PP Medications Flashcards
Use of pitocin
PPH
Route of pitocin for PPH
IV bolus
IM injection
Actions of pitocin
Control PP bleeding
Stimulates uterine smooth muscle causing uterine contractions
Vasoactive and antidiuretic properties
Side effects of pitocin
Water intoxication
Nursing responsibilities for pitocin
Monitor uterine height, tone, and deviation
Monitor lochia flow
Monitor vital signs
Patient teaching for pitocin
Report boggy uterus or increase in lochia flow
Teach pt to massage their fundus
Use of methergine
Treat or prevent PPH caused by uterine atony or subinvolution
Preferred route of methergine
IM for rapid absorption
Action of methergine
Stimulates sustained contractions of uterus and causes arterial vasoconstriction
Side effects of methergine
*Hypertension
N/V
Uterine cramping
Dyspnea
Dysrhythmias
Nursing responsibilities for methergine
Caution in pts with HTN and cardiac disease
*Caution pts to avoid smoking b/c nicotine cause vasoconstriction
Monitor BP/VS. Check BP prior to each dose
*Monitor fundus and lochia
Patient teaching for methergine
*Avoid smoking because nicotine constricts vessels
Abdominal cramps are normal SE
Notify prescriber if you have chest pain, N/V, HA, muscle pain, weakness, cold, numb extremities
Teach Pt to massage fundus
Use of Mylicon (Simethicone)
Antiflatulent
Relieves pressure, bloating, and gas
Causes coalescence of gas bubbles, but does not prevent the formation of gas
Route for mylicon (Simethicone)
PO
Side effects of Mylicon (Simethicone)
Diarrhea
Nausea
Belching
Nursing responsibilities for mylicon (Simethicone)
Assess for abdominal pain, distention, and BS prior to administration and throughout course of therapy
Administer after meals and at bedtime for best results
**Instruct pt to chew tablets
Patient teaching for mylicon (Simethicone)
Diet and exercise important in prevention of gas
This med does not prevent the formation of gas
*Tablets must be chewed
Route for RhoGam
Deep IM
Use of RhoGam
*Prevent Rh sensitization in Rh negative moms who deliver Rh positive infants
*Also given at 28 weeks prophylactically
Action of RhoGam
Suppresses immune non sensitized Rho negative patients exposed to Rh positive blood
Prevents antibody response preventing hemolytic disease of newborns in future pregnancies
Side effects of RhoGam
Pain at injection site
Fever
Myalgia
Lethargy
HA
Nursing responsibilities for RhoGam
Obtain type and antibody screen of mother’s blood and neonate’s cord blood
Mom must be Rh negative and infant Rh positive
Assess for allergies, previous administration of this product
Assess for reaction after administration
Patient teaching for RhoGam
This med must be given after subsequent deliveries if the babies are Rh positive
Immediately report signs of intravascular hemolysis
Medication is made from human plasma (consideration for Jehovah’s Witness)
Educate mother on why med is given and importance
Symptoms of intravascular hemolysis
Shaking
Fever
Chills
Dark urine
Swelling of hands or feet
Back pain
SOB
Name of rubella virus vaccine
Meruvax II
Route for Meruvax II
SQ
Side effects of Meruvax II
Transient stinging at site
Fever
Arthralgia
Transient arthritis
Lymphadenopathy
Nursing responsibilities for Meruvax II
Refrigerate vials
Reconstitute with diluent supplied with vial
Use immediately after reconstitution (discard if not used in 8 hrs)
Protect from light
*Obtain informed consent
Who is the Meruvax II vaccination contraindicated for?
Immunosuppressed
Pregnant
Sensitive to vaccine component
Severe illness
Patient teaching for Meruvax II
Live virus may appear in breast milk causing rash in infant
Vaccine given to prevent acquiring rubella in subsequent pregnancies which can cause serious fetal anomalies
*Must practice contraception to prevent pregnancy for 1 month after being vaccinated
Give within 28 days before pregnancy or after childbirth
Route for Tdap
IM
Deltoid preferred for adults
Use of Tdap
Prevent diphtheria, tetanus, and pertussis
Side effects of Tdap
Local pain
Swelling or erythema at injection site
Fever
HA
Syncope
Myalgias
Nursing repsonsibilities for Tdap
Shake well
Give to pt while seated or lying down to decrease syncope
DO NOT mix with other vaccinations
Encourage adult family members who will be around baby to be vaccinated
Assess injection site for reaction
Pregnant women should be vaccinated during the second or third trimester or after childbirth with each pregnancy
Patient teaching for Tdap
Sit or lie down until syncope or dizziness has subsided to prevent falls
Vaccine is to prevent you from getting tetanus, diphtheria, and pertussis and is safe during pregnancy
Recommended to be given at 27-36 weeks gestation
Can also be given after delivery
Not a live virus
What is lanolin used for?
Topical skin protectant/conditioner for sore or cracked nipples due to breastfeeding
Side effects of lanolin
Burning
Stinging
Redness
Irritation
Nursing responsibilities for lanolin
*Assess for wool allergy
Monitor patient’s breast for signs of irritation from medication
Assist with application when needed
Patient teaching for lanolin
*Apply after nursing, no need to wipe off after baby feeds
Do not use if you have wool allergy
Safe for baby
What is Americaine Spray (Benzocaine) used for?
Topical local anesthetic
Used for PP perineal care
(Episiotomy and hemorrhoidal pain)
Side effects of Americaine (Benzocaine)
Localized burning or stinging
Rash
Pruritus
Local edema
Hypersensitivity
Nursing responsibilities for Americaine (Benzocaine)
Assess pain prior to administration
Assess for infection
Evaluate episiotomy site, hemorrhoids
Encourage fluids, fiber, ambulation, and stool softeners
Patient teaching for Americaine (Benzocaine)
Avoid contact with eyes
Use only for one week
May stain clothing
Don’t breathe in spray
Hold nozzle 6-12 inches from treatment area
Medication may feel cold when sprayed on perineum
What are tucks pads?
Topical pads with witch hazel
Topical anesthetic and antihemorrhoidal agent
Use of Tucks
Perineal pain reduction
Temporary management of hemorrhoidal burning and itching
Helps treat perianal surgical wounds and episiotomies
Decreases swelling and Pruritus
Provides protectant barrier over hemorrhoids
Prevents drying of tissues
Shrinks swollen tissue
Blocks pain signals from nerve endings in the skin
Side effects of tucks
Contact dermatitis (rash, erythema, itching and swelling)
Dryness
Adverse reaction
Nursing responsibilities for tucks pads
Assess for allergic reaction
Do not use internally
Assess for pain or irritation after use
Patient teaching for tucks pads
Use medication after urination or defecation up to 6 times per day
You may flush pad after use
For external use only
Wash hands after use
Route for Percocet
PO
Classification of Percocet
Opiate analgesic
Controlled substance schedule II
Max dose of acetaminophen
4000 mg/day
What is in Percocet?
Oxycodone (1.5-10 mg)
Acetaminophen (325 mg)
Side effects of Percocet
Sedation
*Constipation
N/V
Dizziness
Pruritus
Nursing responsibilities for Percocet
Max acetaminophen 4000mg/day
Obtain pain assessment prior to and after administration
*Assess for constipation and address prevention
Increase fluid intake and dietary fiber (stimulant laxative may be needed)
Assess for CNS changes
Give with food
Patient teaching for Percocet
Avoid getting up without assistance
Change positions slowly to avoid orthostatic hypotension
Max acetaminophen dose = 4000mg/day
Don’t drive while taking this med
Review SE of drug: CNS depression, drowsiness, sedation, constipation
Avoid other CNS depressants for at least 24 hr after last dose (alcohol, sedatives/hypnotics)
What is in Lortab?
Hydrocodone (2.5-10mg)
Acetaminophen
Route for Lortab
PO
Classification of Lortab
Opioid analgesic
Schedule III
Use of Lortab
Mild to moderate pain
Side effects of Lortab
CNS depression
*Constipation
N/V
Dizziness
Pruritus
Nursing responsibilities for Lortab
Obtain pain assessment prior to giving med and after
Monitor VS and CNS changes
Monitor bowel status (*Med cause constipation so RN should address prevention)
Give fluids, fiber, and laxatives as needed
Max 4000mg/day of acetaminophen
Patient teaching for Lortab
Avoid other CNS depressants for at least 24 hrs after last dose
Avoid getting up without assistance
Change positions slowly
Do not drive while taking med
Review SE of drug - drowsiness, sedation, constipation
Route for ibuprofen
PO
IV
Use of ibuprofen
Mild to moderate pain
Anti inflammatory
Antipyretic
Side effects of ibuprofen
Dyspepsia
Nausea
Fluid retention
GI bleeding
Elevated liver enzymes
Nursing responsibilities for ibuprofen
Max dose = 3200mg/day
Assess for pain prior to and after giving med
Assess for infection
Give with food
Monitor for fluid retention
Monitor liver and renal function tests if on long term therapy
I&O
Assess history of peptic ulcer disorder
Patient teaching for ibuprofen
Daily max = 3200mg/day
Take with food
Report new or worsening dyspepsia, fluid retention or signs of bleeding (increased bruising, blood in stools or urine)
Use of Toradol
NSAID
Non-opioid mild to moderate pain relief
Relieves inflammation
Route for Toradol
PO
IM
IV
Side effects of Toradol
Dyspepsia
Fluid retention
Pruritus/rash
Edema
Hypertension
Nursing responsibilities for Toradol
Assess pain prior and after administration
*DO NOT administer with other NSAIDS
Assess for dyspepsia and GI bleeding
Assess for edema
Patient teaching for Toradol
*DO NOT take with other NSAIDS
Take with full glass of water
Report bleeding
May cause drowsiness or dizziness
Caution with driving
Classification of Roxicodine (oxycodone)
Opioid analgesic
Schedule II
Route for oxycodone
PO
Side effects of oxycodone
Respiratory depression
Nausea
Constipation
Pruritus
Hypotension
CNS changes
Nursing responsibilities for oxycodone
Caution in combination with other sedating meds (Benzo’s opioids)
Assess pain prior to and after giving medication
Monitor VS and CNS changes prior to additional doses
Med can cause constipation - RN should address preventions (give fluids, fiber, and laxative as needed)
Generic name for Colace
Docusate sodium
Route for Colace
PO
PR
Use of Colace
Stool softener
for easy passage of stool without great effort of pushing
To prevent constipation
Increases water and fat penetration time in intestine
Side effects of Colace
Cramps
Diarrhea
Throat irritation
Rash
Electrolyte disorders
Nursing responsibilities for Colace
*If 4th degree lac or episiotomy, nothing in rectum
Assess cramping, rectal bleeding, diarrhea - if present, discontinue
Ensure adequate fluid and fiber intake
Give with 8 oz liquid, give on empty stomach
Monitor I&O
Identify cause of constipation
Patient teaching for Colace
Adequate fluid intake
Fiber and exercise necessary for adequate bowel function
May take up to 3 days for stool to soften
Proper peri care to prevent infection
Generic name for Dulcolax
Biscodyl
Route for Dulcolax
PO
PR (suppository/enema use)
Classification of Dulcolax
Stimulant laxative
Use of Dulcolax
Short term treatment of constipation
Acts directly on intestine by increasing motor activity
Side effects of Dulcolax
N/V
Abdominal cramps
Diarrhea
Rectal burning
Weakness
Nursing responsibilities for Dulcolax
*If 4th degree laceration or episiotomy, nothing in rectum
Monitor I&O
Assess GI symptoms: cramping, rectal bleeding, N/V - if these occur, discontinue
Encourage fluids/fiber
Lubricate suppository prior to insertion
Have patient retain for 30 min
Patient teaching for Dulcolax
Adequate fluid intake, fiber and exercise
Take with full glass of water
Take 2 hrs after consuming dairy, take 1 hr after eating other foods
Swallow tablets whole
DO NOT take long term. This will result in loss of bowel tone. Use no longer than 1 week
Classification of tylenol
Non-opioid analgesic
Use of tylenol
Mild to moderate pain or fever
Does not possess anti-inflammatory properties
Side effects of tylenol
Nausea
Rash
HA
Hepatotoxicity
Allergic reaction
nursing responsibilities for tylenol
Assess pain before and after administration
Monitor liver function studies
Monitor renal and blood studies
Patient teaching for tylenol
Inform max dose is 4000mg/day and may be contained in other meds
May mask fever, so watch for S/S of infection
Recognize the signs of chronic OD: bleeding, bruising, malaise, fever, sore throat
Toxicity may occur when using acetaminophen with other combination drugs
