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OB > Sim Lab Medications > Flashcards

Sim Lab Medications Flashcards

1
Q

Uses of pitocin

A

Induction/augmentation of labor
PPH

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2
Q

Route for pitocin used for labor induction/augmentation

A

IV titration

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3
Q

Route used for pitocin for PPH

A

IV bolus
IM injection

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4
Q

Action of pitocin

A

Stimulates uterine smooth muscle, resulting in increased strength, duration, and frequency of contractions
Vasoactive and anti diuretic properties

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5
Q

Side effects of pitocin for mother

A

*Water intoxication
Tachysystole
Impaired uterine blood flow
Fetal asphyxia
Uterine rupture

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6
Q

Side effects of pitocin for fetus

A

Bradycardia
Tachycardia
Reduced variability
Late or prolonged decels

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7
Q

Nursing responsibilities for pitocin given for induction/augmentation

A

Assess contractions and VS every 15 min
Assess FHR before induction and every 15 min during
Monitor for water intoxication
Monitor I&Os

Stop infusion if:
- contractions <2 min apart and >50-65 sec or if they last longer than 60-90 seconds
- fetal distress

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8
Q

Symptoms of water intoxication

A

Drowsiness
Listlessness
Confusion
HA
Anura

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9
Q

Nursing responsibilities for pitocin given PP

A

Monitor uterine height, tone, deviation
Monitor lochia flow
Monitor VS

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10
Q

Patient teaching for pitocin given for induction/augmentation

A

Expect cramping similar to menstrual cramps that gradually increase in intensity and become strong
Report increased abdominal pain, blood loss, or fever

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11
Q

Patient teaching for pitocin given PP

A

Report boggy uterus or increase in lochia flow
Teach pt to massage their fundus

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12
Q

Preferred route for methergine

A

IM for rapid absorption

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13
Q

Use of methergine

A

Treat/prevent PPH (or post abortion hemorrhage) caused by uterine agony or subinvolution

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14
Q

Action of methergine

A

Stimulates sustained contraction of the uterus and causes arterial vasoconstriction

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15
Q

Side effects of methergine

A

*Hypertension
N/V
Uterine cramping
Dyspnea
Dysrhythmias

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16
Q

Nursing responsibilities for methergine

A

Use caution in pts with HTN and cardiac disease
Nicotine causes vasoconstriction and cannot be used with methergine
Monitor BP/VS (*check BP prior to each dose)
Monitor vaginal bleeding, uterine tone, height of fundus

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17
Q

Patient teaching for methergine

A

*Avoid smoking because nicotine constricts vessels
Abdominal cramps are a side effect
Notify prescriber if you have chest pain, N/V, HA, muscle pain, weakness, cold, numb extremities
Teach pt to massage fundus

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18
Q

Route for Hemabate

A

IM

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19
Q

Use of Hemabate

A

to treat PPH

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20
Q

Action of Hemabate

A

Stimulate contraction of the uterus

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21
Q

Maximum dose of methergine

A

Can be given every 2-4 hours for a maximum of 5 doses

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22
Q

Maximum dose of Hemabate

A

May repeat at 15 to 90 min intervals
Maximum total of 2 mg

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23
Q

Side effects of Hemabate

A

*Diarrhea
Titanic contractions and laceration of uterus or uterine rupture
Hypertension/hypotension
Nausea

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24
Q

Nursing responsibilities for Hemabate

A

*Administer anti diarrheal as ordered
*Monitor fundus and lochia
Should be refrigerated
Give via Deep IM injection
Rotate sites if repeated
Monitor vitals
Administer antiemetics as ordered

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25
Q

Patient teaching for Hemabate

A

Almost always causes diarrhea so we will admin antidiarrheal to avoid
Expect abdominal cramps similar to menstrual cramps
Change position slowly
Report any increase in vaginal bleeding

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26
Q

Routes for cytotec

A

PO
PR
PV
(Rectal preferred for PPH)

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27
Q

Uses for cytotec

A

Cervical ripening
Treatment of PPH

28
Q

Action of cytotec

A

Induces uterine contractions
Ripens cervix, making it softer and causes it to begin to dilate and efface

29
Q

Side effects of cytotec

A

Uterine cramping
Tachysystole
Uterine rupture
Diarrhea
Nausea/vomiting
Dyspepsia

30
Q

Nursing responsibilities for cytotec

A

*NOT used in women with previous uterine scar
*DO NOT start pitocin for at least 4 hours after vaginal cytotec dose (for induction)
Monitor FHR, contraction pattern, cervical dilation/effacement

31
Q

Patient teaching for cytotec

A

Lie flat for 30 min after insertion of medication (void prior to insertion)
Report contractions lasting > 1 min
Report any worsening or increase in vaginal bleeding

32
Q

Route for terbutaline

A

SQ

33
Q

When should terbutaline not be given?

A

If pulse is > 120
If systolic BP < 80-90
If FHR >180
Don’t use beyond 48-72 hours

34
Q

Use of terbutaline

A

To stop preterm labor contractions

35
Q

Action of terbutaline

A

Relaxes uterine smooth muscle by acting on beta2 receptors with less effect on the heart

36
Q

Side effects of terbutaline

A

*Maternal and fetal tachycardia
Dyspnea
Palpitations
Chest pain/discomfort
Restlessness
Tremors
Flushing
Hypokalemia

37
Q

Nursing responsibilities for terbutaline
What is the antidote?
Which pts should you use caution with?

A

Monitor VS/HR
Ensure inderal is available to reverse adverse effects
Caution in women with history of cardiac disease, gestational diabetes, severe gestational HTN, eclampsia
Monitor fetus, contraction pattern, dilation/effacement

38
Q

Patient teaching for terbutaline

A

Inform her that she will hear baby’s HR increase on monitor and that this is expected
Limit caffeine
Drug is only administered in the hospital
Report if symptoms continue once you go home

39
Q

What is the max dose of magnesium sulfate?

A

24 grams in 24 hours

40
Q

Route for mag sulfate

A

IV
IM (rarely)

41
Q

Use of mag sulfate

A

Prevent seizures
Treatment of preterm labor

42
Q

Action of mag sulfate

A

Increases osmotic pressure, draws fluid into colon, neutralizes HCL
Plays important role in neurotransmission and muscular excitability

43
Q

Side effects of magnesium sulfate on patient

A

Depression of DTR
CNS depression
Flushing/sweating
Hypotension
Respiratory depression

44
Q

Side effects of magnesium sulfate on fetus

A

Reduced FHR variability
Hypotonia

45
Q

Nursing responsibilities for mag sulfate

A

*Antidote = calcium gluconate (keep in room)
Monitor BP closely
Assess VS (RR should be > 12)
Monitor I&O (UOP should be > 30 mL/hr)
Monitor DTRs
Assess edema in LE
If preeclampsia - seizure precautions
Assess magnesium toxicity
Monitor Mg and Ca levels (therapeutic mag level: 4.8-8.4)

46
Q

Symptoms of magnesium toxicity

A

Thirst
Confusion
Decreased DTR
Visual changes: blurring, halos

47
Q

Patient teaching for magnesium sulfate

A

Med is given to delay preterm labor and prevent seizures associated with eclampsia
Need for frequent monitoring
Report SE (family or pt)
Side rails up
OOB with assistance

48
Q

Route for Lebatalol

A

IV
PO
IM

49
Q

Use of Lebatalol

A

Treat HTN during pregnancy
hypertensive emergencies
Reduces BP associated with preeclampsia/eclampsia and preserves uteroplacental blood flow

50
Q

Action of Lebatalol

A

Produces decrease in BP without reflex tachycardia or significant reduction in HR through mixture of A and B blocking effects

51
Q

Side effects of Lebatalol

A

Orthostatic hypotension
Flushing
Tremulousness
Minimal change in pulse rate

52
Q

Nursing responsibilities for Lebatalol
Who is it contraindicated for?

A

Monitor VS
Maintain BR in left lateral position with SR up
Continuous fetal monitoring
Contraindicated in patients with asthma, heart disease, or CHF

53
Q

Patient teaching for Lebatalol

A

Change positions slowly to prevent orthostatic hypotension
Explain need for BR and increased monitoring in labor
Explain why receiving medication and potential SE
If intrapartum, monitor BP, eat well, keep appointments

54
Q

Route for vitamin k

A

IM in Vastus lateralis

55
Q

Use for vitamin K

A

*Prevent hemorrhagic disease of the newborn

56
Q

action of vitamin k

A

Provides vitamin k which is not synthesized in the intestine until flor is present for vitamin k production

57
Q

Side effects of vitamin k

A

Pain
Edema or erythema at injection site
Hyperbilirubinemia
Hemolytic anemia
Bronchospasm
Respiratory arrest

58
Q

Nursing responsibilities for vitamin k

A

*Give within 2 hours of birth
*Give prior to circumcision
Protect drug from light until ready to give
Observe for signs of bleeding (bruising or bleeding from site, blood in urine/stools)

59
Q

Patient teaching for vitamin k

A

Report symptoms of bleeding or bruising, blood in urine, or black tarry stools
Periodic lab tests to monitor coagulation

60
Q

Dose for erythromycin eye ointment

A

1 cm ribbon into each conjunctival sac

61
Q

Use for erythromycin eye ointment

A

*Prophylaxis for gonorrhea in eyes

62
Q

Action of erythromycin eye ointment

A

Inhibits protein synthesis in bacteria (bacteriostatic)

63
Q

Side effects of erythromycin eye ointment

A

Temporary blurred vision
Chemical conjunctivitis
Burning
Itching
Redness

64
Q

Nursing responsibilities for erythromycin eye ointment

A

*Apply - inner to outer canthus, may wipe away after 1 minute
*Give within 1-2 hours after birth
Observe for irritation

65
Q

Patient teaching for erythromycin eye ointment

A

Med does not need to be rinsed from infant’s eyes
Infant’s vision will be blurred while medication is in place
Not treating the infant could lead to blindness from infection

OB (11 decks)

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