Chapter 52 : Pregancny And Preterm Labor Flashcards
What are some changes in drug action during pregnancy?
Effect in steroid hormones on liver metabolism
Reduced GI motility
Increased renal perfusion
Drug dilution - blood volume increased
Alteration in drug clearance
What are some factors that alter drug half lives?
Pregnancy
Labor
Disease states
What is teratogens mean?
Substances that causes developmental abnormalities
Risk for birth defects after exposure to teratogens begins after ___of pregnancy
2 weeks
What are the two herbs used for pregnancy?
Iron
Folic acid
What is the adverse effects of iron?
Dont over think it
Nausea
Vomiting
Constipation
Diarrhea
Epigastric pain
Urine discoloration
We should warn patients who take iron to what?
Poop
Teeth
Dark tarry stools
Stains teeth
How is iron best absorbed?
With an addition of vitamin C
Like orange juice
To avoid staining the teeth with iron that’s taken orally/liquid
We should tell patients what?
Take it with a straw
Someone who is planning on getting pregnant what do they normally tell patients to take, how much and when ? (3)
Folic acid
400-800mcg/day
Starting 1 month before conception
What are some adverse reactions to folic acid?
Main one
Bronchospams!!
Flushing
Rash
Pruritus
Erythema
Malaise
Dark yellow urine
Folic acid helps decrease what?
Neural tube defects in the baby
Patients who take SSRI, TCAs,, so your antidepressants, what might we see in a newborn baby?
Low birth weight
Preterm
Neonatal irritability
What are some drugs that help decrease uterine muscle contractility
Usually those who have preterm labor?
Tocolytic therapy - calcium antagonist
- magnesium sulfate
What’s the action of magnesium sulfate?
Relaxed the smooth muscle of the uterus through calcium displacement
What are the benefits of magnesium sulfate in someone who is pregnant? (2)
Decrease blood pressure in preeclampsia
Reduces seizures
What are your adverse reactions of mangesium sulfate? (5)
Major ones
Flushing
Hypotension
Depressed reflexes
Respiratory depression
Constipation
What is the antidote for magnesium sulfate?
Calcium gluconate
What is the normal level of magnesium sulfate?
4-7 mg/dl
When a mom is getting magnesium sulfate, what should we do for the baby?
Assess 24-48 hours of magnesium side effects
When a women is in preterm labor, not only is magnesium sulfate good to have to stop it, but if we can’t
What other drug what might we give?
Corticosteroids
What is the 2 medication of corticosteroid for preterm labor?
Bethamethasone
Dexamethasone
What is the function of bethamethasone and dexmethasone? (2) main two
Accelerated lung maturation and lung surfactant development in the fetus
Increases survival
Decreased respiratory distress syndrome
What is the time frame we like to give steroids for preterm labor?
48 hours before delivery to help speed up lung development
What are your side effects of betamethasone & dexamethasone?
Hyperglycemia
Swelling
Bruising
All the basic steroid symptoms
How do we give steroids to pregnant preterm labor patients?
IM
So no need for food
What is the first line therapy for mild preeclampsia?
What is acute onset, severe hypertension?
Severe preeclampsia?
Methyldopa
Hydralazine
Magnesium sulfate
What is your meyhyldopa side effects? (3)
Peripheral edema
Anxiety
Nightmares
What is your hydralazine side effects ? (3)
Nasal congestion
Angina
Tachycardia
What is your magnesium sulfate side effects?
Same as before
Hypotension
DTR
respiratory depression
Heavy eyelids
Slurred speech
Notes
Nursing responsibilities
Assess moms vital signs
Assess fetal heart rate
Monitor I & O
If mom if getting magesium sulfate, have suction equipment, assess for signs of magnesium toxicity
Left lateral position if possible for mom
