exam 2: OB + Newborn Flashcards
ethinyl estradiol and norethindrone therapeutic effect
- prevention of pregnancy
- dysmenorrhea
- acne
side effects of ethinyl estradiol and norethindrone
- n/v
- weight gain/bloating
- breast tenderness
- chloasma
- depression
- h/a
- HTN
- blood clots
nursing considerations for ethinyl estradiol and norethindrone
- may alter blood glucose levels
- contraindicated in pts over 35 yrs and breastfeeding pts
does not protect against STIs - reduced risk of PID, endometrial + cervical cancer, death associated with colorectal cancer
progestin (“mini pill”) indication
prevention of pregnancy
sides effects of progestin (“mini pill”)
- irregular bleeding
- depression
- mood changes
- decreased libido
- fatigue
- weight gain
progestin (“mini pill”) nursing considerations
- preferred option for clients who have a hx VTE, heart disease/HTN, are breastfeeding, are 35 yrs and older, smoke
doxycycline (vibramycin) indication
treatment/prevention of Chlamydia
side effects of doxycycline (vibramycin)
- urticaria
- photosensitivity
- nephrotoxicity
- hepatotoxicity
- anaphylaxis
nursing considerations for doxycycline (vibramycin)
- do not use if pregnant or breastfeeding
- avoid in 2nd and 3rd trimester of pregnancy (may impact coloration or teeth and bone growth)
- take on empty stomach
- report rash/signs of bleeding
- monitor for superinfection
metronidazole (flagyl) indication
treatment/prevention of trichomoniasis
side effects of metronidazole (flagyl)
- peripheral neuropathy
- discolored urine
- metallic taste
- anaphylaxis
metronidazole (flagyl) nursing considerations
- avoid alcohol
- do not use if pregnant or breastfeeding
- increased risk for secondary malignancy
penicillin-G indication
treatment/prevention of Syphilis/GBS
side effects for penicillin-G
- colitis
- vaginitis
- moniliasis
- injection site rxn (pain, tenderness, fever)
- anaphylaxis
nursing considerations for penicillin-G
- avoid use during pregnancy or if breastfeeding
- report GI symptom changes
- do not give penicillin-G benzathine via IV
acyclovir indication
treatment of HSV
side effects for acyclovir
- gingival hyperplasia (requires regular dental care)
- rash/pruritus
- phlebitis
- mouth pain
- hepatic and renal toxicity
acyclovir nursing considerations
- not curative
- treatment takes 7-10 days (may extend to 21 + days)
- treatment should be initiated within 1 day of outbreak
- avoid during pregnancy/breastfeeding
- minimize contact with lesions
folic acid indication
prevention of neural tube defects
side effects for folic acid
- flushing
- malaise
- erythema
- pruritus
- rash
- bronchospasm
nursing considerations for folic acid
- deficiency contributes to premature birth, low birth weight, and placental abruption
- may change urine color (deep yellow)
- encourage intake of folate-rich foods (strawberries, oranges, asparagus, dark green leafy vegetables, bread, rice, pasta, cereal (enriched))
rho (D) immune globulin (rhogam) indication
- prevent the sensitization (isoimmunization)
- administered to rh-negative mothers
side effects of rhogam
- hypotension
- rash/pruritus
- gi upset
- injection site reaction
nursing considerations for rhogam
- adm to mother (26-28 weeks gestation, within 72 hours of delivery; any time mixing of blood may occur (trauma, miscarriage, amniocentesis))
- report signs of hemolytic rxn (chills, back pain, dark urine, edema, SOB)
- risk of hemolysis
dinoprostone (prepidil, cervidil) indication
induction of labor
dinoprostone (cervidil, prepidil) side effects
- GI distress
- back pain
- hyperstimulation (FHR changes)
- anaphylaxis
nursing considerations for dinoprostone (cervidil, prepidil)
- remain recumbent for at least 2 hours
- med is frozen = warm to room temp before insertion
- insert remains in place for up to 12 hours
misoprostol (cytotec) indication
- induction of labor (not approved by FDA for induction)
- may be used to control PP bleeding
side effects for misoprostol (cytotec)
- cramping
- vaginal bleeding
- uterine rupture
nursing considerations for misoprostol (cytotec)
- contraindicated for hx c-section
- remain recumbent for 30 mins
- repeat dose Q4-6 as needed
oxytocin (pitocin) indication
induction of labor (stimulates contractions)
oxytocin (pitocin) side effects
- HTN
- dysrhythmias
- hyperstimulation (UC >2 mins, >5 UC in 10 mins)
- tachysystole (>6 UC in 20 mins)
- uterine rupture
oxytocin (pitocin) nursing considerations
- effective contraction pattern (UC Q2-3 mins, duration 50-60 sec, moderate intensity)
- keep tocolytic and oxygen readily available
fetal intolerance to labor interventions
- stop infusion
- place client on left side
- administer oxygen
- notify HCP
terbutaline (brethine) indication
- stop preterm labor
- asthma
terbutaline (brethine) side effects
- tachycardia/palpitations
- hyperglycemia
- fetal hypoglycemia
- hypokalemia
terbutaline (brethine) nursing considerations
- contraindications: heart disease, diabetes
- readily crosses placenta
- do not used for prolonged tocolysis
magnesium sulfate indication
- stop preterm labor
- lower BP (BP: pregnancy-induced HTN (PIH) and preeclampsia/eclampia)
- neuroprotection (preterm delivery (<32 weeks))
magnesium sulfate side effects
- sluggishness
- blurred vision
- hypotension/tachycardia
magnesium sulfate nursing considerations
- readily crosses placenta (neonate should be monitored for increased magnesium)
- monitor for s/s of mag. toxicity (depressed DTRs, lowered RR and HR)
- antidote = calcium gluconate
hydroxyprogesterone (makena) indication
prevents contractions
hydroxyprogesterone side effects
- injection site reaction
- blood clots
- hyper/hypoglycemia
- anaphylaxis
hydroxyprogesterone (makena) nursing considerations
- given with hx preterm delivery
betamethasone indication
prevents respiratory distress syndrome (RDS) in preterm infant
betamethasone side effects
- vertigo
- arrhythmias
- HTN
- increased blood glucose
betamethasone nursing considerations
- most effective 24 hours after administration
- l/s ratio is an indicator of lung maturity
- contraindicated with pulmonary edema, gestational HTN, PPROM
methylergonovine (methergine) indication
prevention/treatment of PPH
methylergonovine (methergine) side effects
- tinnitus
- HTN
- seizure
methylergonovine (methergine) nursing considerations
- contraindicated with HTN, PVD, CAD
- do not adm with other ergot alkaloids or beta-blockers
- monitor for ergot toxicity (pain in arms, legs, lower back, numbness, cold hands/feet, weakness, hallucinations)
- do not adm IV
carboprost (hemabate) indication
treatment of PPH d/t uterine atony
used only following delivery of placenta
carboprost (hemabate) side effects
- fever
- cramping
- bronchospasm
carboprost (hemabate) nursing considerations
- contraindicated with asthma, PID, renal or heart disease, hyper/hypotension
- rotate injection site
erythromycin indication
prevention of STI-related infection and subsequent blindness
erythromycin side effects
- redness
- blurred vision
erythromycin nursing considerations
- chlamydia and gonorrhea = most common (damage to cornea)
- adm within 1 hour of delivery (delayed to promote bonding)
- apply to lower conjunctival sac
- wash hands/wear gloves with adm
aquamephyton (phytonadione) indication
- prevent bleeding
- treatment of vitamin K deficiency
aquamephyton (phytonadione) side effects
- rash
- hyperbilirubinemia
- injection site rxn
aquamephyton (phytonadione) nursing considerations
- VKDB
- 0.5-1mg per dose
- adm within 1 hour of delivery
hepatitis B vaccine indication
prevention of hepatitis B infection
hepatitis B vaccine side effects
injection side rxn (pain, erythema, swelling)
hepatitis B vaccine nursing considerations
- HBIG (hepatitis B immune globulin)
^given if mom is hep B positive or unknown; hep b vaccine can be given concurrently - adm into vastus lateralis
- requires parental consent
- three-dose series
lidocaine indication
- pain management
- ventricular arrhythmia
lidocaine side effects
- burning
- hypotension
- bradycardia
lidocaine nursing considerations
maternal use:
- injected into skin, muscle, or cervix
- FHR monitoring
- lidocaine spray = used for PP discomfort
neonatal use:
- dorsal penile nerve block (DPNB)
- provide oral sucrose prior to local injection
- EMLA cream (lidocaine/prilocaine) applied at least 60 mins before procedure
poractant alfa (curosurf) indication
- respiratory distress syndrome (RDS)
- preterm delivery
poractant alfa (curosurf) side effects
- hyperoxia
- hypocarbia
- desaturation
- cyanosis
- bradycardia
poractant alfa (curosurf) nursing considerations
- reduces surface tension of alveoli (increases residual air + keeps expanded)
- beractant (survanta) (can be used prophylactically, 1/4 per each lung quadrant)
- monitor ABG and ventilator settings (requires RN, RT, and provider guidance)
- do not suction ET tube
- requires ET tube administration
