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PHARMACOLOGY > Pregnancy & Preterm Labor > Flashcards

Pregnancy & Preterm Labor Flashcards

1
Q

It determines how well the kidneys are working

A

GLOMERULAR FILTRATION RATE

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2
Q

Organ of exchange for numerous substances

A

PLACENTA

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3
Q

Liver metabolism of drugs is much slower in the fetus because of ________

A

Liver immaturity

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4
Q

Substances that cause developmental abnormalities

A

TERATOGENS

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5
Q

Drug used to prevent iron deficiency anemia

A

IRON

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6
Q

Required dose of iron during pregnancy

A

27 mg/day

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7
Q

It increases iron absorption

A

VITAMIN C

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8
Q

It is taken to avoid birth defects (NTDs), complications, spontaneous abortion, and spina bifida

A

FOLIC ACID (B9)

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9
Q

Amount of folic acid required during pregnancy

A

600 mcg/day

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10
Q

Deficiency of folic acid can lead to:

A

SPONTANEOUS ABORTION
BIRTH DEFECTS
NEURAL TUBE DEFECTS

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11
Q

Failure of embryonic neural tube to close properly

A

NEURAL TUBE DEFECTS

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12
Q

What multiple vitamins are needed during pregnancy?

A

VIT. A
VIT. B-complex
VIT. B12
VIT C
CALCIUM
VIT. D
VIT. E
IRON

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13
Q

3 Therapeutic drugs needed during pregnancy

A

IRON
FOLIC ACID
MULTIVITAMINS

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14
Q

Also called as “morning sickness”

A

NAUSEA & VOMITING

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15
Q

—severe nausea and
vomiting that may require hospitalization for hydration and
nutrition

A

HYPEREMESIS GRAVIDARUM

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16
Q

Drugs for nausea & vomiting

A

DOXYLAMINE SUCCINATE
PYRIDOXINE HYRODCHLORIDE

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17
Q

a burning sensation in the epigastric and sternal regions that occurs with reflux of acidic stomach contents,

A

HEARTBURN (PYROSIS)

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18
Q

PYROSIS

A

HEARTBURN

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19
Q

An increase in this hormone causes decreased motility of GI tract and relaxation of lower esophageal sphincter, causing pyrosis & constipation

A

PROGESTERONE

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20
Q

Drug for heartburn (pyrosis)

A

SUCRALFATE

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21
Q

It should be considered first-line therapy if the patient
does not respond to nonpharmacologic therapy

A

ANTACIDS

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22
Q

A combination of various compounds with various salts of calcium, magnesium, and aluminum as active ingredients that act by neutralizing the acid in the stomach by inhibiting pepsin (a proteolytic enzyme)

A

ANTACIDS

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23
Q

Caused by decreased GI motility

A

CONSTIPATION

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24
Q

Drugs for constipation

A

METAMUCIL
DOCUSATE SODIUM

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25
Q

DOXYLAMINE SUCCINATE
PYRIDOXINE HYRODCHLORIDE

A

Nausea & Vomiting

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26
Q

Antacids

A

HEARTBURN & INDIGESTION

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27
Q

SUCRALFATE

A

HEARTBURN (PYROSIS)

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28
Q

METAMUCIL
DOCUSATE SODIUM

A

CONSTIPATION

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29
Q

Oil that stimulates uterine contractions

A

CASTOR OIL

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30
Q

oil that reduces absorption of fat-soluble vitamins

A

MINERAL OIL

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31
Q

Castor Oil
Mineral Oil

A
  1. Stimulate uterine contractions
  2. Reduce absorption of fat-soluble vitamins
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32
Q

Vitamin K deficiency will lead to

A

HEMORRHAGE; NEONATAL HEMORRHAGE

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33
Q

Drugs for pain

A

ACETAMINOPHEN

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34
Q

It is the most commonly non-Rx ingested drug for pain / headaches during pregnancy

A

ACETAMINOPHEN

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35
Q

Acetaminophen

A

PAIN

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36
Q

can inhibit the initiation of labor and may prolong labor through its effects on uterine contractility; therefore its use is not recommended during pregnancy.

A

ASPIRIN

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37
Q

Classified as Category C drug which changes to category D if used in 3rd trimester. If taken late in pregnancy, it can cause premature closure of ductus arteriousus

A

IBUPROFEN

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38
Q

Antidepressant Drugs

A
  1. SELECTED SEROTONIN REUPTAKE INHIBITORS (SSRIs)
  2. TRICYCLICS
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39
Q

Adverse outcomes have included low birth weight (LBW), infants born small for gestational age (SGA), preterm delivery, and increased neonatal
irritability and decreased attentiveness

A

ANTIDEPRESSANT DRUGS

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40
Q

Responsible for contractions

A

CALCIUM

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41
Q

Antidote for magnesium sulfate overdose

A

CALCIUM GLUCONATE

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42
Q

CALCIUM GLUCONATE

A

Antidote for magnesium sulfate overdose

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43
Q

CALCIUM

A

Responsible for contractions

44
Q

Decreases intensity and frequency of uterine contractions and relaxes muscles

A

TERBUTALINE

45
Q

TERBUTALINE

A

Decreases intensity and frequency of uterine contractions and relaxes muscles

46
Q

Main treatment for eclampsia

A

MAGNESIUM SULFATE

47
Q

MAGNESIUM SULFATE

A

for eclampsia

48
Q

It speeds up fetal lung maturity

A

CORTICOSTEROIDS

49
Q

COTRICOSTEROIDS

A

speeds up lung maturity

50
Q

Defined as cervical changes and uterine contractions that occur between 20 and 37 weeks of pregnancy

A

PRETERM LABOR

51
Q

any birth that occurs before the completion of 37 weeks of pregnancy, regardless of birth weight

A

PRETERM BIRTH

52
Q

It includes monitoring the heart rate & fetal lung maturity

A

FETAL SURVEILLANCE

53
Q

drug therapy to decrease uterine muscle contractions.

A

TOCOLYTIC THERAPY/DRUGS

54
Q

It stops preterm labor, only if dilation is 3 cm below

A

TOCOLYTIC DRUGS

55
Q

TOCOLYTIC DRUGS

A

It stops preterm labor, only if dilation is 3 cm below

56
Q

Examples of Tocolytic Drugs

A
  1. Beta2-adrenergic receptor agonists (Terbutaline)
  2. Calcium antagonists
  3. Magnesium sulfate
  4. Calcium channel blockers
  5. Nifedipine
  6. Indomethacin prostaglandin inhibitors
57
Q

Goals of Tocolytic drugs

A
  1. Interrupt/inhibit uterine contractions to allow more time for fetal maturation in uterus
  2. To delay delivery so antenatal corticosteroids can be delivered to facilitate lung maturation
  3. To allow safe transport of px to appropriate facility if needed
58
Q

act by stimulating β2-receptors on
uterine smooth muscle

A

BETA-SYMPATHOMIMETIC DRUGS

59
Q

Example of beta-sympathomimetic drug

A

TERBUTALINE

60
Q

A calcium antagonist and central
nervous system (CNS) depressant, relaxes the smooth muscle of the uterus through calcium displacement and can be given as an “off label” use for PTL

A

MAGNESIUM SULFATE

61
Q

Contraindications of using tocolytic drugs:

A
  1. If woman is hemorrhaging- bleeding will increase
  2. Fetal distress is noted
62
Q

Examples of corticosteroids therapy in Preterm Labor

A

BETAMETHASONE
DEXAMETHASONE

63
Q

Most common serious complication of pregnancy

A

GESTATIONAL HYPERTENSION

64
Q

Gestational hypertension with proteinuria

A

PREECLAMPSIA

65
Q

A severe sequela of preeclampsia

A

HELLP syndrome:

HEMOLYSIS
ELEVATED Liver enzymes
Low Platelet count

66
Q

New-onset of grand mal seizures in px with preeclampsia

A

ECLAMPSIA

67
Q

Symptoms of Preeclampsia

A

-Hypertension
-Proteinuria
-Abdominal pain
-Pitting edema
-Blurred vision

68
Q

Symptoms of Eclampsia

A

Preeclampsia + muscle twitching, seizures, coma

69
Q

The only cure (treatment) for preeclampsia

A

Delivery of infant and placenta

70
Q

Maternal seizzure

A

ECLAMPSIA

71
Q

Treatment for Eclampsia

A

Delivery is postponed for 1-3 hrs if fetal status allows

72
Q

Drug treatment of Preeclampsia

A

METHYL-HYDRA-LAB-PRAZO-NI-CLO

METHYLDOPA
HYDRALAZINE
LABETALOL
PRAZOSIN
NIFEDIPINE
CLONIDINE

73
Q

passage of blood and blood products through the circulatory system to organs or tissues to deliver oxygen
and nutrients to cells, such as to the uterus and fetus.

A

PERFUSION

74
Q
  1. A client in her first trimester of pregnancy calls the nurse to ask for suggestions on decreasing
    nausea in the morning when she awakens. Which nonpharmacologic measures would the nurse be
    aware of to decrease nausea and vomiting? (Select all that apply.)

a. Eating dry toast before rising
b. Eating small frequent meals
c. Eating a high-protein bedtime snack
d. Eating high-fat foods

A

a. Eating dry toast before rising

74
Q
  1. When nonpharmacological treatment fails for
    constipation, which drug would be a first-line
    treatment for constipation during pregnancy?

a. Docusate sodium
b. Magnesium citrate
c. Castor oil
d. Mineral oil

A

a. Docusate sodium

75
Q
  1. The nurse is teaching a pregnant client how to decrease the gastrointestinal distress she
    experiences with prenatal vitamins. Which instruction would the nurse provide?

a. Take her vitamins between meals
b. Eat when she takes her vitamins
c. Drink orange juice when she takes her vitamins
d. Drink milk when she takes her vitamins

A

b. Eat when she takes her vitamins

76
Q
  1. The nurse, working with a preconceptional couple at an infertility clinic, advises the woman
    to take which supplement for at least 3 months before becoming pregnant?

a. Iron
b. Ginger
c. Folic acid
d. Vitamin B6

A

c. Folic acid

77
Q
  1. A patient with severe preeclampsia is on magnesium sulfate. Which initial action by the nurse would be most appropriate for a magnesium sulfate level of 7 mEq/L?

a. Continue to monitor the patient because this level is therapeutic.
b. Contact the health care provider and report the level.
c. Prepare to administer 1 g of calcium gluconate.
d. Turn the patient on her left side and administer 10 liters of oxygen by nasal cannula.

A

a. Continue to monitor the patient because this level is therapeutic.

78
Q

Therapeutic level of Magnesium Sulfate

A

4-7 mg/dl

79
Q
  1. Which assessment finding is most concerning when examining a client in preterm labor who is receiving magnesium sulfate?

a. Feelings of lethargy
b. Feelings of warmth
c. Loss of patellar reflexes
d. Positive clonus +2 bilaterally

A

c. Loss of patellar reflexes

80
Q

Continuous infusion of Magnesium Sulfate should not exceed ____ or maximum ____g/24 hrs

A

5-7 days or 40 g

81
Q
  1. The client has been receiving magnesium sulfate
    intravenously for 24 hours to treat severe preeclampsia. On assessment, the nurse finds a temperature of 37.3°C (99°F), pulse of 88, respirations at 14, blood pressure of 138/76, 2+
    patellar reflexes, and negative ankle clonus.

Which intervention would be most appropriate for the nurse to take?

a. Obtain a stat magnesium sulfate level.
b. Discontinue magnesium sulfate.
c. Contact the health care provider.
d. Continue to monitor the patient.

A

d. Continue to monitor the patient.

82
Q
  1. The nurse working in labor and delivery is reviewing messages to be returned to clients. Which statement made by the client alerts the
    nurse to call that client first?

a. “I’m 32 weeks pregnant and taking calcium carbonate for my heartburn. Is there anything else I can take?”

b. “I’m 38 weeks pregnant and taking ibuprofen for my backache. Should I take aspirin too?”

c. “I’m 8 weeks pregnant and taking folic acid. Will it hurt me or the baby if I stop?”

d. “I checked my blood glucose with a friend’s machine and it was 120 mg. I’m not diabetic. Is that normal?”

A

b. “I’m 38 weeks pregnant and taking ibuprofen for my backache. Should I take aspirin too?”

83
Q
  1. A client is planning to become pregnant. Which actions should the nurse counsel the client to initiate before she stops taking her oral
    contraceptive? (Select all that apply.)

a. Stop smoking immediately.
b. Take omega-6 fatty acids every day.
c. Take a multivitamin every day.
d. Stop taking over-the-counter acetaminophen.
e. See her health care provider.

A

a. Stop smoking immediately.
c. Take a multivitamin every day.
e. See her health care provider.

84
Q

Uterine contractions produce progressive cervical effacement & dilation

A

1ST STAGE OF LABOR

85
Q

Nonpharmacologic measures for Pain

A
  • ambulation
  • touch & massage
  • aromatherapy
  • heat & cold applications
86
Q

Systemic drugs used during labor

A
  1. Sedative-hypnotics
  2. Narcotic agonists-antagonist
87
Q

It promotes relaxation but not pain relief. Administered to minimize maternal anxiety & fear.

A

SEDATIVES

88
Q

Examples of Sedatives

A
  1. Secobarbital (PO)
  2. Pentobarbital (IV)
  3. Hydroxyzine (IM)
89
Q

Interfere with pain impulses at subcortical level of the brain

A

NARCOTIC AGONIST

90
Q

Example of Narcotic Agonist

A
  1. Meperidine (most common)
  2. Fentanyl
  3. Morphine Sulfate
90
Q

Represents loss of painful sensation w/ or w/o loss of consciousness

A

ANESTHESIA

91
Q

2 Types of Pain in Childbirth

A
  1. VISCERAL
  2. SOMATIC
92
Q

Pain due to pressure of the presenting part & by stretching of perineum & vagina

A

SOMATIC PAIN

93
Q

Pain relief without loss of consciousness

A

REGIONAL ANESTHESIA

94
Q

Types of regional anesthesia

A

-Pudendal block
-Epidural
-Combined epidural
-Spinal block

95
Q

Anesthetic injected to epidural space

A

EPIDURAL BLOCKS

96
Q

Anesthesia for cesarean birth

A

SUBARACHNOID BLOCK

97
Q

Allows woman to sense contractions w/o feeling pain

A

EPIDURAL & INTRATHECAL OPIOIDS

98
Q

Anesthesia that relives pain thru loss of consciousness. Rarely given for vaginal birth

A

GENERAL ANESTHESIA

99
Q

Drugs that enhance uterine muscle contractility

A
  1. UTEROTROPIC DRUGS
  2. OXYTOCIN
  3. ERGOT ALKALOIDS
  4. (SOME) PROSTAGLANDINS
100
Q

Drugs that stimulates smooth muscles of uterus

A

UTEROTROPIC DRUGS

101
Q

It stimulates smooth muscle contraction in px already in labor

A

IV OXYTOCIN

102
Q

Large group of alkaloids derived from fungi and are NOT used during labor because they can cause sustained uterine contractions

A

ERGOT ALKALOIDS

103
Q

Ergot toxicity

A

ERGOTISM

104
Q

the period from delivery until 6 weeks

A

PUERPERIUM

PHARMACOLOGY (11 decks)

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