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OB > L & D Medications > Flashcards

L & D Medications Flashcards

1
Q

Brand name for ampicillin

A

Ampicin

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2
Q

What is ampicillin used for?

A

GBS prophylaxis

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3
Q

Class of ampicillin

A

Broad spectrum antibiotic

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4
Q

Side effects of ampicillin

A

Pain at infusion site
Allergic response
Rash
N/v/d
HA

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5
Q

Nursing responsibilities for ampicillin

A

Assess for previous sensitivity reactions to penicillin’s or other cephalosporins
Assess for S/S of infection
VS
WBC
Obtain hx for GBS status
Assess bowel pattern daily
If severe diarrhea occurs, product should be DC

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6
Q

Patient teaching for ampicillin

A

Teach why med is being given
Report any adverse symptoms or SE

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7
Q

Brand name of Penicillin G

A

Pfizerpen

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8
Q

Classification of Penicillin G

A

Broad spectrum antibiotic

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9
Q

Use of penicillin G

A

Prevention and treatment of GBS

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10
Q

Side effects of penicillin G

A

Pain at infusion site
Allergic reaction
Rash
N/v/d
HA

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11
Q

Brand name for oxytocin

A

Pitocin

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12
Q

*Routes of pitocin

A

For induction/augmentation: IV titration
For PPH: IV bolus or IM injection

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13
Q

*Use of pitocin

A

Control PP bleeding
Induction/stimulation of labor

(Stimulates uterine smooth muscle, has vasoactive and anti diuretic properties)

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14
Q

*Side effects of pitocin

A

*Water intoxication
Tachysystole
Impaired uterine blood flow
Fetal asphyxia
Uterine rupture

Fetal:
Bradycardia
Tachycardia
Reduced variability
Late or prolonged decels

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15
Q

Nursing responsibilities for pitocin

A

Assess character, frequency, duration, intensity of contractions every 15 min
Stop infusion if: CTX <2 min apart and are >50-65 mmHg, last 60-90 seconds or longer
Assess FHR prior to induction and every 15 min during induction
Assess VS every 15 min
Monitor for water intoxication: drowsiness, listlessness, confusion, HA, anuria)
Monitor I&O
DC or decrease drip for fetal distress or prolonged contractions

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16
Q

Patient teaching for pitocin

A

Advise pt to expect contractions similar to menstrual cramps that gradually increase in intensity and become strong
Report increased abdominal pain, blood loss, or fever
PP - report boggy uterus or increase in lochia flow
Teach pt to massage their fundus

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17
Q

Brand name for Methylergonovine

A

Methergine

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18
Q

*Use of methergine

A

Treat/prevent PPH (or post abortion hemorrhage) cause by uterine atony or subinvolution
(Stimulates sustained CTX of uterus and causes arterial vasoconstriction)

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19
Q

Classification of methergine

A

Oxytocic
Uterine stimulant

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20
Q

*Routes for methergine

A

*IM - preferred route for rapid absorption
PO
Intrauterine
(IV use not recommended unless life threatening situation)

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21
Q

*Side effects of methergine

A

*HTN
N/V
Uterine cramping
Dyspnea
Dysrhythmias

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22
Q

Nursing responsibilities for methergine

A

Caution in pts with HTN and cardiac disease
Caution to avoid smoking: nicotine causes vasoconstriction
Monitor BP/VS
*Check BP prior to each dose
Monitor vaginal bleeding, uterine tone, height of fundus

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23
Q

*Patient teaching for methergine

A

*Avoid smoking because nicotine constricts vessels
Abdominal cramps are a SE
Notify prescriber if you have chest pain, N/V, HA, muscle pain, weakness, cold/numb extremities
Teach to massage fundus

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24
Q

Brand name for dinoprostone

A

Cervidil, prepidil

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25
Q

*Routes for cervidil

A

*Vaginal suppository (10 mg time release)
Or gel

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26
Q

Classification of cervidil

A

Prostaglandin oxytocic
Abortifacient

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27
Q

*Use of cervidil

A

*Cervical ripening/induction
(Stimulates uterine contractions similar to labor by myometrium stimulation, causing abortion)
Acts within 30 hrs for complete abortion

Used for cervical effacement and dilation in term pregnancy when they have not occurred spontaneously

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28
Q

*Side effects of cervidil

A

*Fever
*Uterine hypertonicity (tachysystole)
HA
Nausea
Uterine rupture
Diarrhea

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29
Q

*Nursing responsibilities of cervidil

A

*Delay start of pitocin for 30-60 mins after cervidil is removed
Monitor contractions
Cervical ripening: assess dilation and effacement of cervix, uterine CTX, and fetal heart tones
Monitor for CTX lasting more than 1 min, hypertonic, fetal distress
Assess for fever occurring 30 min after administration
Gel should be at room temp

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30
Q

Patient teaching for cervidil

A

Gel may produce warmth in vagina
Void prior to insertion
Remain supine for 30 mins to 2 hrs after insertion of medication
Report any contractions lasting longer than 1 min

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31
Q

Brand name for carboprost

A

Hemabate

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32
Q

Route for hemabate

A

*Deep IM

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33
Q

Maximum total dose of Hemabate

A

2 mg

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34
Q

Class for hemabate

A

Prostaglandin
Abortifacient
Oxytocic

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35
Q

*Use of hemabate

A

*Treat PPH
Stimulates contraction of uterus

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36
Q

*Side effects of hemabate

A

*Diarrhea
May cause tetanic contractions and laceration or uterine rupture
hypertension/hypotension
Nausea

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37
Q

*Nursing responsibilities for hemabate

A

*Administer antidiarrheals as ordered
*Monitor fundus and lochia
Should be refrigerated
Rotate sites if repeated
Monitor vitals
Administer antiemetics as ordered

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38
Q

Patient teaching for hemabate

A

This med almost always causes diarrhea, so we will admin antidiarrheal to avoid this side effect
Expect abdominal cramps similar to menstrual cramps
Change positions slowly
Report any increase in vaginal bleeding

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39
Q

Brand name for misoprostol

A

Cytotec

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40
Q

*Route for Cytotec

A

*PO
* PR (preferred route for PPH)
*PV

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41
Q

Classification of Cytotec

A

Prostaglandin

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42
Q

*Use for Cytotec

A

*Cervical ripening/induction
*Treatment of PPH
Induces uterine CTX, ripens cervix

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43
Q

Side effects of Cytotec

A

Uterine cramping
Tachysystole
Uterine rupture
Diarrhea
N/V
Dyspepsia

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44
Q

*Nursing responsibilities for Cytotec

A

*NOT used in women with previous uterine scar
*DO NOT start pitocin until at least 4 hours after vaginal Cytotec dose (for induction)
*Preferred route is rectal for PPH

Monitor FHR, contraction pattern, cervical dilation/effacement
Monitor bleeding and fundus in PPH pt

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45
Q

Patient teaching for Cytotec

A

Lie flat for 30 min after insertion of medication
Void prior to insertion of medication
Report CTX lasting >1 min
Report any worsening or increase in vaginal bleeding

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46
Q

Brand name for nalbuphine

A

Nubian

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47
Q

Route for Nubian

A

IV (preferred)
IM
SQ

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48
Q

Classification of Nubian

A

Opioid analgesic

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49
Q

Use of Nubian

A

Moderate to severe pain

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50
Q

Side effects of Nubian

A

Sedation
Respiratory depression in mom and neonate
N/V
Dizziness
HA

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51
Q

Nursing responsibilities for Nubian

A

Assess pain prior to and after giving med
Monitor VS (Don’t give if RR<12)
Monitor fetus (can cause bradycardia, respiratory depression at birth, apnea, cyanosis, and hypotonia)
Don’t give close to delivery d/t fetal effects
Narcan is antidote

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52
Q

Patient teaching for Nubian

A

Dizziness and drowsiness are common: do not get up without assistance
Risk of baby having resp depression effects if this drug is given too close to delivery
Avoid CNS depressants (alcohol, sedatives) for at least 24 hours after taking this med

53
Q

Brand name of Butorphanol

A

Stadol

54
Q

Route of Stadol

A

IV (preferred)
IM

55
Q

Class for Stadol

A

Mixed opioid analgesic

56
Q

Use of Stadol

A

Pain relief during labor

57
Q

*Side effects of Stadol

A

*Decreased FHR variability
Respiratory depression or apnea (maternal and fetal)
Sedation/lethargy
N/V
Dizziness

58
Q

Nursing responsibilities for Stadol

A

Assess pain before and after giving med
Monitor VS & LOC
Monitor fetus and FHR variability
Have narcan available
Side rails up at all times

59
Q

Patient teaching for Stadol

A

Tell pt and family she shouldn’t get out of bed without assistance
Side rails up at all times
Change positions slowly to prevent orthostatic hypotension

60
Q

Brand name for naloxone

A

Narcan

61
Q

Route for narcan

A

IV (preferred)
IM
SQ
Intra nasal
ET tube

62
Q

Classification of narcan

A

Opiate antagonists

63
Q

*Use of narcan

A

*Treat maternal opioid overdose and/or treat newborn with severe respiratory depression secondary to maternal opioid dose near delivery

64
Q

Side effects of narcan

A

Tachycardia
Tremor
Diaphoresis
HTN
Opioid withdrawal

65
Q

*Nursing responsibilities for narcan

A

*Caution may cause withdrawal in opioid addicted patients
Monitor fetus if not delivered
Monitor VS, LOC, and pain
Monitor for respiratory depression
Duration of effect is 20-60 mins. May need to repeat dose. Monitor for withdrawal

66
Q

Patient teaching for narcan

A

Explain reason for expected results of medication when pt is alert
This drug used to reverse effects of maternal overdose of opioids and to treat newborns with severe respiratory depression secondary to maternal opioid dose near delivery

67
Q

Brand name for nifedipine

A

Procardia

68
Q

Route for Procardia

A

PO

69
Q

Classification of Procardia

A

Calcium channel blocker
Tocolytic

70
Q

*Use of Procardia

A

*Control BP
*Inhibit preterm labor contractions
(Blocks calcium channels and reduces smooth muscle contractions in uterus

71
Q

Side effects of Procardia

A

Flushing of skin
HA
Hypotension
N/V/D
Transient increase in maternal and FHR

72
Q

Nursing responsibilities for Procardia

A

Monitor VS
Assess status of fetus/contractions
Avoid concurrent use with Mag sulfate b/c skeletal muscle blockade can result
Monitor BS in diabetic pts
Don’t give immediately after Terbutaline b/c of effects on HR and BP

73
Q

Patient teaching for Procardia

A

Change positions slowly to prevent orthostatic hypotension
This med can cause dizziness, call for assistance if you need to sit, stand, or walk

74
Q

Brand name for terbutaline

A

Bricanyl
Brethine

75
Q

Route of terbutaline

A

SQ

76
Q

Class for terbutaline

A

Selective B2 agonist
Tocolytic

77
Q

*Use of terbutaline

A

*To stop preterm labor contractions *Manage tachysystole
Relaxes uterine smooth muscle by acting on beta2 receptors with less effect on the heart

78
Q

*Side effects of terbutaline

A

*Maternal and fetal tachycardia
Dyspnea
Palpitations
Chest pain/discomfort
Restlessness
Tremors
Flushing
Hypokalemia

79
Q

Nursing responsibilities for terbutaline

A

Hold dose if maternal HR >120bpm or if systolic BP falls below 80-90 of FHR >180
Monitor VS/HR
*Ensure inderal is available to reverse adverse effects
Caution in women with hx of cardiac diasease
Gestational diabetes: sever gestational HTN, severe pre-eclampsia or eclampsia
Monitor fetus; contraction pattern and dilation/effacement

80
Q

Patient teaching for terbutaline

A

Review SE with pt and have her report problems if they occur
Inform her that she will hear the baby’s HR increase on the monitor and that this is an expected SE
Limit caffiene
Drug is only administered at the hospital
Report if symptoms continue once you go home

81
Q

Brand name for indomathacin

A

Indocin

82
Q

Route for indocin

A

PO

83
Q

Classification of indocin

A

NSAID
Prostaglandin synthesis inhibitor
Tocolytic

84
Q

*Use of indocin

A

*used to treat preterm labor prior to 32 weeks
Relaxes uterine smooth muscle by inhibiting prostaglandins

85
Q

Side effects of indocin

A

N/V
Heartburn
GI bleeding
Increased BP in women with HTN
Fetal: constriction of ductus arteriosus, impaired renal function (reduced amniotic fluid vol = > cord compression)

86
Q

*Nursing responsibilities for indocin

A

*Can only be used for 48 hrs due to risk of closing ductus arteriosus
Assess fetal status, FHR, and contractions
Drug can mask maternal fever
Don’t use in women with renal, hepatic, active PUD, poorly controlled HTN, asthma, or coagulation disorders
Must be used prior to 32 weeks gestation

87
Q

Patient teaching for indocin

A

Only use drug for 48 hours
Review SE/take drug with food
Caution if mom is sick as drug can mask fever
Report if labor symptoms continue

88
Q

Route for magnesium sulfate

A

IV
IM (rarely)

89
Q

Classification of magnesium sulfate

A

Anticonvulsant
Tocolytic

90
Q

*Use of magnesium sulfate

A

*Patient seizures
*Treatment of preterm labor
(Increases osmotic pressure, draws fluid into colon, neutralizes HCL. Plays important role in neurotransmission and muscular excitability)

91
Q

Side effects of magnesium sulfate

A

Dose related depression of DTR
CNS depression
Flushing/sweating
Hypotension
Resp depression
Fetal: Reduced FHR variability, hypotonia

92
Q

*Nursing responsibilities for magnesium sulfate

A

*Antidote = Calcium gluconate
Monitor BP closely
Assess VS. RR should be > 12
Monitor I&O. UO should be >30 ml/hr
Keep calcium gluconate in room
Monitor DTR
Assess edema in lower extremities
If pre-eclamptic - seizure precautions
Assess magnesium toxicity
Monitor mg and ca levels

93
Q

Symptoms of magnesium toxicity

A

Thirst
Confusion
Decreased DTR
Visual changes: blurred vision, halos

94
Q

Patient teaching for magnesium sulfate

A

This med is given to delay preterm labor and to prevent seizures associate with preeclampsia
Need for frequent monitoring
Report SE (family or pt)
Side rails up
OOB with assistance

95
Q

Brand name for calcium gluconate

A

Calcinate

96
Q

Route for calcium gluconate admin

A

IV

97
Q

Classification for calcium gluconate

A

Electrolyte replacement
Calcium product

98
Q

*Use of calcium gluconate

A

*Treat hypermagnesemia secondary to magnesium sulfate treatment
*Antidote to magnesium sulfate (Prevents respiratory arrest)

99
Q

Side effects of calcium gluconate

A

Pain at IV site
N/V
Flushing
Hypotension
Arrhythmia

100
Q

Nursing responsibilities for calcium gluconate

A

Monitor VS
Monitor fetus
Monitor labs (Ca and Mg)

101
Q

Patient teaching for calcium gluconate

A

Prevent injuries - side rails up
Assist oob
Teach that this med given when levels of magnesium sulfate become too high in blood, which is more common in preeclampsia than PTL

102
Q

Brand name for Lebatalol

A

Trandate

103
Q

Route for Lebatalol

A

IV
PO
IM

104
Q

Classification for Lebatalol

A

Antihypertensive
Alpha and beta blocker

105
Q

Use for Lebatalol

A

Treatment of HTN during pregnancy
Reduces BP associated with preeclampsia/eclampsia and preserves uteroplacental blood flow
Produces decreases in BP without reflex tachycardia or significant reduction in HR through mixture of alpha and beta blocking effects

106
Q

Side effects of Lebatalol

A

Orthostatic hypotension
Flushing
Tremulosness
Minimal change in pulse rate

107
Q

Nursing responsibilities for Lebatalol

A

Monitor VS
Maintain BR in left lateral position with SR up
Continuous fetal monitoring
Contraindicated in pts with asthma, heart disease, or CHF

108
Q

Patient teaching for Lebatalol

A

Change positions slowly to prevent orthostatic hypotension
Explain need for BR and increased monitoring if in labor
Explain reason why receiving med and potential SE
If intrapartum - monitor BP, eat well, keep appointments

109
Q

Hydralazine brand name

A

Apresoline

110
Q

Route for Hydralazine

A

IV
IM
PO

111
Q

Classification of hydralazine

A

Antihypertensive
Vasodilator

112
Q

Use of hydralazine

A

Treatment of HTN r/t preeclampsia/eclampsia
Vasodilate arterioles in smooth muscle by direct relaxation
Reduces BP with reflex increases in HR, stroke volume, cardiac output

113
Q

Side effects of hydralazine

A

Flushing
Palpitations
Tachycardia
Hypotension
HA
Fetal effects: tachycardia, late decels, bradycardia if diastolic bp >90

114
Q

Nursing responsibilities for hydralazine

A

Monitor VS frequently
Monitor fetus
Higher doses are associated with maternal hypotension, HA, and fetal distress
Monitor I&O
Maintain BR in lateral position with SR up
Caution in the presence of tachycardia

115
Q

Patient teaching for hydralazine

A

Change positions slowly to prevent orthostatic hypotension
Inform pt of need for drug and frequent monitoring, bedrest and potential SE

116
Q

Brand name for betamethasone

A

Celestone Soluspan

117
Q

*Route for betamethasone

A

*IM two doses given 24 hours apart

118
Q

Classification of betamethasone

A

Corticosteroid

119
Q

*Use for betamethasone

A

*Acceleration of fetal lung maturity
Biochemical stimulation of surfactant production

120
Q

Side effects of betamethasone

A

Few due to short term use
Pulmonary edema possible secondary to sodium and fluid retention
HTN, hyperglycemia, decreased wound healing

121
Q

*Nursing responsibilities for betamethasone

A

Use between 24-32 weeks gestation
*Caution in patients with DM - hyperglycemia
PLTs and WBCs may rise temporarily (72 hrs)
Monitor I&O
Daily weights

122
Q

Patient teaching for betamethasone

A

Explain potential benefits of steroid admin to preterm neonate and that drug cannot prevent or lessen the severity of all complications of prematurity
Report CP, heaviness, or dyspnea

123
Q

Brand name for Tranexamic Acid

A

Lysteda

124
Q

Route for tranexamic acid

A

IV (PO forms available for less emergent situations)

125
Q

Classification of tranexamic acid

A

Anti Fibrinolytic agent / hemostatic agent

126
Q

Use of tranexamic acid

A

Treatment of PPH
Completely inhibits multiple plasminogen binding sites, decreasing plasmin formation and Fibrinolytic

127
Q

Side effects of tranexamic acid

A

HA
Abdominal pain
Musculoskeletal pain
N/V/D
Fatigue

128
Q

Nursing responsibilities for tranexamic acid

A

Monitor VS
Monitor fundus/lochia
Weight pads/linens
Discontinue tx if ocular changes occur
Monitor I&Os
Monitor lab results
Prepare for surgical procedures as needed

129
Q

Patient teaching for tranexamic acid

A

Explain why med is being given as well as need for frequent intervention (VS, fundal massage, etc.)
Provide comfort and reassurance as much as possible
Keep pt informed as hemorrhage treatment progresses

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