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pharm 2 > Reproductive > Flashcards

Reproductive Flashcards

1
Q

Human Chorionic Gonadotropin (hCG) Class/Use

A

Ovulation stimulant
Promotion of ovulation
* Treatment of infertility in conjunction with drug therapy for follicular maturation

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2
Q

Human Chorionic Gonadotropin (hCG) Adverse Drug Reactions

A

Ovarian hyperstimulation
* Ovarian cyst rupture
* CNS effects: irritability, headache, fatigue, restlessness

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3
Q

Human Chorionic Gonadotropin (hCG) Interventions

A

Monitor for indications of ovarian hyperstimulation this syndrome warrants hospitalization and immediate discontinuation of drug therapy.
* Monitor for indications of bleeding into the peritoneum.
* Monitor for CNS effects.

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4
Q

Human Chorionic Gonadotropin (hCG) Administration

A

Confirm follicular maturation with clomiphene (Clomid), menotropins, or follitropins before administration.
* Give via IM injection after reconstituting powder with the supplied dilu- ent.

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5
Q

Human Chorionic Gonadotropin (hCG) Teaching

A

Seek medical care immediately for pelvic or low abdominal pain or pressure, unusual weight gain, or swelling.
* Report pelvic or abdominal pain.
* Take over-the-counter analgesics as needed for headache.

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6
Q

Human Chorionic Gonadotropin (hCG) Contraindications

A

Pituitary tumor
* Dysfunctional uterine bleeding

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7
Q

Human Chorionic Gonadotropin (hCG) Interactions

A

antidepressants - impairs fertility

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8
Q

Oxytocin Class/Use

A

Oxytocin
Uterine stimulation
* Induction or enhancement of labor near or post term
* Treatment of postpartum hemorrhage

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9
Q

Oxytocin Adverse Affects

A

Uterine hyperstimulation
* Hypertensive crisis

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10
Q

Oxytocin Interventions

A

Monitor risk factors such as multiple deliveries.
* Monitor length, strength, and duration of contractions.
* For indications of hyperstimulation, turn clients on their side, stop the infusion, and administer oxygen.
* Be prepared to administer a uterine relaxant.
* Monitor for headache, nausea, vomiting, and increasing blood pressure.
* Monitor intake and output and level of consciousness.

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11
Q

Oxytocin Administration

A

Administer IV via infusion pump.
* Gradually increase the flow rate by 1 to 2 milliunits/min every 30 to 60 min until contractions last 1 min or less every 2 to 3 min.
* Monitor blood pressure and pulse rate.
* Monitor for uterine hyperstimulation (contractions lasting longer than 60 seconds, occurring more frequently than every 2 to 3 min, Stop the infusion and report hyperstimulation immediately.
* Monitor fetal heart rate and rhythm, and report signs of fetal distress.
* Stop the infusion for serious alterations in fetal heart rate or rhythm.

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12
Q

Oxytocin Teaching

A

Report increasing duration or strength of contractions.
* Report headache, palpitations, nausea, or chest pain.
* Report drowsiness or headache

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13
Q

Oxytocin Contraindications

A

Unripe cervix
* Placental abnormalities
* Active genital herpes
* Uterine surgery
* Fetal distress
* Lung immaturity
* Cephalopelvic disproportion
* Malpresentation
* Prolapsed umbilical cord

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14
Q

Oxytocin Interactions

A

vasopressors

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15
Q

Oxytocin Precautions

A

HTN/preeclamsia
multiple fetus
seizures

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16
Q

Magnesium Sulfate Class/Use

A

Anticonvulsant
Prevent and treat seizure activity in client with severe preeclampsia or eclampsia

17
Q

Magnesium Sulfate Adverse Drug Reactions

A

Flushing, diaphoresis
* Drowsiness, muscle weakness
* Maternal hypotension, bradycardia, bradypnea
* Depressed/absent deep tendon reflexes (DTRs)
* Altered level of consciousness
* Decreased urine output
* Magnesium toxicity
* Reduced variability of fetal heart rate

18
Q

Magnesium Sulfate Interventions

A

Monitor blood pressure, pulse, and respiratory rate every 15 to 30 min.
* Report respiratory rate of 12/min or less.
* Monitor DTRs every 1 to 4 hr.
* Discontinue infusion and notify provider of diminished or absent reflex.
* Monitor level of consciousness before initiation of medication and throughout therapy.
* Monitor strict input and output, with urinary output hourly.
* Report urine output of less than 25 to 30 mL/hr.
* Output less than 25 mL/hr can warrant discontinuation of treatment.
* Monitor serum magnesium levels (target range 4 to 7 mEq/L).
* Ensure antidote for toxicity, calcium gluconate or calcium chloride, is readily available.
* Monitor breath sounds.
* Report presence of crackles.
* Discontinue infusion and notify provider of findings.
* Monitor fetal heart rate for decreased variability

19
Q

Magnesium Sulfate Administration

A

Loading dose of 4 to 6 g magnesium sulfate intermittent IV bolus as a secondary infusion over 15 to 30 min. Use a volumetric pump to ensure accuracy of dose.
* Administer maintenance dose by continuous infusion at 2 g/hr.
* Monitor blood levels to maintain therapeutic level at 4 to 7 mEq/L.

20
Q

Magnesium Sulfate Teaching

A

Provide comfort measures.
* Instruct the client to change positions slowly from supine to upright and to sit until dizziness resolves.
* Assist the client as needed to promote safety.
* Explain the purpose of strict measurement of oral intake and urinary output.

21
Q

Magnesium Sulfate Contraindications

A

Anuria
* Hypermagnesemia
* Heart block
* Hypocalcemia

22
Q

Magnesium Sulfate interactions

A

Ca channel blockers – increases antihypertensive effects

23
Q

Betamethasone Class/Use

A

Glucocorticoid
To increase the production of lung surfactant and to accelerate lung maturity in fetuses between 24 and 34 weeks’ gestation

24
Q

Betamethasone Adverse Drug Reaction

A

Pulmonary edema if given with beta blockers
hyperglycemia if gestational DM
hypertension

25
Q

Betamethasone Interventions

A

Monitor lung sounds and other indications.
* Report crackles in the lungs, productive cough, dyspnea, cyanosis, and other clinical manifestations of pulmonary edema to the provider.
* Monitor and treat episodes of hyperglycemia.
* Monitor blood pressure.

26
Q

Betamethasone Admin

A

IM

27
Q

Betamethasone Teaching

A

Instruct client to report shortness of breath, cough, and increased pro- duction of sputum.
* Tell the client to report polyphagia, polydipsia, or polyuria.
* Instruct client to report headache and dizziness.

28
Q

Betamethasone Contraindications

A

Hypersensitivity to betamethasone
* Systemic fungal infections

29
Q

Betamethasone Interactions

A

Glucocorticoids can decrease antibody responses to vaccines and can increase the risk of infection from live vaccines.
* Immunizations should be avoided while glucocorticoids are in use

30
Q

Oral Contraceptives

A

prevent pregnancy

31
Q

Oral Contraceptives Adverse Reactions

A

Thromboembolism
* Uterine bleeding
* Increased growth of breast malignancies

32
Q

Oral Contraceptives Interventions

A

Monitor for and report any indications of deep vein thrombosis, pulmonary embolism, myocardial infarction, and cerebrovascular accident.
* Encourage clients who smoke to quit.
* Monitor blood pressure.
* Monitor the pattern and amount of any reported bleeding.
* Recommend mammograms and breast examinations at appropriate intervals.
* Discontinue the drug for any indications of breast cancer.

33
Q

Oral Contraceptives Admin

A

Confirm negative pregnancy status before starting therapy.
* Use an additional method of contraception during the first cycle.
* Take pills at the same time each day.
* Take according to the precise dosing schedule, typically 21 days of a drug-containing pill and 7 days of an inactive pill.

34
Q

Oral Contraceptives Teaching

A

Report leg or chest pain, leg edema, sudden change in vision, severe headache, or shortness of breath.
* Do not smoke.
* Stop taking at least 4 weeks before any surgery that increases the risk of thromboembolic events.
* Report palpitations, paresthesia, weakness, or abdominal cramps.
* Obtain regular blood pressure checks.
* Report any unusual breakthrough bleeding or spotting or changes in menstrual patterns.
* Perform breast self-examination every month.

35
Q

Oral Contraceptives Contraindications

A

Pregnancy-has teratogenic effects
* History or other risk for thromboembolic events
* Suspected or confirmed breast cancer
* Smokers older than 35 years

36
Q

Oral Contraceptives Precautions

A

Hypertension
* Diabetes mellitus
* Heart disease
* Migraines

37
Q

Oral Contraceptives Interactions

A

Rifampin (Rifadin), ritonavir (Norvir), phenobarbital (Luminal), carba- mazepine (Tegretol), primidone (Mysoline), phenytoin (Dilantin), and St. John’s wort can reduce the effectiveness of oral contraceptives.
* Oral contraceptives can reduce the effects of warfarin (Coumadin) and hypoglycemic drugs.
* Oral contraceptives can increase levels of theophylline (Theo-24), diaze- pam (Valium), chlordiazepoxide (Librium), and tricyclic antidepressants.

38
Q

Clomid

A

pharm 2 (5 decks)

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