Medications Flashcards

1
Q

morphine sulfate

A
  • opioid
  • s/e resp depression
  • cautious in 2nd stage
  • used during labor
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2
Q

butorphanol

A

opioid agonist-antagonist

  • 2-4mg IM, .5-2mg IV
  • s/e no resp depress in mom + bb
  • dont give to drug dependent woman>possible suddent withdrawal of bb or mom
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3
Q

nalbuphine (Nubain)

A

opioid agonist-antagonist

  • 10mg IM or IV
  • s/e no resp depress in mom + bb
  • dont give to drug dependent woman>possible suddent withdrawal of bb or mom
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4
Q

sublimaze (Fentanyl)

A

short acting opioid

  • 50-100 mg IM, 25-50 mg IM
  • s/e cross placent, synth opioid, FHR changes, hypotension, mom/bb CNS depress, resp depress
  • monitor s/e like sedation, n/v, itch, resp effort
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5
Q

local anesthesia used during labor is given during ____ for ____but puts mom at risk for _____ so monitor _____

A

> 2nd stage of labor or immediately before delivery
anesthesize episiotomy/repair
risk for hematoma/infection
monitor returnof sensation or incr swellign at injection site

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6
Q

pudendal block

A

anesthetic injected to pudendal nerve close to ischial spine via trumpet needle

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7
Q

pudendal block is admin during ____ for ____

A

2nd stage or before labor

>to anesthesize vulva, lower vagina, part of perineum, or to use low forceps

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8
Q

pudendal block risks + nursing implicaitons

A

toxicity, hematoma, infection

monitor for retun of sensation, s/s infection, urinary retension

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9
Q

epidural block

A

anesthetic injected to epidural space

  • outside of dura bw dura + spinal canal
  • bw 4th -5th vertebrae

via epidural catheter

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10
Q

when is epidural given

A

1st or 2nd stage of labor

  • for both vaginal + c section
  • potl for 100% block of pain
  • can be used w opioids like sublimaze to allow walking + effective pushing
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11
Q

epidural adverse effects

A

hypotension is most common

  • n/v
  • pruritis
  • resp depress
  • alt FHR
  • decr mom hypervent
  • reduced sweat
  • alt thermoregulatory
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12
Q

pre-epidural care

A

-assess pain lvl
-contact HCP is epidural is requested
-assess/doc baseline VS
-assess/confirm norm FHR
obtain consent
-check lab val esp bleeding/clotting
-IV bolus w norm saline or lactated ringer
-ensure emergency equipment is available
do time-out procedure verification

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13
Q

walking epidural

A

combined spinal epidural analgesia

-injection into subarachnoid space

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14
Q

do nurses manage the care of pt receiving epidural?

A

no, they can monitor, but DO NOT MANAGE

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15
Q

actions OUTSIDE of nursing scope re epidural

A
  • managing care
  • dosing, cont infusion
  • insertion, injection, manage rate changes
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16
Q

responsibilities of nurses caring for epidural pt

A
  • monitor stable VS, mobility, LOC, pain perception, fetal status
  • assess, monitor + intervene
17
Q

during epidural care

A

-assist anesthesia provider w placement of pt in lateral position w head flexed towards chin or sitting w head flexed + elbows on knees

18
Q

nursing care after epidural

A
  • VS + FHR Q5-15min
  • assess hypotension or resp depress
  • assess level of motor blockage
  • monitor for s/s of intravascular injection
19
Q

s/s of intravascular injection

A
  • occurs during placement
  • tachy/bradycardia
  • HTN
  • dizzy
  • tinnitus
  • metallic taste
  • loss of consciousness
20
Q

folic acid for chilbearing age

A

0.4-0.8 mg

21
Q

folic acid for pregnancy W/O hx of NTD

A

0.6 mg

22
Q

folic acid for women w hx of NTD

A

4mg for 1st month,

>then .4mg

23
Q

prenatal vitamins

A
  • calcium
  • magnesium
  • vitamin D
  • iron
24
Q

terbutaline indication + MOA

A
  • decr UC + delay delivery

- beta adrenergic agonist> relax smooth muscles

25
Q

terbutaline CI + SE

A

CI: arrythmia, pulmo edema, MI, hypotn

SE: tremor, tachy, anxiety

26
Q

procardia inidcation + MOA

A
  • decr UC

- blcks Ca fr entering smooth muscle> relaxed uterus

27
Q

procardia CI + SE

A

CI: cardiac disease, renal disease, hypotension

SE: headache, flushing, dizzy

28
Q

oxytocin indication + MOA

A

-prevent PPH after placental expulsion, mgmt of 3rd stage labor

MOA: stim UC

29
Q

methergine indication + MOA

A
  • prevent PPH; for uterine atony

- ergot alkaloid act on smooth muscles to stimulate contraction

30
Q

methergine CI

A

HTN, heart problems

31
Q

hemabate indication + MOA

A

for uterine atony

-prostaglandin> stim smooth muscle contraction

32
Q

hemabate CI

A

asthma