitor pulse, BP, resps., and ECG; institute seizure precautions, test patellar reflexes, monitor I&Os (100ml/4hr)
*Reversal agent: calcium gluconate (10ml IV over 1-3mins)

3
Q

Betamethasone, Dexamethasone (corticosteroid)

A

Indications- to prevent or reduce severity of RDS in preterm infants btw 24-34 weeks
Action- stimulates fetal lung maturity by promoting release of enzymes that induce production and/or release of surfactant
Contraindications/Precautions- medical indication for delivery (severe preeclampsia, eclampsia, cord prolapse), women w/systemic fungal infection
Side effects- seizures, H/A, vertigo, hypertension, increased perspiration, petechiae, ecchymoses, facial erythema, maternal infection, pulmonary edema, may worsen conditions like diabetes and hypertension
Nursing Implications- inform benefit of medication and the need to admin. to prevent RDS; teach s/s of pulmonary edema, assess lung sounds, shake suspension well, avoid exposure to heat/light, admin. into large muscle, avoid deltoid, monitor vitals frequently and fetal monitoring, accurate I&Os, monitor blood sugars; do NOT admin. if woman has an infection

4
Q

Erythromycin (Ilotycin)

A

Indication- prophylaxis of opthalmia neonatorum
Action- suppresses protein sythesis at level 50s ribosome; bacteriostatic action against susceptible bacteria spectrum
Contraindications- hypersensitivity
Side effect- irritation
Route/dosage- apply thin strip to ea. eye as single dose
Nursing implications- inform parents of med, prepare to admin. one hr after birth, apply thin strip to ea. eye, start at inner canthus and go to outer canthus, dab excess off, do not wash away

5
Q

Aquamephyton (Vitamin K)

A

Indications- for prevention and tx of hypothrombinemia, may be associated w/excessive doses of oral anticoagulants, salicylates, certain anti-infective agents, nutritional deficiencies, and prolonged total parenteral nutrition, *prevention of hemorrhagic disease in newborn
Contraindications- hypersensitivity, caution w/impaired liver fxn
Side effects- gastric upset, unusual taste, flushing, rash, uticaria, hemolytic anemia, erythema, pain at site, swelling
Route/dosage- 0.5-1mg given w/in 1-2 hrs after birth, may repeat in 6-8 hrs if needed, may be repeated in 2-3wks, *1-5mg may be given IM to mother 12-24hrs before delivery

6
Q

Beractant (survanta)

A

-prevents and treats RDS in newborns
-decreases minimum surface tension and increases pulmonary compliance and oxygenation
-monitor HR and respirations
Side effects-bradycardia, hypotension, oxygen desaturation, endotracheal tube blockage, pulmonary hemorrhage, possible increase in nosocomial infections
Nursing implications- give w/in 15 mins of birth, naso-oral suction before admin. warm vial 20mins to room temp, do not suction for 1 hr after admin. and discard vial after use