Med Quiz III Flashcards
clomiphene citrate: classification
ovarian stimulant
clomiphene citrate: indication
- female fertility in which estrogen levels are normal
clomiphene citrate: contraindications
- pregnancy
- liver disease
- abnormal bleeding of undetermined origin
- ovarian cysts
- neoplastic disease
- therapy is ineffective in women with ovarian or pituitary failure
clomiphene citrate: ADRs
- ovarian enlargement
- symptoms similar to PMS
- ovarian hyperstimulation syndrome
- multiple gestation
- visual disturbances
- abdominal distention
- discomfort
- n/v
- abnormal uterine bleeding
- breast tenderness
- insomnia, nervousness, HA< depression, fatigue, lightheadedness, dizziness
- hot flashes
- inc urinartion
- allergic symptoms
- dry cervical mucous
clomiphene citrate: nursing considerations
- take hx to determine if woman has a hx of liver dysfunction or abnormal uterine bleeding
- rule out possibility of pregnancy
- teach women to report abdominal distention, pain the pelvis, visual disturbances
- avoid tasks that require mental alertness or coordination b/c the drug can cause lightheadedness, dizziness, visual disturbances
- stop taking if suspect pregnancy
- teach that S/S of PMS may occur, but hese are temporary
hepatitis B vaccine: classification
vaccine
hepatitis B vaccine: indications
- prevention of hepatitis B in exposed and unexposed infants
hepatitis B vaccine: how is it given normally
- first dose: can be given before infant leaves hospital or at first neonatal appointment
- second dose: 1-2 mos
- third dose: 6-18 mos (at least 16 weeks after 2nd dose)
hepatitis B vaccine: how is it given is mother is hep B positive or has an unknown status
- give vaccine w/in 12 hours of birth
- give along with hepatitis B immune globulin
- follow normal course for the rest of the series
hepatitis B vaccine: contraindications
- hypersensitivity to yeast
hepatitis B vaccine: ADRs
- pain or redness at site
- fever
- fatigue
- HA
hepatitis B vaccine: nursing considerations
- if vial is used, shake the solution well before preparing
- give vaccine w/in 12 hours of birth to an infant of an infected mother
- do not give IV or ID
- obtain parental consent before administering
hepatitis B immune globulin (HBIG): classification
immune globulin
Hepatitis B Immune Globulin: indications
- prophylaxis for infants of hepatitis B surface antigen positive mothers
hepatitis B immune globulin: contraindications
none known
hepatitis B immune globulin: ADRs
- pain and tenderness at the site
- urticaria
- anaphylaxis
hepatitis B immune globulin: nursing considerations
- do not shake or give IV
- hepatitis vaccine series should begin w/in 12 hours of birth
- give injection of vaccine and immune globulin at separate sites
vitamin K (phytonadione): classification
- fat soluble vitamin
- antihemorrhagic
vitamin K: indication
- prevention or tx of vitamin K deficiency bleeding (hemorrhagic disease of the newborn)
vitamin K: ADRs
- erythema, pain, and edema at injection site
- anaphylaxis
- hemolysis
- hyperbilirubinemia, especially in a preterm infant or when a large dose is used
vitamin K: nursing considerations
- protect drug from light until just before administration to prevent decomposition and loss of potency
- observe all infants for signs of vitamin K deficiency (ecchymoses or bleeding from any site)
- check that the infant has vitamin K before circumcision
erythromycin ophthalmic ointment: classification
antibiotic
erythromycin ophthalmic ointment: indications
- prophylaxis against gonorrhea
- helps prevent ophthalmia neonatorium in infants of mothers infected with gonorrhea
- required by law for all infants, even if mother is not known to be infected
erythromycin ophthalmic ointment: ADRs
- burning, itching, irritation may result in chemical conjunctivitis lasting 24-48 hours
- may cause temporary blurred vision
erythromycin ophthalmic ointment: nursing considerations
- do not rinse
- ointment may be wiped from outer eye after 1 minute
- observe for irritation
pertussis vaccine: classification
vaccine
pertussis vaccine: indication
- recommended for all adults in contact with infants to prevent whopping cough in the infants
- may be offered to women during pregnancy or before hospital discharge after childbirth
- usually given with tetanus and diptheria vaccines (Tdap)
pertussis vaccine: ADRs
- Abdominal pain,
- arthralgia,
- chills,
- diarrhea,
- fatigue,
- headache,
- myalgia,
- n/v
- pain at injection site
pertussis vaccine: contraindications
- anaphylactic rxn after a previous dose of Tdap vaccine
pertussis vaccine: nursing considerations
- administer IM
- preferably given during weeks 27-36 gestation
rubella vaccine: classification
attentuated live virus vaccine
rubella vaccine: indications for childbearing women
- administered at least 28 days before pregnancy or after childbirth/abortion to women whose antibody screen shows they are not immune to rubella
- prevents rubella infection and possible severe congenital defects in the fetus during a subsequent pregnancy
rubella vaccine: contraindications
- women who are: immunosuppressed, pregnant, sensitive to vaccine components, or have severe illness
- should be tested for immune status at 6-8 weeks to be sure that they are immune
rubella vaccine: ADRs
- transient stinging at site
- fever
- lymphadenopathy
- arthralgia
- transient arthritis
rubella vaccine: nursing considerations
- vials should be refridgerated
- reconstitute only w/ diluent dupplied w/ vial
- use immediately after reconstitution and discard if not used w/in 8 hours
- protect from light
- check with HCP before giving near time of administration of RhoGAM
- avoid pregnancy for at least 28 days (4 weeks) after vaccination
Rho(D) Immune Globulin: classification
- concentrated immunoglobulins directed toward the RBC antigen Rho(D)
Rho(D) Immune Globulin: indications
- administered to Rh-negative women who have been exposed to Rh-positive blood by doing the following:
- delivering an Rh-positive infant
- aborting an Rh-positive infant
- undergoing chorionic villous sampling, amniocentesis, or intraabdominal trauma while carrying an Rh-positive infant
- receiving inadvertent transfusion of Rh-positive blood
Rho(D) Immune Globulin: contraindications
- women who are Rh-positive or who were previously sensitized to Rho(D) should not receive
Rho(D) Immune Globulin: ADRs
- local pain at IM site
- fever
Rho(D) Immune Globulin: Nursing considerations
- administer w/in 72 of childbirth
- type and antibody screening of the mother’s blood and cord blood type of the newborn to determine need for the medication
- the mother must be Rh-neg and negative for Rh antibodies
- the newborn must be Rh positive
- if fetal blood type after termination is unknown, the medication should be administered
- newborn may have a weakly positive antibody test if the woman received Rho(D) Immune Globulin during pregnancy
- administer IM in the deltoid
varicella vaccine: classification
live vaccine
varicella vaccine: indication
- chickenpox in pregnant women can cause infection and complications in the fetus/newborn
- recommended that women who are not immune to varicella should receive the first dose of varicella vaccine after delivery and before discharge
- do not become pregnant for 1 month after receiving vaccine
varicella vaccine: contraindications
- anaphylactic rxn after previous dose
- immunosuppression
- pregnancy
varicella vaccine: ADRs
- Fever,
- pain at injection site.
- Immunosuppression may ↓ antibody response to injection and ↑ the risk of viral transmission
varicella vaccine: nursing considerations
- should not become pregnant for 1 month after receiving vaccine
- administer subQ
Sweet Ease: classification
sucrose analgesia
Sweet Ease: indication
- used to decrease pain during painful or stressful procedures
- heel stick, venipuncture, IV insertion, injections, eye exams, suturing, circumcisions
- can decrease crying, grimacing, HR and pain
Sweet Ease: contraindications
- less than 32 weeks gestation
- critical illness
- confirmed or suspected GI pathology for necrotizing enterocolitis, cardiac lesions, hx of asphixia, feeding intolerance, lack of bowel sounds
- preop sedated patients
- paralyzed infants
Sweet Ease: ADRs
- slight transient desauration
- hyperglycemia
- gagging, choking
Sweet Ease: nursing considerations
- analgesic effects of sucrose can be maximized if given with a pacifier
- do not give if less than 32 weeks gestation
- only give PO: should receive no more than 1 mL/day
- if given for circumcision, patient should also receive other forms of pain relief
