OB (5/10) Flashcards
s/e of terbutaline for tocolysis
- tachycardia
- increased blood glucose
__________________ is a tocolytic that relaxes vascular and bronchial smooth muscles
magnesium
use of magnesium in OB
- pre-eclampsia
- tocolysis
dose of magnesium for tocolysis or pre-eclampsia
4-6 gm IV bolus over 20 minutes
2-4 gm/hr infusion
if your pregnant pt is on magnesium, what blood level would be therapeutic
4-8 mg/dL
s/e of magnesium for tocolysis/pre-eclampsia
- hypotension
- flushing
- lightheaded
dose of nubain (nalbuphine)
10 mg IV/IM/SQ/PCA
_________________ is a opioid receptor agonist/antagonist used in OB. chemically related to naloxone and oxymorphone
nubain (nalbuphine)
what drug would you use to reverse the pruritus from epidural opioids but maintain the analgesia in pregnant mom
nubain (nalbuphine)
what drugs are opioid agonist/antagonists commonly used in OB
- nubain (nalbuphine)
- stadol (butorphanol)
dose of stadol (butorphanol)
0.5-2 mg q3-4 hours
dose of zofran for N/V in laboring mother
4 mg
dose of phenergen in laboring mother for N/V
12.5-25 mg IV q4-6 h
use of benadryl in OB
- pruritus
- cervical “swelling”
dose of benadryl in OB
12.5-50 mg
what is zyrtec used for in OB
for itching 2/2 neuraxial opioids
dose of zyrtec for itching in OB
10 mg
dose of phenylephrine for parturient
10-30 mcg
if mom is hypotensive, but has a HR of 60, what pressor would you use
ephedrine
if mom is hypotensive and has a HR of 120 what pressor would you use
phenylephrine
which pressor used in OB can compromise uterine blood flow
phenylephrine
how do you mix phenylephrine in the OB setting
- 10 mg/mL vial
- take 10 mL NS and 1 mg (0.1 mL) of drug
- = 100 mcg/mL
infusion dose of phenylephrine in OB
30 mcg/min
usual dose of ephedrine in OB
5-10 mg
how do you mix ephedrine for OB
- 50 mg/mL vial
- take 9 mL add 50 mg
- = 5 mg/mL
_______________ if used for hypotension in the mother will also cause increase in fetal HR
ephedrine
_________________ is the process of strong contractions that thin the cervix permitting passage of fetus through the birth canal
parturition
full term pregnancy
40 weeks +/- 2 weeks from LMP
true labor is defined as?
braxton hicks contractions that increase in strength and frequency into a regular pattern
T/F: true labor is always defined as amniotic membranes rupture spontaneous then contractions start to follow
false; while this can happen sometimes contractions begin and first and cause the membranes to rupture
gravida
number of pregnancies (delivered or not)
para
number of pregnancies delivered past 20 weeks
primigravida
a woman who is pregnant for the first time
multigravida (multiparous)
2+ pregnancies
grand maltip
5+ pregnancies
who is at higher risk of hemorrhage the primigravida or the multigravida
multigravida d/t uterus being “old and stretched out” so does not clamp down the way it should
what is the first stage of labor
begins with regular painful uterine contractions and ends with complete dilation of cervix
what is the pain pathway for the first stage of labor
uterocervical afferents pass through paracervical ganglion, hypogastric nerve, and lumbar sympathetic chain entering spinal cord in the T10 - L1 area
during the first stage of labor, you would want to ensure your epidural has coverage over what area
T10-L1
which stage of labor is described as “visceral pain”
first stage
______________ is described as the final phase of the first stage of labor
transition phase
the transition phase of labor is categorized when the cervix is _________ cm dilated
7-10
second stage of labor begins with ____________ and ends with ______________
complete dilation of cervix; birth of the baby
pain pathway for the second stage of labor
additional afferent innervate the cervix, vagina, perineum and pass througth the pudendal nerve at S2-S4 and are processed in the spinal cord
which stage of labor is described as “somatic pain”
second stage
third stage of labor begins with ___________ and ends with __________
birth of the baby; delivery of the placenta
you have given mom and epidural and it has been has been working wonderfully, suddenly she starts to call out and c/o pain and pressure in her bottom - what do you think is occuring
she has entered transition phase of labor,
should ask nurse to check cervix
what is normal fetal HR
110-160
fetal HR should have variability between __________ bpm
6-25
absence of fetal heart rate variability is associated with what?
fetal distress
