Chapter 31 Flashcards
RhoGAM
prevention of anti Rho antibody
best if administered twice @ 28wks and 72hrs post delivery
IM route, never by IV
tocolytics
medications that produce uterine relaxation and suppress uterine activity in an attemp to halt uterine contractions and prevent preterm birth
tocolytics (kinds)
indomethacin (indocin)
magnesium sulfate
nifedippine (procardia, Adalat, Nifedical)
Terbutaline (Brethine)
tocolytics (maternal contraindications)
severe preeclampsia and eclampsia active vaginal bleeding intrauterine infection cardiac disease medical or obstetric condition that contraindicates continuation of pregnancy
tocolytics (fetal contraindications)
gestational age > 37 wks cervical dilation > 4cm fetal demise lethal fetal anomaly chorioamnionitis acute fetal distress chronic intrauterine growth restriction
interventions when receiving tocolytic therapy
position client on her side to enhance placental perfusion and reduce pressure on cervix
2 monitor maternal VS, fetal status, and labor status frequently
3 monitor for signs of adverse reactions
4 monitor daily weight and I&Os
magnesium sulfate
CNS depressant and anticonvulsant
uses: stops preterm labor
prevents/controls pre/eclamptic seizures
magnesium sulfate antidote
calcium gluconate
magnesium sulfate adverse rxns
maternal - depressed respirations, depressed DTRs, hypotension, extreme muscle weakness, flushing, decreased urine output, pulmonary edema, serum mag levels > 9 mg/dL
newborn - hypotonia and sleepiness
IV admin should not be used for 2 hrs preceding delivery
monitor DTRs hourly
indomethacin (indocin) - tocolytic
prostaglandin inhibitor; relaxes uterine smooth muscle
used when other methods fail ONLY if gestational age <32 wks
indomethacin (indocin) adverse effects
maternal - N&V, dyspepsia, dizziness
fetal - premature closure of ductus arteriosus
newborn - bronchopulmonary dysplasia, respiratory distress syn, ICP, necrotizing enterocolitis, hyperbilirubinemia
nifedipine (procardia, adalat, nifedical) - tocolytic
calcium channel blocker, relaxes smooth muscles
nifedipine (procardia, adalat, nifedical) adverse effects
maternal - tachycardia, hypotension, dizziness, headache, nervousness, facial flushing, fatigue, nausea
newborn - hypotension
terbutaline (brethine) - tocolytic
beta adrenergic agonist (relaxes smooth musc) - inhibits uterine activity and causes bronchodilation
terbutaline (brethine) adverse effects
maternal - tachycardia, palpitations, pulmonary edema, chest pain, MI, hypotension, tremors, hypokalemia, hyperglycemia
newborn - tachycardia, hypotension, ileus, hypocalcemia, hyperbilirubinemia, hyperinsulinemia w/ hypoglycemia
