Postpartum Flashcards
Non-steroidal Anti-inflammatory Drug (NSAID), Analgesic
•Acts peripherally to prevent prostaglandin formation in inflamed tissue by inhibiting stimulation of pain receptors and inflammation and on the hypothalamus to increase peripheral blood flow, vasodilation which results in fever reduction
•Indication: Relief of moderate pain (cramping), fever and inflammation
•Metabolism: Renal
Ibuprofen (motrin)
- Severe fatigue, Dizziness
- GI distress, heartburn, GI ulcers, Renal toxicity
- Platelet inhibition with higher doses
- Nursing Actions:
- Assess Platelet level, s/s of excessive bleeding
- Maintain modified fall precautions
- Assess ability to care for neonate
- Patient teaching:
- Take with meals to decrease GI irritation
- Take a nap when tired
Ibuprofen (motrin) 2
- pain (analgesic)
- inflammation
- antipyretic
indications for motrin
- Sedation, Dizziness, Orthostatic hypotension, Respiratory Depression, Dependence
- GI distress, heartburn, Constipation, Hepatic toxicity
Acetaminophen with codeine (T3)
- Nursing Actions:
- Do not exceed 4000 mg of acetaminophen in 24 hours (beware of all medications)
- Maintain modified fall precautions
- Assess ability to care for neonate
- Patient teaching:
- Take with meals to decrease GI irritation
- Take a nap when tired
Acetaminophen with codeine (T3)
Opioid agonist analgesic more potent and addicting than codeine
• Acts as a weak agonist at mu, kappa, and delta opioid receptors within the central nervous
system (CNS
• Indication: Relief of moderate to severe pain
• Metabolism: Hepatic
Oxycodone with APAP (Percocet)
- Adverse Effects:
- Sedation, Dizziness, Tachycardia, Respiratory Depression, Dependence
- GI distress, Constipation, Pruritus & Urticaria, Diaphoresis
- Nursing Actions:
- Assess LOC, Respiratory and GI system closely
- Maintain modified fall precautions
- Assess ability to care for neonate
- Patient teaching:
- Take with meals to decrease GI irritation
- Take a nap when tired
Oxycodone with APAP (Percocet) 2
- Drug class: opioid analgesic
- It interacts with an opiate receptor sites in the CNS for analgesia and sedation
- Metabolism: Hepatic
- Adverse Effects:
- Sedation/dizziness, confusion,
- Respiratory & Cardiac Depression
- N&V, constipation, dry mouth
- Narcotic intolerance and dependence
Morphine sulfate
- Nursing Actions:
- Monitor CNS, cardiac and respiratory status closely
- Administer slowly over at least 4-5 minutes usually into running IV or via PCA
- Initiate modified fall precautions
- Assess ability to care for neonate
- Patient teaching:
- Pain relief lasts approximately 5-6
morphine sulfate
Drug class: Antipyretic, Non-opioid analgesic, NSAID
• Inhibits prostaglandins and leukotriene synthesis
• Indications: Short term management of pain
• Metabolism: Hepatic and excreted Renally
Adverse Effects:
• Severe fatigue, Dizziness
• GI distress, heartburn, GI ulcers, Renal toxicity
• Platelet inhibition with higher doses
Ketorolac (Toradol)
Nursing Actions:
• Assess Platelet level, s/s of excessive bleeding
• Maintain modified fall precautions
• Assess ability to care for neonate
• Patient teaching:
• Take with meals to decrease GI irritation
• Take a nap when tired
-Give to post op patients when they are NPO
-For cramping and afterbirth contractions
Ketorolac (Toradol) 2
Local anesthetic
• Binds to sodium channels and reversibly stabilizes the neuronal membrane which
decreases its permeability to sodium ions. Depolarization of the neuronal membrane is
inhibited thereby blocking the initiation and conduction of nerve impulses.
• Indication: Relief of moderate pain
• Metabolism: Excreted in Urine
Benzocaine (Dermoplast)
- Adverse Effects:
- Hypersensitivity reaction (rash, pruritus and breathing difficulty
- Nursing Actions:
- Teach proper perineal care
- Patient teaching:
- It may sting slightly
Benzocaine (Dermoplast) 2
Drug class: Moisturizing Ointment
• Inhibits prostaglandins and leukotriene synthesis
• Indications: Treats and prevents sore and cracked nipples caused by breast-feeding.
Lanolin Cream (Lanisonoh)
• Allergic reaction: hives; difficult breathing; swelling of face, lips, tongue, or throat.
Nursing Actions:
• Assess for an allergies to medication prior to use
• Patient teaching:
• Does not harm nursing infant
• Apply after nursing session or bathing
• Avoid getting in eyes
Lanolin Cream (Lanisonoh) 2
Saline Cathartic Laxative
• Osmotic force of the magnesia suspension acts to draw fluids from the body and to retain those
already within the lumen of the intestine, serving to distend the bowel, thus stimulating nerves
within the colon wall, inducing peristalsis and resulting in evacuation of colonic contents.
• Indication: Constipation, antacid
• Metabolism: Intestinal microflora
Milk of Mag (MOM, Mag Hydroxide)
Postpartum constipation
Adverse Effects:
• GI distress, flatulence, dehydration, electrolyte imbalance (leads to cardiac arrhythmias), dependence
Nursing Actions:
• May reduce intestinal transit time and may decrease absorption of orally administered
medications
• Assess abdomen for pain, distention, bowel sounds, I&O
• Assess heart sounds
• Patient teaching:
• For short term use only
• Take at bedtime
Milk of Mag (MOM, Mag Hydroxide)
Postpartum constipation
Produce a modified infection and stimulate and active immune reaction with antibodies
to these viruses
• Indication: Illness prevention (given to mothers not immune or equivocal to rubella)
measles mumps rubella (MMR)
Adverse Effects:
• Moderate fever, rash, burning at injection site
Nursing Actions:
• SC injection
• Do not administer to patients with history of anaphylactic hypersensitivity to
neomycin, immune deficient conditions, pregnant or sensitivity to eggs/chickens
measles mumps rubella (MMR) 2
• Pregnant women should not get MMR vaccine. Pregnant women who need the vaccine should wait until after giving birth. Women should avoid getting pregnant for 4 weeks after vaccination with MMR vaccine.
• Anyone who had a life-threatening allergic reaction to a previous dose of MMR or
MMRV vaccine should not get another dose.
measles mumps rubella (MMR) 3
Produce a modified infection and stimulate and active immune reaction with antibodies to these
viruses
• Indication: Illness prevention (prevention of neonate exposure to diphtheria)
TdaP (Tetanus/Diphtheria and pertussis) (Adacel)
- Adverse Effects:
- Redness, rash, burning at injection site, fretfulness, drowsiness
- Nursing Actions:
- IM injection
- Wait 5 years from last booster
- Patient teaching:
- Comfort measures to provide include analgesics, warm soaks at injection site, small meals
TdaP (Tetanus/Diphtheria and pertussis) (Adacel) 2
Vaccine (Infant)
• Provides antigenic hepatitis B vaccine to stimulate an immunologic response in
children, leading to an active immunity against the disease.
• Indication: Illness prevention
Hepatitis B (Hep B)
• Adverse Effects: • Redness, rash, burning at injection site, fretfulness, drowsiness • Nursing Actions: • IM injection • Given only if mother is HBsAG negative • Patient teaching: • Comfort measures to provide include analgesics, warm soaks at injection site
Hepatitis B (Hep b) 2
Provides antigenic influenza vaccine to stimulate an immunologic response leading to an
active immunity against the disease.
• Indication: Illness prevention
Influenza (Flu) Vaccine (Inactivated)
• Adverse Effects:
• Redness, rash, burning at injection site, swelling, itching
• Hoarseness, sore, red or itchy eyes, cough, fever, aches, headache, fatigue
• Nursing Actions:
• IM injection
• Live (intra-nasal) contraindicated if pregnant, history of asthma, egg allergies or weak
immune system
Influenza (Flu) Vaccine (Inactivated) 2
• Patient teaching:
• Comfort measures to provide include analgesics, warm soaks at injection site, small
meals
• Inactivated flu vaccine does not contain live flu virus, so patients cannot get the flu from
this vaccine.
Influenza (Flu) Vaccine (Inactivated) 3
Macrolide antibiotic
• Binds to cell membrane causing a change in protein function leading to cell
death
Use to combat infection, like chlamydia
• Indication: Prophylaxis of ophthalmia neonatorum caused by N. gonorrhoeae
or C. trachomatis
• Metabolism: Hepatic
Erythromycin ointment
infant meds
- Adverse Effects:
- Edema, urticaria, burning at site
- Nursing Actions:
- Avoid touching eye with applicator
- Apply from inner canthus to outer
- Patient teaching:
- Blurriness lasts only brief time
Erythromycin ointment
infant meds 2
Necessary for the production via the liver of active prothrombin (factor II),
proconvertin (factor VII), plasma thromboplastin component (factor IX), and Stuart
factor (factor X)
• Indication: Prevention of Hemorrhagic Disease of the Newborn (HDNB)
• Metabolism: Absorbed from the GI tract
Vitamin K (Phytonadione)
Adverse Effects: • Pain, swelling, and tenderness at the injection site • Hyperbilirubinemia (rare) • Nursing Actions: • IM injection Patient teaching: • The American Academy of Pediatrics recommends that a single dose be given within one hour of birth.
Vitamin K (Phytonadione) 2