Ch 32 Labor & Delivery Flashcards
What is dinoprostone ( Cervidil)
It is a prostaglandin used to promote cervical ripening and to stimulate uterine contractions
What is methedrine used for
It is used for emergency intervention for serious postpartum HEMMORRHAGE
What is the prototype drug and other drugs in the class uterine stimulant oxytocics
Oxytocin (pitocin)
Dinoprostone ( Cervidil)
Methylergonovine ( Methergin)
What are adverse effects of the uterine stimulant oxytocic Pitcocin
Uterine rupture ( presses risk factors such a multiple deliveries, monitor length, strength, and duration of contractions, have magnesium sulfate on standby if needed for relaxation of muometrium)
What is an adverse effect of the uterine stimulant drug methylergonovine ( methergine)
Hypertensive crisis monitor for manifestations such as headache, nausea, vomiting, increased BP.
What are contraindications of oxytocin ( pitocin)
Maternal factors,include sepsis,,an unripe cervix, genital herpes, history of multiple births and or uterine surgery
Fetal factors include immature lungs, cephalopelvic,disproportion, fetal malpresentation, prolapsed umbilical cord, fetal distress, and threatened spontaneous abortion.
Methylergonovine ( methergine) is contraindicated in who
Ppl who have HTN
use cautiously in ppl with organ Failure,( cardiovascular, kidney, liver)
Only used after labor NOT DURING
Mothers shouldn’t breastfeed until after 12 hours of there last dose of methergine.
What are tocolytic medications
Terbutaline sulfate ( Brethine) Nifedipine ( Procardia, Adalat), indomethacin ( Indocin)
What is the therapeutic use of terbutaline
SC terbutaline can be used for up to 48 hrs to delay not prevent preterm labor
What are adverse effects of tocolytic meds such as terbutaline, nifedipine, and indomethacin
Tachycardia, palpitations, chest pain
Tremors anxiety, headache
What is important to remember regarding the administration of nifedipine, indomethacin,and terbutaline
Greater than 34 weeks gestation the maternal and fetal risk from tocolytics outweigh the benefits of prolonging the pregnancy
Do not administer in acute fetal distress
Severe gestational HTN or preeclampsia
Vaginal bleeding
Cervical dilation greater than 6cm.
What are uterine stimulant oxytocics
Uterine stimulants that increase the strength, frequency, and length of contractions.
It induced labor ( post term pregnancy, premature rupture of membranes,pre- eclampsia)
Enhancement of labored
Delivery if placenta
Management of postpartum HEMMORRHAGE
Stress testing
