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Nursing 263 > OB Unit 3 > Flashcards

OB Unit 3 Flashcards

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0
Q

During the first stage latent phase

A
  • you assess the Mothers Heart rate, resp. rate and blood pressure every 30 to 60 minutes,
  • you check the mothers temp every 4 hours until the rupturing of the membranes then it is checked every 2 hours.
  • Check the fetal heart rate and pattern every 30 to 60 min.
  • Check uterine activity and vaginal show every 30 to 60 min.
  • Do a vaginal exam and check fetal station as needed to check progress
  • monitor I&O every 8 hours and check bladder distention
  • ## Mom should void every 2 hours
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1
Q

The first stage of labor and delivery is

A
  • the latent phase
  • the active stage
  • and the transition stage
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2
Q

During the first stage active phase

A
  • Check moms Heart rate, resp. rate, and blood pressure every 30-60 min.
  • Check moms temp every 4 hours until the rupture of the membrane and then check it every 2 hours
  • Check the fetal hart rate and pattern every 15-30 mins.
  • Check uterine activity and vaginal show every 15-30 mins.
  • Do a vaginal exam and check fetal station as needed to check progress
  • Monitor I&O every 8 hours and assess bladder distention.
  • Mom should coin every two hours
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3
Q

During the first stage Transition

A
  • Assess mothers HR, RR, And BP every 15-30 minutes
  • Assess fetal Heart rate and pattern every 15-30 min.
  • Check uterine activity and vaginal show every 10-15 mins.
  • Do a vaginal exam and check fetal station as needed to check progress
  • Monitor I&O every 8 hours and assess bladder distention
  • Mom should void every 2 hours
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4
Q

During the second stage of labor and delivery

A
  • Check the mothers HR, BP, RR every 5-30 minutes
  • Check moms temp every 2 hours until the rupture of the membrane then check it every 2 hours
  • Check fetal heart rate and pattern every 5-15 mins.
  • Assess every 5-15 minutes to assess contraction and bearing down effort
  • Do a vaginal exam and check fetal station at least every 30 min.
  • For I&O just check bladder distention
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5
Q

During the third stage of labor and delivery

A
  • monitor the mothers HR, BP, and RR every 15 minutes
  • FHR and pattern are not appl. at this point
  • Assess for signs of placental separation, and check the amount of bleeding
  • No more vaginal exam at this point
  • Don’t worry about I&O at this point
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6
Q

During the fourth stage of labor and delivery

A
  • Assess the mothers BP, RR, and HR every 15 minutes for the first hour; after 1 hour if it is within normal limits check once in the second hour.
  • Check her temp at the beginning and the end of the first hour
  • with the fetus you will assist with the APGARS and initiate neonatal transition care
  • assess bladder distention
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7
Q

With assessment

A
  • Remember that pain assessment, psychological assessment, and comfort measures are continuous.
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8
Q

Analgesic medication in labor includes

A
  • Meperidine (demerol)
  • Butorphanol (stadol)
  • Nalbuphine (Nubian)
  • Sublimaze (fentanyl)
  • Sufenta (sufentanil)
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9
Q

Meperidine (Demerol)

A
  • can give 50-100 mg IM or 25-50 mg IV q 3-4 hours
  • class/ action
  • *****opioiod agonist
  • **-effective analgesic, feeling of well-being, no amnesiac effect
  • **-may aid progress as cervical relaxation occurs
  • **-will halt labor contractions if given too early
  • Side effects
  • *****CNS depression
  • *****neonatal respiratory depression
  • *****decreases gastric emptying and increase nausea and vomiting
  • *****bladder and bowel elimination can be inhibited
  • *****bradycardia, tachycardia, hypotension
  • Nursing implications
  • *****avoid use when close to delivery(about 1 hour)
  • *****usually given between 4-7 cm
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10
Q

Butorphanol (stadol)

A
  • Class/Action
  • **opioid agonists-antagonists
  • **moderate to severe labor pain and postoperative after cesection
  • **mild maternal sedation
  • can give 1mg-4mg IM every 3-4 hours PRN, or 0.5mg-2mg IV every 3-4 hours PRN
  • Side effects
  • **No respiratory depression in women or neonate
  • **less N/V than opioid agonists
  • **confision, sedation, hallucinations, floating feeling, dizziness, sweating, difficulty with urination (retention, urgency)
  • Nursing implications
  • **check maternal history for drug abuse
  • **do not give to drug dependent women due to possible precipitation of sudden withdrawal response in women and baby
  • **encourage voiding every 2 hours
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11
Q

Nalbuphine (Nubian)

A
  • Class/Action
  • **opioid agonists-antagonists
  • **moderate to severe labor pain and postoperative after cesection
  • **mild maternal sedation
  • can give 1mg-4mg IM every 3-4 hours PRN, or 0.5mg-2mg IV every 3-4 hours PRN
  • Side effects
  • **No respiratory depression in women or neonate
  • **less N/V than opioid agonists
  • **confision, sedation, hallucinations, floating feeling, dizziness, sweating, difficulty with urination (retention, urgency)
  • Nursing implications
  • **check maternal history for drug abuse
  • **do not give to drug dependent women due to possible precipitation of sudden withdrawal response in women and baby
  • **encourage voiding every 2 hours
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12
Q

Sublimaze (fentanyl)

A
  • can be given as 50-100mg IM or 25-50mcg IV; 1 to 2 mcg with 0.125% bupivacaine at 8 to 10 ml/hr epidurally
  • class/action
  • ** short acting opioid agonists
  • **rapid action, short duration
  • **relieve moderate to severe pain and postoperative pain after cesection
  • Side effects
  • **FHR changes, hypotension, respiratory depression, dizziness, drowsiness, rash/pruritus, nausea/vomiting, and urinary retention
  • Nursing implications
  • **sufentanil use is increasing because it has more potent analgesic action and less crosses the placenta
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13
Q

Sufenta (sufentanil)

A
  • can give 10-15 mcg with 0.125% bupivacaine at 10 ml/hr epidurally
  • class/action
  • ** short acting opioid agonists
  • **rapid action, short duration
  • **relieve moderate to severe pain and postoperative pain after cesection
  • Side effects
  • **FHR changes, hypotension, respiratory depression, dizziness, drowsiness, rash/pruritus, nausea/vomiting, and urinary retention
  • Nursing implications
  • **sufentanil use is increasing because it has more potent analgesic action and less crosses the placenta
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14
Q

When giving analgesic medications during labor and delivery the nurse should

A
  • assess fetal heart rate, mothers vital signs, and cervical status prior to and after administration
  • give analgesics at peak of contraction so less medication will transfer to baby
  • assess for effectiveness/side effects
  • provide for safety, especially of LOC expected to be altered
  • Narcotic reversal
  • **Naloxone Hydrochloride (narcan); can be used for mom or neonate to reduce respiratory depression; mom 0.4-2mg IV/IM/subQ every 2-3 minutes up to 10mg; neonate 0.1 mg/kg/im/subQ every 2-3 minutes up to 3 doses
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15
Q

Types of Anesthesia in Labor and Delivery

A
  • Local
  • Regional: Pudenal block
  • Regional: Epidural block
  • Regional: Spinal block
  • General
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16
Q

Local Anestetics

A
  • Are injected into the perineum at the episiotomy site
  • **Inject 10-20 mL of 1% lidocaine into skin the SubQ region to be anesthetized
  • Time to be given
  • **Second stage of labor, immediately before delivery if no regional anesthesia
  • Action
  • **Anesthetizes local tissue for episiotomy and repair
  • **Rapid anesthesia
  • Adverse effects
  • *****Risk of hematoma
  • *****Risk of infection
  • Nursing Implications
  • **Monitor for:
  • *******Return of sensation to area
  • *******Increased swelling at site of injection
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17
Q

Regional: Pudenal block

A
  • Is an Anesthetic injected in the pudendal nerve (close to the ischial spines)
  • **Drug used: xylocaine
  • **Should be administered 10-20 minutes before perineal anesthesia is needed
  • Time to be given
  • *****Second stage of labor, prior to time of delivery
  • Action
  • *****Anesthetizes vulva, lower vagina and part of perineum for episiotomy and use of forceps or vacuum
  • *****Third stage for episiotomy or laceration repair
  • *****Rapid effect
  • Adverse effects
  • *****Risk of local anesthetic toxicity
  • *****Risk of hematoma
  • *****Risk of infection
  • *****Bearing-down reflex is lessened or lost completely
  • Nursing implications
  • **Monitor for:
  • **Return of sensation to area
  • **Increased swelling
  • **Signs and symptoms of infection
  • **Urinary retention
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18
Q

Regional: Epidural block

A
  • Is an Anesthetic injected in the epidural space (located outside the dura mater between the dura and spinal canal via an epidural catheter)
  • **Drugs used: xylocaine, marcaine, fentanyl
  • Time given
  • *****First stage and/or second stage of labor
  • Action
  • *****Can be used for both vaginal and cesarean births
  • *****Has the potential of 100% blockage of pain
  • *****Can be used with some opioids to allow walking during first stage of labor and effective pushing in second stage of labor
  • *****Rapid onset in minutes; lasts 60-90 minutes
  • *****Loss of pain perception for labor contractions and delivery
  • Adverse effects
  • *****Most common complication is hypotension
  • *****Other side effects include nausea, vomiting, pruritis, respiratory depression, alterations in FHR
  • *****Could slow labor if given too early; obliterates pushing feeling so second stage may be prolonged
  • Nursing implications
  • **Pre-anesthesia care:
  • **Obtain consent
  • **Check lab values-especially for bleeding or clotting abnormalities, platelet count
  • **IV fluid bolus with Normal Saline or Lactated Ringer’s (1500 cc’s)
  • **Ensure emergency equipment is available
  • **Do time-out procedure verification
  • **Post-procedure care:
  • **Monitor maternal VS and FHR every 5 minutes initially and after every re-bolus then every 15 min and manage hypotension or alterations in FHR
  • **Urinary retention is common and catheterization may be needed
  • **Assess pain and level of sensation and motor loss
  • **Position woman side-lying
  • **Assess for itching, nausea, vomiting, and headache and administer meds prn
  • **When catheter discontinued, note intact tip when removed
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19
Q

Regional: Spinal block

A
  • Is an Anesthetic injected in the subarachnoid space
    *****Drugs used: Xylocaine, Marcaine
  • Time Given
    ****Second stage of labor or for cesarean section
    Rapid acting (5-10 minutes) with 100% blockage of sensation and motor functioning below insertion site (nipple to feet).
  • Action
    ****Can last 1-3 hours depending on agent used
  • Adverse effects
    ****Adverse effects are similar to the epidural with the addition of a spinal headache.
  • Nursing implications
    **Before injection, VS and a 20-30 min FHR strip is obtained and evaluated
    **    Bolus of 500-1000 mL’s LR or NS, 15-30 min prior to injection
    **    Assist with maternal positioning for placement
    **Maternal BP, HR, RR, FHR evaluated q 5-10 minutes
    ***Must be coached when to push
    **    *Monitor site for leakage of spinal fluid or formation of hematoma
    **    Observe for headache
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20
Q

General anesthesia

A
  • Is the Use of IV injection and/or inhalation of anesthetic agents that render the woman unconscious
  • **Drug used: Thiopental; Nitrous oxide and oxygen mix 50:50
  • Time given
  • *****Used mainly in emergency cesarean birth
  • Action
  • **Rapid onset
  • **Rapid recovery
  • **ET intubation required
  • Adverse effects
  • *****Risk for fetal depression
  • *****Risk for uterine relaxation
  • *****Risk for maternal vomiting and aspiration
  • Nursing implications
  • *****Obtain consent
  • *****Ensure woman is NPO
  • *****IV with large-bore needle
  • *****Place indwelling urinary catheter
  • *****Administer meds to decrease gastric acidity (Tagamet, Zantac, Reglan)
  • *****Place wedge under hip to prevent vena cava syndrome
  • *****Assist with supportive care of newborn
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21
Q

Nursing summary for anesthesia

A

✓ Preload of IV fluids
✓ Preop meds before c/s
✓ Positioning during procedure of epidural and spinal anesthesia
✓ Displace uterus after procedure for better placental circulation
✓ Monitor VS according to hospital policy, usually q 15 minutes
✓ Repositioning for even block
✓ Bladder assessment and catheterization as needed
✓ Continued assessment of pain relief and communication with provider

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22
Q

Cardiovascular response to labor

A
  • Increase cardiac output
  • Increase BP (especially during UC)
  • Increased heart rate
  • Supine hypotensive syndrome
  • Stage 2 - Valsalva maneuver
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23
Q

Respiratory response to labor

A
  • Increased respiratory rate
  • Increased oxygen demand and consumption
  • Hyperventilation + fall in PaCO2 result in respiratory alkalosis
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24
Q

Gastrointestinal response to labor

A
  • Gastric motility decreased
  • Gastric emptying prolonged
  • Increased risk of aspiration with anesthesia
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25
Q

Body Temp response to labor

A
  • Slight elevation due to muscle activity
  • Temperature over 100.4 –sign of infection
  • Assess every 2 hours after rupture of membranes
  • Increase fluid loss from sweating and mouth-centered breathing
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26
Q

Fluid and electrolytes during labor

A
  • Diaphoresis

* Hyperventilation

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27
Q

Blood values during labor

A
  • Increased WBC (may be 15,000 or higher)
  • Increased fibrinogen
  • Decreased blood glucose
  • Slight proteinuria
28
Q

FETAL RESPONSE TO LABOR

A
  • Positive effects:
  • **Decrease respiratory tract secretions
  • Potential adverse effects:
  • **Decreased placental perfusion
  • **Hypoxia
29
Q

THE PASSAGE = PELVIS & BIRTH CANAL

A
  • Type/shape of pelvis
  • **Gynecoid (most common)
  • Ability of cervix to change
  • **Efface
  • **Dilate
  • Ability of vaginal canal and external opening of the vagina (introitus) to distend
30
Q

THE PASSENGER = FETUS & PLACENTA

A
  • Fetal head
  • Fetal attitude
  • Fetal lie
  • Fetal presentation
  • Fetal position
  • Placenta implantation site
31
Q

Fetal Position

A
  • Determines type of delivery
  • Affect nursing care given to patient
  • Abnormal positions may lead to difficult delivery
  • Can change up until “engagement” occurs
  • Ballotable
  • Determined by Leopold’s Maneuvers and ultrasound
32
Q

Relationship of passage and passenger

A
  • Engagement
  • *****Occurs when the largest diameter of fetus reaches or passes thru the pelvic inlet
  • *****In primigravida usually occurs 2 weeks before term
  • *****Multipara may occur several weeks before labor or during labor
  • *****Confirms the adequacy of the pelvic inlet (not midpelvis or outlet)
  • Station
  • *****Relationship of presenting part to an imaginary line drawn btw ischial spines of maternal pelvis
  • *****Narrowest diameter
  • *****Designated as “0” station
  • *****Higher than ischial spines - - number
  • *****Lower than ischial spines - + number
33
Q

The Powers

A
  • Primary force is uterine muscular contractions
  • **Begins in fundus where greatest concentration of muscle fibers are located
  • Causes dilation and effacement of cervix
  • Causes changes in station
  • Secondary force is use of abdominal muscles to “PUSH”
34
Q

THE POSITION (OF THE LABORING WOMAN)

A
  • Upright position recommended
  • **Walking, sitting, kneeling, or squatting
  • Lateral position when lying down
  • Encourage and allow mom to listen to her body cues
35
Q

Pre-Labor signs

A
  • Lightening
  • Braxton-Hicks Contractions
  • **Irregular, intermittent, painless
  • **Become painful as term approaches
  • **Described as “drawing” sensation
  • “Ripening “of cervix
  • Bloody show - pink tinged secretions from cervical capillaries
  • **Labor usually results in next several weeks
  • Burst of energy
  • Diarrhea, nausea and vomiting
  • Increased backache and sacroiliac pressure
  • **Result of hormones
  • 1 to 3 pound weight loss
  • **Result of fluid loss and electrolyte shift
36
Q

True Labor

A
  • Contractions regular
  • Interval btw UC gradually shorten
  • Increase in duration and intensity of UC
  • Discomfort begins in back and radiates to abdomen
  • Intensity increases with walking
  • PROGRESSIVE cervical dilation and effacement
37
Q

False Labor

A
  • Contractions irregular
  • No change in duration and intensity of UC
  • Discomfort usually in abdomen
  • Walking has no effect on contractions, or actually lessens severity of UC
  • NO CERVICAL CHANGE
38
Q

First stage of labor

A
  • from beginning of labor to complete dilation and effacement of cervix
  • Latent or early phase (0-3cm)
  • Active phase (4-7cm)
  • Transition phase (8-10cm)
39
Q

Interventions for first stage of labor

A

○ Complete Admission Assessment and Review History
○ Assessment: Maternal VS, Response to Labor and Pain, FHR and UC, Cervical Changes, Membrane Status, Fetal Position and Descent
○ Diet and Hydration: Clear Liquids
○ Activity and Rest: Frequent Position Changes/Ambulation
○ Elimination: Frequent Emptying
○ Comfort: Meds and Non-Pharmacologic Strategies
○ Support: Keep Family Involved
○ Education: About Labor, Procedures, Policies
○ Safety: Safe and Friendly Environment
○ Documentation

40
Q

Second stage of labor

A
  • begins with complete dilation of cervix and ends with birth of baby “PUSHING”
  • S&Sx = sudden increase in bloody show, uncontrolled bearing down efforts, bulging of the perineum
  • Crowning
  • Episiotomy
  • **Midline
  • **Mediolateral
41
Q

Interventions for 2nd stage of labor

A 
○ Support and Encourage Spontaneous Pushing Efforts
○ Monitor for Fetal Response to Pushing
○ Provide Comfort Measures
○ Position Changes as needed
○ Perineal Hygiene as needed
○ Give Praise and Encouragement
○ Encourage Rest between Contractions
○ Teach Breathing Technique
○ Teach Pushing Technique
○ Meds as ordered
○ Assist the Support Person
○ Advocate on Woman’s Behalf
○ Documentation
42
Q

Third stage of labor

A
  • begins with birth of the baby and ends with delivery of placenta
    – Should deliver within 30 minutes
    – Considered a “retained placenta” if greater than 30 mins.
    – May need to remove manually
43
Q

Interventions for 3rd stage of labor

A 
○ Maternal VS per protocol
○ Encourage Breathing
○ Encourage Rest
○ Encourage Bonding with Neonate
○ Meds as ordered
○ Documentation
44
Q

Fourth stage of labor

A
  • initial recovery time
  • First 1-2 hours after delivery of placenta
  • Expected amount of blood loss - 250 - 500 ml for vaginal delivery
  • Essential for uterus to remain contracted
  • Priority problems during this stage
  • Risk for hemorrhage
  • Risk for hypotonic bladder
45
Q

Interventions for 4th stage of labor

A

○ Maternal VS
○ Assess Uterus: Position, Tone, Location
○ Assess Lochia: Color, Amount, Clots
○ Monitor Perineum for Swelling or Hematomas
○ Meds as ordered
○ Assist with Laceration/Episiotomy Repair
○ Apply Ice to Perineum
○ Monitor for Bladder Distention
○ Assess for motor-sensory function return if spinal or epidural used
○ Encourage Bonding with Neonate
○ May Eat and Drink Immediately if Vaginal Delivery
○ Documentation

46
Q

Pain relief options for labor

A
  • Relaxation techniques
  • Cutaneous stimulation
  • Breathing techniques
  • Patient hygiene/comfort measures
  • Systemic analgesia
  • Pudendal block
  • Local anesthesia
  • Regional analgesia/anesthesia
  • General anesthesia
47
Q

Relaxation techniques include

A
  • Muscle tension causes fatigue and increased oxygen demands

* Comfortable position

48
Q

Cutaneous stimulation

A
  • Massage of large muscle groups stimulates gate-control theory
  • “Effleurage”
  • Heating pad / warm shower / bath
  • Counter-pressure to lower back
49
Q

Breathing techniques

A
  • A form of distraction
  • Enhances relaxation
  • Provides good O2 exchange
  • Teach slow deep breathing if no prenatal education
50
Q

Systemic analgesia

A
  • Nubain – drug of choice
  • Recommended to wait until labor established
  • IM, Subq, or IV
  • Should not be given within a few hrs of birth because it may depress neonatal respirations
51
Q

Pudendal block

A
  • provides perineal numbness

* Used during 2nd stage

52
Q

Local anesthesia

A
  • Used during 2nd stage to provide perineal numbness
53
Q

Regional analgesia/anesthesia

A
  • Epidural - major side effect - hypotension
  • *****Bolus of fluid prior to procedure, monitor BP q 5 mins after procedure, side-lying position, monitor for urinary retention
  • *****Used for labor and delivery
  • Spinal - major side effect - hypotension
  • *****Immediate effects
  • *****Used during 2nd stage
  • *****Tilt patient to side during C/S to lessen hypotensive effects
54
Q

General anesthesia

A
  • Only used in emergency situations!

* High risk of fetal depression

55
Q

assessment of laboring patient

A
  • Maternal assessment
    ** Review of prenatal history
    **    Identify risk factors
    **Maternal vital signs, labor status, uterine activity, fetal status and lab values
    **    Don’t forget assessment of pain and psychosocial status!!!
     Standard Precautions
56
Q

Fetal malposition/malpresentation

A
  • The Posterior position most common; brow, face, breech, shoulder presentations
  • Causes Labor length increased
  • Increased need for intervention
  • EXTERNAL VERSION MAY BE ATTEMPTED
  • **Usually attempt to turn the fetus from breech to cephalic presentation
  • **Significant risk of cord compression &/or entanglement
  • **NEVER do with multiple gestation
  • **Medicated with tocolytic (terbutaline) prior to procedure to relax uterus
57
Q

Amniofusion

A
  • Infusion of warmed, sterile fluid into the uterine cavity thru intrauterine catheter
  • Oligohydramnios, thick, meconium stained fluid, variable decelerations
  • Monitoring, comfort measures, peri-care, bedrest
58
Q

Induction of labor

A
  • Artificial stimulation of labor
  • NOT recommended to induce “electively” PRIOR to 39 weeks gestation
  • Reasons for induction
  • *****Medical condition of mother / fetus
  • *****Post-dates
  • *****Decreased amniotic fluid
  • *****Non-reassuring antenatal testing
  • *****Large infant
  • Assess
  • *****Position, presentation of fetus, gestation
  • *****The more “favorable” the cervix; the more likely the induction will be successful
59
Q

Types of induction

A
  • Amniotomy

- Pharmachological

60
Q

Amniotomy

A
  • Note color, odor, amount
61
Q

Pharmacological

A
  • Oxytocin major complication is tacky systole
  • **more than 5 contractions in10 min or less than 30 sec. rest period
  • **Risk of Abruptio placenta or uterine rupture
  • **Assess for signs of fetal distress
  • Cervical ripening agents
  • **PROSTAGLANDIN GEL – prepidil & cervidil
  • **MISOPROSTAL - cytotec
62
Q

Nursing responsibilities with induction

A
  • Monitor vital signs of mother
  • Monitor fetal response to contractions
  • **FHR baseline
  • **Variability
  • **Presence of decelerations
  • Monitor contraction pattern
  • Monitor intake and output
  • Major concern is tachysystole resulting in
  • **Fetal distress
  • **Uterine rupture
68
Q

Adjunct Medications

A
  • Promethazine (phenergan)
  • Hydroxyzine (vistaril)
  • Meroclopramide (reglan)
  • Ondansetron (zofran)
  • Diphenhydramine (Benadryl)
68
Q

Promethazine (phenergan)

A
  • Can give 50 mg in early labor; when labor is established, additional doses of 25–75 mg may be given 1–2 times at 4-hr intervals (should not exceed 100 mg/24 hr).
  • Class/Action
  • **Phenothiazines:
  • **Decrease anxiety and apprehension, increase sedation, reduce nausea and vomiting
68
Q

Hydroxyzine (vistaril)

A
  • Can give 25-100mg IM
  • Class/action
  • **Antihistamines:
  • ***Decrease anxiety and apprehension, increase sedation, reduce nausea and vomiting, potentiate opioid effects
68
Q

Meroclopramide (reglan)

A
  • Can give PO, IM, IV 10–15 mg 30 min before meals and at bedtime (not to exceed 0.5 mg/kg/day). A single dose of 20 mg may be given preventively. Some patients may respond to doses as small as 5 mg.
  • Class/Action
  • **Antiemetics:
  • ***Cause little sedation and can potentiate the effects of analgesics
  • ***Relieves N/V, and accelerates gastric emptying
68
Q

Ondansetron (zofran)

A
  • Can give IM, IV 4 mg before induction of anesthesia or postoperatively.
  • Class/Action
  • **antiemetics
  • *******Cause little sedation and can potentiate the effects of analgesics
  • *******Relieves N/V, and accelerates gastric emptying
68
Q

Diphenhydramine (Benadryl)

A
  • Can give IM / IV 25–50 mg q 4 hr as needed (may need up to 100-mg dose, not to exceed 400 mg/day).
  • Class/Action
  • *****Antiemetics
  • **Relieves N/V, mild sedation, decreases anxiety, relieves itching
  • **Alternative of local anesthetics in patients with history of hypersensitivity to local anesthetics

Nursing 263 (8 decks)

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