Labor & Delivery

Question 1

Terbutaline

Answer 1

Therapeutic Class: Selective Beta 2 adrenergic agonist

Indication: (vasodilation) rescue/relief + maintenance drug for wheezing, SOB, coughing caused by asthma

Action: Blocks Beta 2 receptors in resp. sys. = bronchodilation by inhibiting release of hypersensitivity reaction products from mast cells; ALSO works on beta 2 receptors that are in the uterus to slow/stop premature contractions

NC:
- *SE: shakiness, jittery, tachycardia, drowsy, sleep disturbances, HA/N/V, ↑ BP + BS, CNS overstim.
- *Assess HR, BP, EKG, BG
- Can be given PO, SC, inhaler 4-6 hr duration → more SE w/ PO d/t ↑ dosage
- *Monitor HR of mom + baby when used in labor - monitor FHR strips closely
- Teach proper inhaler use

Question 2

Magnesium-Sulfate

Answer 2

Therapeutic Class: electrolyte

Indication: (vasodilation) hypomagnesemia, torsade de point, pre-eclampsia, preterm labor, seizures, asthma exacerbations

Nursing Considerations:
- Monitor for hypermagnesemia - confusion, dizziness, hypotension, weakness, warm, flushed, decreased reflexes
- Give IV slowly

Question 3

Oxytocin

Answer 3

Therapeutic Class: hormones

Indication: induction of labor, PPH (post-partem hemorrhage)

Action: stimulates uterine smooth muscle causing it to contract

Nursing Considerations:
- Monitor contractions
- Monitor fetus
- Warn mother contractions will be more painful
- Monitor BP, HR, glucose, and K+